It has laid waste to the tribal chiefdoms of Sierra Leone, leaving
hundreds dead, but the Ebola crisis began with just one healer's claims
to special powers.
The outbreak need never have spread from
Guinea, health officials revealed to AFP, except for a herbalist in the
remote eastern border village of Sokoma.
"She was claiming to have
powers to heal Ebola. Cases from Guinea were crossing into Sierra Leone
for treatment," Mohamed Vandi, the top medical official in the hard-hit
district of Kenema, told AFP.
"She got infected and died. During her funeral, women around the other towns got infected."
Ebola
has killed more than 1 220 people since it emerged in southern Guinea
at the start of the year, spreading first to Liberia and cutting a
gruesome and gory swathe through eastern Sierra Leone since May.
'Aggressive infections'
The
tropical pathogen can turn people into de facto corpses with little
higher brain function and negligible motor control days before they die.
The
virus attacks almost every section of tissue, reducing organs and flesh
in the most aggressive infections to a pudding-like mush which leeches
or erupts from the body.
The virus is highly infectious through
exposure to bodily fluids, and its early rapid spread in west Africa was
attributed in part to relatives touching victims during traditional
funeral rites.
The herbalist's mourners fanned out across the
rolling hills of the Kissi tribal chiefdoms, starting a chain reaction
of infections, deaths, funerals and more infections.
A worrying outbreak turned into a major epidemic when the virus finally hit Kenema city on 17 June.
An
ethnically-diverse, Krio-speaking city of 190 000, Kenema already has
the highest incidence of Lassa fever - another viral haemorrhagic
disease - in the world.
But the brutality and cold efficiency of
the Ebola virus - described in medical literature as a "molecular shark"
- caught the city's shabby, chaotic hospital off-guard.
'Deadly and unforgiving'
Crumpled
photographs of dead nurses cover noticeboards on the flaking walls
outside the maternity unit and in the administration block.
Twelve
nurses have been among 277 people to die since the first case showed up
in Kenema hospital. A further ten have been infected with Ebola and
survived.
"The nurses who lost their lives and those who got
infected would never have gone in knowing that they would get infected,"
Vandi, the district medical officer, told AFP.
"We are fighting a battle that is new. Ebola is new here and we are all learning as we go along."
The first case at the hospital was a woman who had partially miscarried, having probably passed the virus to her unborn child.
The
facility boasts the only Lassa fever isolation unit in the world, set
apart from the main building, and a makeshift Ebola unit was quickly set
up there.
It was then that the nurses began dying.
As head
sister of the Lassa fever ward for more than 25 years, Mbalu Fonnie was
credited with attending to more haemorrhagic fever patients than anyone
in the world.
She had survived Lassa fever herself, but was no
match for the Ebola virus when it got into her bloodstream from a
patient in July.
She was dead within days, along with fellow nurses Alex Moigboi and Iye Gborie, and ambulance driver Sahr Niokor.
The deaths prompted a strike of 100 nurses, who complained of poor management of the Ebola centre.
"Wherever
the Ebola virus strikes for the first time, there is a heavy toll on
healthcare workers because they don't have experience with it," Vandi
told AFP.
"The Ebola virus is deadly and unforgiving. The slightest mistake you make, you will get infected."
Umar
Khan, a hugely admired doctor and the country's leading Ebola
specialist, died after saving more than 100 lives, and at least nine
nurses have died since.
Inadequate protection
There are 80 beds in the hospital's Ebola centre, almost double its capacity.
Shifts are voluntary, and many nurses have refused to work in the unit, while those who remain are overworked and exhausted.
Some staff say they have gone weeks without a day off, and 12-hour shifts are par for the course.
Sister Rebecca Lansana was quoted by the Guardian newspaper as saying she was nervous about the high number of staff deaths.
"My
family do not want me to come here anymore. They think I will die, they
don't want to be around me in case I give them Ebola," she told the
London-based daily.
By the time the article came out on 9 August, Lansana had already been dead five days, aged just 42.
Her
husband Emmanuel Karimu, aged 45, told AFP she was moved from maternity
to the Ebola unit after a crash course of just one week.
One day after work, she began to feel feverish and feared the worst, checking herself in for tests which came back positive.
"They
transferred her to the Ebola ward that day and four days later she
died," Karimu said, accusing the hospital of providing inadequate
protective clothing.
The hospital told AFP staff training had
hugely improved in recent weeks, with the help of global aid agencies
and the World Health Organization.
The Ebola outbreak has infected
848 people and claimed 365 lives in Sierra Leone since the herbalist
began inviting clients across the border with promises of salvation.
"These
figures tell us one thing: Ebola is here with us and its impact on us
is real," Maya Kaikai, the government minister for the eastern region,
told a news conference in Kenema on Saturday.
"It is a disease
that spreads very fast, without regard for academic or economic status,
political affiliation, age, ethnic grouping, gender or religion."
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