Reflections on the Ebola outbreak

Freetown, 19 Nov – The following reflections on the Ebola outbreak were written by Andy Kervell, MapAction’s Team Leader in Freetown, Sierra Leone. They were originally drafted to update friends and family members on the team’s progress in the field. Any opinions are Andy’s own.

*************************************************

On my arrival in Freetown I couldn’t help but be struck by the heartbreaking stories of loss, pain and misery from the communities affected by this terrible virus. This must in some ways be on a par with the horror stories following the Sierra Leonean civil war. This battle though is against one of nature’s most lethal biological weapons, and here in Sierra Leone it really is being treating by the government and population like being at war.

MapAction is working out of the National Ebola Response Centre (NERC) in Freetown, which has been set up to coordinate and support the courageous efforts of the many medical and support staff (cleaners, ambulance drivers, burial teams included) battling it out on the front line. They all deserve a medal and the world’s respect for the personal risk they are accepting in carrying out their essential work.  In our back office function we don’t feel at any risk – the only thing is that you have to wash your hands every time you enter a building and have your temperature taken.

Working within the NERC, the daily routine involves a number of meetings and briefings, covering subjects ranging from ambulance distribution to the implementation of burial policies. It is not easy debating distressing subjects like ‘dead body management’, but is essential that such things are done with the professionalism and dignity required to generate the right support, action and authority.

So what role has MapAction played in all of this? Like many emergencies, information management and its visualisation plays such a key role in the response. Fighting the spread of the virus is as much about information management as it is logistics and epidemiology. The processing of data about a suspected case, from the call to the 117 helpline set up to report possible cases, through to their isolation, the laboratory testing of their samples, subsequent treatment, and unfortunately in some cases, the safe burials, must be recorded and collated.

MapAction has been advising the NERC team on how such information can be best managed, and how to visualise it in useful ways. This then provides experts such as the UK epidemiologists, the World Health Organisation and Centre for Disease Control (CDC) with essential information about how the virus is spreading, its rate of infection and how the country is implementing the control measures required. Key indicators such as number of cases, treatment beds available, safe burials within 24 hours, etc are all being reported daily to the NERC. Bringing these numbers down below target levels is essential in slowing transmission rates and therefore stemming the spread of the virus.

MapAction’s field team has presented its maps to the Sierra Leone President and Minister of State for Defence and the British High Commissioner at various briefings, so we certainly have been in the thick of it! It was very heartening to hear Palo Conteh, Chief Executive of the NERC, comment on one of our presentations: “This is a fantastic picture. I can sit here and see everything.”

Freetown itself is an amazing city, clinging Rio-esque to the steep hills plummeting towards the Atlantic Ocean, it makes for a really spectacular journey from our lodgings to the office each day. The roads are fairly chaotic and full of enormous pot holes, and you see from the houses by the roadside the limited development of this country.

However life appears to be carrying on, although it is apparently much quieter than normal owing to the fear of Ebola. Large gatherings have been banned, so spectator sports such as football games, and even the Hash House Harriers have been postponed. There is a growing frustration in the community that they would like to get back to normal. But unfortunately for this country, already blighted by poverty, it will be many months yet before this occurs.

I will have to return quickly back to everyday life after my two-week deployment is up, but the mission will have a lasting memory and impact on my life. This, though, is what being part of MapAction is all about and it is again a privilege to represent such a great charity and perform its role as we have been trained to do. Hopefully our short input will have some positive impact to the response, and this amazing country and people will be rid of this terrible virus.