December 4 2014

In Liberia, slowdown in Ebola infection rate poses new dangers

It is still too early to claim that the infection rate has declined in the West African country worst-hit by the Ebola outbreak, says Mr George Kordahi, national director for SOS Children’s Villages Liberia. Claiming early victories may lead to Liberians becoming relaxed about safety precautions while the disease continues to spread in neighbouring Sierra Leone.

4 December 2014 - The infection rate in Liberia has shown evidence of a decline at national level in past weeks and according to the World Health Organisation (WHO) new cases in the past 21 days are about 6.8% of the total confirmed cases since the outbreak began. In comparison, for the same period, the escalating rate of new cases in Sierra Leone accounts for almost a quarter of all confirmed cases.
This does not comfort Kordahi and his team. In fact, it worries them. “We are afraid that people might become lax. When the outbreak became a crisis in March it was actually the second round of infections, but it suddenly escalated because people relaxed prematurely,” he explained.
“When the infection rate is high people run away to other towns, and when it becomes better they return. This causes new infections and this type of movement is very difficult to control, especially in border towns. So, the reported increase in infections currently in Sierra Leone might spill over to Liberia through such movements and then we face round three. Therefore it is too early to say the infection rate is coming down. We cannot drop our guard,” warned Kordahi.

Children at the SOS Children's Village in Bo, Sierra Leone, carry water from the village well back in buckets to their SOS family homes. Photo: Claire Ladavicius.
The currently increasing infection rate in Sierra Leone has Mr Olatungie Woode, national director of SOS Children’s Villages Sierra Leone, quite nervous. “The situation is very, very grave in Freetown at the moment. It is really frightening and if it gets worse we will have to shut down completely,” he said.
Woode says he cannot afford to become depressed about the worsening situation as it will not serve any purpose for him and his team. “The team cannot become afraid of the situation and therefore I have to be strong… but in my quiet times it gets very tough,” he admitted.
SOS Children’s Villages Liberia is in the process of concluding an agreement with the Liberian Ministry of Health and Social Welfare, by which SOS Children’s Villages Liberia would receive funding to manage an interim care centre for 25 to 30 children under five years old who have been orphaned as a result of Ebola. According to the ministry there are 1,400 children in Liberia who are now ‘Ebola orphans’.
“Our health system is caput, the economy is suffering and these children deserve a future. As a country we will be overwhelmed once this is over, but as SOS Children’s Villages Liberia we will have to do something – whether that means more children’s villages or a more aggressive family strengthening programme in the counties, I don’t know. But we are in the middle of this,” said Kordahi.
Apart from their work to strengthen and support families in the community, SOS Children’s Villages in Liberia and Sierra Leone are home to several hundred children who have lost the care of their biological parents and are growing up with SOS mothers, in SOS families.
“Our SOS mothers and children are still under observation and confined to the villages so we tend to give them much more support now... The risk of infection is so high that we are trying to avoid the need for movement out of the villages. The mothers are coping very well but it is difficult. There… [is] no hugging or kissing… and all of this takes a toll on a human being at the end of the day,” said Kordahi.
Woode said that the children struggled to come to terms with not being able to leave the village. “The first three months were very difficult for them. The more they saw on the news how people were suffering and actually dying of the disease the more conscious they became of protecting themselves. To an extent they have accepted life the way it is now,” said Woode.

Children from the SOS Children's Village in Monrovia, Liberia, play on the swings within their village. "They know this is not the time to break an arm," said the national director of SOS Children's Villages Sierra Leone. Photo: Christian Lesske.

“This has led to the most surprising thing of all, because the children are so conscious about Ebola infection that - apart from malaria - not one child has become sick during this time. Normally, the children would be playing outside the village, climbing trees and playing football and they would occasionally break an arm or so, but none of this is happening. They know this is not the time to break an arm,” said Woode, chuckling at the strange turn of events.

SOS Children’s Villages Liberia runs a medical centre in Monrovia, the last one offering non-Ebola medical care. “We have seen a new trend emerge here, which is that malaria and typhoid fever – which used to be serious illnesses – are now considered the mild ones,” said Kordahi.
“One thing we did not foresee was how fast we would be running out of PPE gear [personal protective equipment] in the medical centre. We thought we had six months’ worth of stock but the national protocol for changing gear was quite aggressive during August and September and health care workers were required to change two to three times a day and if a suspected Ebola case was dealt with, the health care worker had to change immediately. This means our supply is not enough anymore and running quite low.”
Woode is not the first one to liken the outbreak to war. “We have to stand together. Together is how we will get through this difficult time. This is more than a civil war. It is an unseen enemy and you don’t know who it will strike next.”
Kordahi is in agreement. “When the outbreak became a crisis, each case was a tragedy. As the cases increased and we counted one hundred, one thousand, we became statistics in West Africa. We have a duty to ensure that behind every infected person there is a story. Every person affected by Ebola has lost a mother, father, child or community for that matter. People forget this and we need to remind them,” said Kordahi. SOS Children’s Villages Liberia has lost an SOS mother and a nurse to Ebola.

*This article first appeared on 23 November, in City Press, South Africa’s second-largest national Sunday newspaper, as an op-ed by Ms Suné Kitshoff, a correspondent for SOS Children’s Villages International.

Read more about how SOS Children's Villages in Liberia, Sierra Leone and Guinea are coping with the Ebola outbreak.