This encouraging news of the successful containment of imported cases of Ebola is tempered by worrying figures. More than 10,000 cases—all but 27 of them have occurred inside Sierra Leone, Liberia, and Guinea—have been reported in eight countries, including the United States and, more recently, Mali. There have been nearly 5,000 deaths, according to the latest figures from the WHO. The uncoordinated and slow nature of the response to the epidemic have come under heavy criticism, most recently by the US ambassador to the UN Samantha Power, who called out countries for not following up on their commitment to send doctors, beds, and reasonable financial support. Meanwhile, the widespread panic (read here Fear-bola) that ensued prompted measures such as travel bans, which severely curtail efforts to beat the disease.
To be clear, we should be optimistic, but we should also be cautious because Nigeria and Senegal remain at risk of additional imported cases as long as the situation doesn’t improve in neighboring countries. Yet, this new development is much needed to provide a nuanced narrative on the Ebola situation in West Africa as a region. What is beyond a doubt is that we ought to use these cases in containing a formidable foe as an inspiration to galvanize our efforts—on the domestic and international front—to contain what has been dubbed “an international [not African] public health emergency.”
Rapid response, early detection, and nationwide public awareness
The first case of Ebola in Senegal was confirmed on August 29th in a young man who had travelled to Dakar, by road, from Guinea, where he had direct contact with an Ebola patient. I had been living in Dakar since July 1st and received the news on the day I travelled to Chad. With the rapidly deteriorating situation in neighboring countries, I feared an increase in the rate of infection in densely populated Dakar.
The Senegalese government’s response was swift and included identifying and monitoring 74 close contacts of the patient, prompt testing of all suspected cases, stepped-up surveillance at the country’s many entry points, and nationwide public awareness campaigns. The patient was treated and recovered from the Ebola virus.
The government’s swift response coupled with awareness-raising efforts, such as the use of apps to provide relevant information to the public about ways to avoid contracting the virus, were vital in preventing an Ebola outbreak in Senegal.
Institutional backing in containment efforts and engagement with the civil society
Nigeria also recorded an imported case of Ebola in late July when an infected Liberian man arrived by airplane into Lagos, Africa’s most populous city. The man, who died in the hospital a few days later, set off a chain of transmission that infected a total of 19 people, 7 of whom died.
Through effective coordination of the response, the Nigerian government established an Emergency Operations Center and repurposed technologies and infrastructures from international partners to help find cases and track potential chains of transmission.
Moreover, strong public awareness campaigns, teamed with the early engagement of traditional, religious, and community leaders also played a key role in the successful containment of this outbreak.
The way forward for Guinea, Liberia, and Sierra Leone
Analysts have pointed to the lack of resources needed to manage the infections, along with devastated healthcare systems in post-conflict societies, to account for the rapid spread of the disease in Guinea, Liberia, and Sierra Leone. While this holds true to an extent, it doesn’t wholly explain how a country such as the Democratic Republic of Congo (DRC) with its share of similar challenges has managed to contain previous Ebola outbreaks. While attention was rightly focused on West Africa and new cases in Europe and the US, another unrelated Ebola outbreak started in the Equateur Province in western DRC. Once the outbreak was reported to health officials in Kinshasa, the response was swift: a team that had contained numerous outbreaks in the past was brought in to respond. The main difference between the case in DRC and those in West Africa, even though we are talking about a different strain of the virus, was that this was the first time that the virus made an appearance in West Africa, making it difficult for severely affected communities and governments to adequately protect themselves.
However, the situation in West Africa is not without hope, even with this lack of experience. As a case in point, health officials in a Guinean town north of the capital Conakry initially thought that Ebola patients had typhoid fever. Following the death of these patients, it became evident that the Ebola virus was at-large. Yet the community came together to gain trust, banish rumors, and provide treatment to those in need. With the help of Medecins Sans Frontières and the WHO, health workers rapidly set up a treatment center rapidly and near the sick people. The town has been Ebola free since July. This is not an isolated case of survival. The powerful story of Fatu Kekula, a Liberian student who nursed family members back to health using the “trash bag method” after being denied access to a hospital also comes to mind.
While we await the availability of an Ebola vaccine and/or effective treatment, Nigeria and Senegal should be hailed for showing us the path to an Ebola-free world. This requires swift action from governments in coordinating containment efforts with the international community, while at the same time engaging with communities through influential figures to raise public awareness on how to avoid contracting the virus.