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Perspectives from the field: Ebola response in Sierra Leone

On Christmas Day 2014, I started a 6-week placement at the Australian-flagged Ebola Treatment Centre, managed by Aspen Medical, in Freetown, Sierra Leone. I joined about 30 doctors, nurses, environmental health officers, and management and support staff from across Australia and New Zealand, working alongside 120 Sierra Leoneans.

A societal disaster

The West African Ebola virus disease (EVD) outbreak is a medical and societal disaster. Most patients die, leaving devastated families and communities. EVD spreads by interpersonal contact, so the community prevention message is “Avoid Body Contact” — ABC. However, body contact makes us human, and the ABC protocol is freakish in all cultures. Dramatic community-wide behaviour change is needed to control an EVD outbreak.

The EVD outbreak is occurring in West African countries already devastated by ecological, economic and governance crises. Access to food is limited; many people require food aid. Schools have closed, and a generation may never reach their potential. Health care services have collapsed — deaths from malaria, tuberculosis, HIV and diarrhoea will far exceed deaths from EVD.1

Challenges in the Ebola Treatment Centre

Outbreaks of EVD are brutal. The Ebola Treatment Centre assists in controlling the outbreak by isolating patients with EVD infection. A razor wire fence surrounds the treatment…