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In Pictures: Sierra Leone’s war against Ebola

Medical facilities are fiercely battling the world’s largest outbreak of the deadly disease.

Treating Ebola patients is not an easy task. All work inside the isolation area must be carried out in full protective clothing.
By Tommy Trenchard
Published On 26 Jul 2014

In Sierra Leone’s Kailahun province, the world’s largest Ebola outbreak continues to spread through remote villages. One of the few lines of defence comes from a treatment centre run by the charity Medicins sans Frontieres (MSF).

While there is no specific cure for the disease, treatment of its symptoms can significantly reduce its fatality rate. With an overstreched team and a series of logisitical obstacles inherent in treating a contagious virus in a remote location, the centre is doing what it can.

“It’s promising to see that the limited amount of things we can do is having such a major effect,” says MSF’s Dr Tim Jagatic. “We’re bringing down the mortality rate significantly”. About four out of 10 patients at the center will survive, he says. A huge improvement from the 10 percent survivial rate in previous outbreaks.

But one crucial problem remains – the chronic fear of hospitals, fuelled by rumours of limb harvesting and blood theft, is dissuading people from seeking medical help.

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Not only does this increase the risk of death, but by keeping infected people in the community, and burying the bodies without professional medical assistance, it also exacerbates the spread of the disease.

Teams of Red Cross volunteers are doing their best to teach people to recognise and respect the danger posed by Ebola. But in a district with nearly half a million people, there are still many villages yet to be reached. Others hear the message but are reluctant to accept it.

Winning the trust of the community is key to ending the current outbreak. But it takes time and resources that the on-the-ground doesn’t possess. “We are running behind Ebola,” according to Anja Wolz, head of MSF’s activities in Kailahun. “I’ve never seen this before.”

Staff at the MSF-run Case Management Centre in Kailahun are fighting the world(***)s largest Ebola outbreak.
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A team prepares to enter the isolation unit. 
Alhaji Sheku has been in the isolation ward for two weeks. He passes his time drawing pictures of his home. He looks stronger by the day, and doctors suspect he will survive.
A young child who survived the disease is passed over to her aunt at the treatment centre. Her mother remains inside.
A lab technician takes a break. Field doctors are the first, and most important line of defence in stopping the spread of the virus. 
While much of the protective gear gets destroyed after one use, Wellington boots are disinfected and reused.
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The town of Kailahun has been hit hard with the disease.
The scale and scope of the problem has impacted the ability of health awareness teams and those tracing Ebola suspects to carry out their work. Kailahun district alone has nearly half a million people, but the district only has four ambulances.
Despite the work of health awareness teams, many still harbour doubts about seeking treatment, fuelled by suspicion of health workers and rumours that they are giving patients Ebola. These Red Cross communication materials aim to teach people how Ebola can be transferred.
A team of Red Cross burial volunteers prepares to enter the house of an Ebola victim in the eastern town of Pendembu.
Despite sensitisation campaigns, many are still not aware that the disease can be easily contracted through contact with the bodily fluids of an infected person.
Sierra Leone(***)s formidable rainy season makes it harder for health workers and ambulance teams to access remote villages. A lack of resources also holds them back.
Police stop motorists at a checkpoint near the eastern city of Kenema. Everyone coming from country(***)s eastern regions has to get screened by getting their temperatures taken.
A child has her temperature taken at a screening point along a main road in Kailahun province. The meausre has a limited success rate since Ebola is symptomless for up to 21 days during its incubation period.