Ebola in West Africa, June 2014, by Sylvain Cherkaoui

jon

Text

jon

EBOLA IN WEST AFRICA

jon

“The epidemic is out of control”

jon

Text

jon

Ebola in West Africa

jon

With Ebola continuing to spread in Guinea, Sierra Leone and Liberia, bringing the epidemic under control will require a massive deployment of resources by governments in West Africa and aid organisations. At Médecins Sans Frontières/Doctors Without Borders (MSF), we have reached the limits of what our teams can do.Ebola patients have been identified in more than 60 separate locations across the three countries, complicating efforts to treat patients and curb the outbreak.“The epidemic is out of control,” says Dr Bart Janssens, MSF director of operations. “With the appearance of new sites in Guinea, Sierra Leone and Liberia, there is a real risk of it spreading to other areas.”Treating EbolaMSF is currently the only aid organisation treating people affected by the virus, which can kill up to 90 percent of those infected. Since the outbreak began in March, our teams have treated some 470 patients, 215 of them confirmed cases, in specialised centres set up in the region. However, we are having difficulty responding to the large number of new cases and locations.“We have reached our limits,” says Janssens. “Despite the human resources and equipment deployed by MSF in the three affected countries, we are no longer able to send teams to the new outbreak sites.”The scale of the current Ebola epidemic is unprecedented in terms of geographical distribution, people infected and deaths. There have been 528 cases and 337 deaths since the epidemic began, according to latest figures from the World Health Organization (WHO).

jon

This and other reports from Médecins Sans Frontières (MSF) are available for publication. Register and login to the MSF Media Library to browse and download photographs and video B-roll from all our projects worldwide.http://media.msf.org

jon

A photo story by Sylvain Cherkaoui / Cosmos

jon

This is the first time that Ebola has broken out in the region, and local communities are still very frightened of the disease, viewing health facilities with suspicion. A lack of understanding about how the disease spreads has seen people continue to attend funerals where infection-control measures are not implemented.Despite the presence of a number of organisations working to raise awareness about the disease, their activities have not yet managed to reduce public anxiety about Ebola. Meanwhile, civil society and political and religious authorities are failing to acknowledge the scale of the epidemic, with few prominent figures spreading messages promoting the fight against the disease.“The WHO, the affected countries and their neighbouring countries must deploy the resources necessary for an epidemic of this scale,” says Janssen. “In particular, qualified medical staff need to be made available, training in how to treat Ebola needs to be organised and, contact tracing and awareness-raising activities among the population need to be stepped up. Ebola is no longer a public health issue limited to Guinea: it is affecting the whole of West Africa.”MSF currently has some 300 international and national staff working in Guinea, Sierra Leone and Liberia. We have sent more than 40 tonnes of equipment and supplies to the region to help fight the epidemic.Ebola response in GuineaIn Guinea, MSF is supporting the health authorities in delivering medical care for patients in Conakry, Télimélé and Guéckédou. Treatment units were built in Macenta, Kissidougou and Dabola. Our teams are responding to alerts in villages, raising awareness in communities and offering psychological support to patients and their families. We are also giving support for epidemiological surveillance.In Sierra Leone, working with the Ministry of Health, an MSF team is constructing a 50-bed Ebola treatment centre in Kailahun, due to open this week. Small transit care units have already been set up in Koidu and Daru, with a third to open soon in Buedu. MSF has also provided the Ministry of Health with supplies in order to support the construction of further treatment centres. In Liberia, an MSF team has set up a treatment unit in Foya (in the north) and another in the JFK hospital in Monrovia in recent weeks. We have also organised training courses and donated equipment.

jon

Text

jon

The trip from Conakry to Guékédou normally takes two days by car. During the Ebola emergency, flights are organized once or twice per week. In less than two hours, the teams land in Kissidougou, a wooded part of Guinea. From there, it takes only two hours to reach Guékédou by road.

jon

Guéckédou is a city of 350,000 inhabitants in the heart of the Guinea Forest Region, near the borders with Liberia and Sierra Leone. This was the first trading post in West Africa.

jon

The outskirts of Guéckédou.

jon

Health promoter Sarah (left) speaks with psychologist Angeline about the strategy for responding to rumours regarding Ebola haemorrhagic fever.

jon

The ebola treatment centre in Guéckédou was opened on the day the outbreak was declared by the Ministry of Health. Tents were erected on the grounds of the Provincial Directorate of Health. This is where suspected and confirmed cases are treated and tests are performed in the WHO mobile European laboratory.

jon

Text

jon

jon

Mattresses are distributed to families of those who sick or deceased. On this square in the Touloubengo neighbourhood, mattresses and kits are given to the five families whose homes had been disinfected several days earlier, following the death of a family member.

jon

Following a phone call, an MSF team goes to the home of Finda Marie Kamano, age 33. She reported extreme weakness, vomiting, and dysentery. These symptoms, along with fever and nosebleeds, are typical of those caused by the Ebola virus.

jon

An MSF doctor takes Finda Marie Kamano’s temperature. At 36.6C she has no fever. Although the Ebola virus often causes a fever, the fact that she does not have one is not a decisive factor in determining whether or not a patient is infected.

jon

Arriving at the treatment centre, Finda Marie is seen by a nurse in a protective suit and is given a bed in the area reserved for suspicious cases, that is, patients with symptoms but who have not yet been tested for Ebola.

jon

An MSF technician uses bleach to disinfect whatever may be contaminated by the virus.

jon

In the treatment area. Despite their protective gear, the medical team tries to maintain human contact with patients by talking with them a great deal and getting close enough to be able to look into their eyes.

jon

Treating a patient in the isolation ward.

jon

A young patient receives a healthy meal.

jon

Patients receiving care in the treatment centre

jon

Maintaining hygene and cleaning all potential means of transmitting the virus.

jon

Looking after a very young patient in the isolation ward.

jon

An MSF team disinfects Finda Marie Kamanois home. She had just been confirmed the day before as suffering from Ebola.

jon

An MSF team disinfects Finda Marie Kamanois home. Anything that can not be disinfected with bleach, such as her mattress, is removed to be burned.

jon

Burning a mattress and other items that are not easily disinfected, in order to stop the transmission of the Ebola virus

jon

The water and sanitation team offers new mattresses, pillows and mosquito nets to replace items removed from a patient’s home to be burnt.

jon

Guekedou treatment centre. Sia Bintou Kamano is an Ebola patient. Through the airlock between the isolation ward and the rest of the structure set up by MSF, a doctor and a nurse inform her that her lab results have been negative twice in a row. She can now return home.

jon

Despite their protective gear, the medical team tries to maintain human contact with patients by talking with them at length and getting close enough to be able to establish eye contact.

jon

Sia Bintou spent more than 10 days in the treatment centre. The teams often thought that she may not make it, but Bintou ended up beating the disease. While there is no specific treatment for Ebola, staff attempt to strengthen the patientis body by treating the symptoms.

jon

Text

jon

Sia Bintou leaves the treatment centre, to the delight of staff, having spent more than 10 days recovering and sucessfully beating the Ebola virus

jon

Sia Bintou now has immunity against the virus and is no longer contagious, except through breastfeeding. Health staff explain to her how to use powdered milk they provide her for her two-year-old child.

jon

Sia Bintou is cured, but local communities are still very much afraid of former patients. Some former Ebola patients have been rejected, despite the awareness-raising and support offered by MSF in the villages. Fortunately, this is not the case for Sia Bintou who is surrounded by her family and neighbours when she arrives home. She is surrounded by her 5 children, aged 2 to 12 years. Emotions are palpable, great happiness, tinged with sadness; other members of her family did not survive the disease.

jon

Louise, a communications officer, has invited the local media in to explain how the MSF treatment centre operates.

jon

Jean Guy, a cartographer, lays out a map of Guékédou showing the various areas affected by the Ebola epidemic.

jon

After exposure to the virus in the the isolation zone, clothing and boots are disinfected with chlorine.

jon

Two days after testing positive for Ebola, Finda Marie Kamano dies. Fatou, her older sister is overwhelmed. Some members of the community accuse Fatou of causing her sisteris death by calling MSF to help. They say that if Finda Marie had stayed home, she would still be alive. There are serious misconceptions about the work MSF is doing; people see their family members go into the isolation ward and never come out alive. Numerous false rumors circulate within the communities. People even talk about organ trafficking.

jon

Text

jon

The sanitary team dresses the deceased to present her to her family to show them that she is indeed the one in the sealed body bag.

jon

Text

jon

Two days after testing positive for Ebola, Finda Marie Kamano dies.

jon

Text

jon

Finda’s family, including her sister, centre, and other community members grieve at her funeral near her house. Traditional funerals are one of the causes of the propagation of the Ebola virus. Finda had previously prepared the body of a victim for burial, and that was most likely how she contracted the disease herself.

jon

Text

jon

The Guinean Red-Cross lowers Finda’s coffin into a grave.

jon

Finda Marie’s grave is marked by a solitary sapling

jon

Naiara, a nurse, is relieved to take off the protective suit and layers that she wears when treating Ebola patients.

jon

Blood samples taken from suspected cases. Laboratory tests will determine within hours whether or not the samples contain the Ebola virus.

jon

Labelling blood samples for Ebola virus testing

jon

Caris, an MSF medical team leader.

jon

The logistics team builds an incinerator unit in the isolation ward.

jon

The teams also work through the night, as the centre operates 24/7. Donka hospital. Conakry, Guinea.

jon

Henry Gray, Non Medical Emergency Coordinator. Mafanko emergency base. Conakry

jon

Doctor Arne a member of the Ebola treatment team in Donka.

jon

The Ebola treatment centre in Donka.

jon

Angeline, a psychologist, informs the drivers of MSF cars and ambulances about the epidemic.

jon

A hygienist approaches patients classified as suspects. They are awaiting results of a blood test that will determine whether or not they have the Ebola virus.

jon

Nurse Lucie informs Mamadou Niang that his test is negative. He is not infected with Ebola. He can go back home.

jon

Further Information and Resources on the Ebola Outbreak:Download these images for publication:-> http://media.msf.org-> http://media.msf.org/Package/24BHRGUWPK4Also available: B-roll raw footage for broadcast (search id: MSB9596)Read about MSF’s response to the Ebola outbreak and follow news updates:-> http://www.msf.org.uk/article/ebola-west-africa-epidemic-out-control http://msf.org.uk | http://msf.org | http://doctorswithoutborders.org

jon

Please credit all photographs: Sylvain Cherkaoui / Cosmos

Ebola in West Africa, June 2014, by Sylvain Cherkaoui

Documents

Transcript of Ebola in West Africa, June 2014, by Sylvain Cherkaoui