Ebola threat is 'far from over' say health experts

Ebola one year on: What is the outlook?


Ebola one year on

It is exactly a year since the deadliest outbreak of Ebola was confirmed and health experts and charities have warned the danger is far from over.

More than 10,000 have died and at least 24,000 have been infected since the epidemic broke out in Guinea in December 2013.

The three-month delay in its official recognition has been blamed for its rapid spread to neighbouring Sierra Leone and Liberia, while other west African countries such as Nigeria and Mali also suffered fatalities.

The World Health Organisation (WHO) has been criticised for its slow response while governments and charities have admitted they could have done things differently.

Medecins Sans Frontieres/Doctors Without Borders (MSF), which had emergency teams on the ground in Guinea before Ebola was even officially declared, said despite raising the alarm that the epidemic was out of control, "it was like shouting into a desert".

The medical humanitarian organisation has released a report to mark the anniversary, which it dedicated to the 500 healthcare workers who have died while fighting Ebola, including 14 involved with the charity itself.

It said there was little sharing of information between the affected countries at first, while their governments tried to downplay the problem for fear of causing panic and driving visitors and investors away.

MSF general director Christopher Stokes said: "The Ebola outbreak has often been described as a perfect storm: a cross-border epidemic in countries with weak public health systems that had never seen Ebola before.

"Yet this is too convenient an explanation. For the Ebola outbreak to spiral this far out of control required many institutions to fail. And they did, with tragic and avoidable consequences."

Meanwhile Oxfam has said more efforts should have been put into engaging the community rather than focusing exclusively on medical treatment when the epidemic first broke out.

It said governments and aid agencies, including Oxfam, got the balance wrong and preventative measures should have been explored rather than purely technical solutions such as more beds, medical workers and medicines.

The charity pointed out that Ebola has upended the most intimate aspects of everyday life: how people treat their families, their neighbours, their sexual partners, their dead, and their own bodies.

To convince people to change their ways of dealing with these intimate issues, an understanding, compassionate approach was vital, Oxfam said.

Without community acceptance, aspects of the fight against Ebola such as treatment, safe burials and contact tracing are difficult to carry out and be effective.

Liberia Ebola One Year

It said negative perceptions and fear of response efforts contributed to non-compliance and resistance in some areas, while its research in Liberia found people's early experiences with the Ebola response created distrust of government agencies and a fear of outsiders, ambulances and medical facilities, which led to people opting to try to treat themselves.

Sue Turrell, head of Oxfam's Ebola response, said: "We are still a long way from getting to zero cases, but the direction of travel is positive and we cannot take the foot off the accelerator.

"This progress could not have happened without the remarkably brave medical effort, but what has happened in the hearts and homes of people at risk of Ebola has been equally crucial.

"Once people were fully involved, understood what they had to do to remain safe and were helped to do the things that they knew would work, the tide began to turn against Ebola.

Ebola epidemic

"If a greater emphasis in community engagement had happened much earlier it is more than likely that many fewer lives would have been lost."

Although the number of cases has decreased in recent months it will take 42 days without any new cases before a country can be declared Ebola-free.

Liberia announced it had discharged its last patient earlier this month but a woman has been diagnosed with the disease in the last few days, while Guinea has just reported its highest weekly case total so far this year.

Dr Jake Dunning, senior clinical researcher and consultant in infectious diseases at the University of Oxford, said: "The fact that the West African Ebola outbreak continues after so long illustrates just how serious an event this is.

"The overall decrease in case numbers is encouraging, especially in Liberia, but West Africa needs to reach zero cases and then stay at zero.

"The recent local spikes in case numbers in Guinea and Sierra Leone are worrying and show that much still needs to be done.

"Existing public health measures alone may not be enough and without additional efforts, including an effective vaccine, the road to zero could be longer and bumpier than expected."

Despite a number of scares, three Britons have tested positive for Ebola, with one currently receiving treatment in a specialist isolation unit at London's Royal Free Hospital (pictured above).

The female military healthcare worker was brought back to the UK from Sierra Leone after contracting the disease earlier this month, but no updates have been given about her condition.

Ebola epidemic

British nurses Pauline Cafferkey and Will Pooley (pictured above) both survived following intense treatment at the Royal Free and are among hundreds of Britons who have volunteered in Sierra Leone, where up to 700 British military personnel have also been working but the overall risk to the public in the UK is described as very low.

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