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Sierra Leone

Why are we there?

  • Endemic/epidemic disease
  • Healthcare exclusion

Our Work

2014

  • Cases of Ebola were first confirmed in the east of Sierra Leone, near the border with Guinea, at the end of May.
  • Even before the Ebola outbreak, people in Sierra Leone had limited access to medical care and the health system was both under-resourced and overburdened.
  • Médecins Sans Frontières was working in the country at Gondama, near the city of Bo, running an emergency paediatric and maternity hospital as well as a midwifery clinic in response to the devastating levels of maternal and infant mortality in the country.
  • When the first cases of Ebola were confirmed in Sierra Leone, the Ministry of Health asked Médecins Sans Frontières to intervene. Teams opened an Ebola management centre (EMC) on the outskirts of Kailahun town on 26 June, where testing and care was available for those people suspected of having the virus.
  • Médecins Sans Frontières teams also launched outreach, health promotion and disease surveillance activities, and trained local health staff. Community health workers were trained to deliver messages about how people could protect themselves from Ebola and what to do if they showed signs or symptoms of the disease.
  • A Médecins Sans Frontières psychologist provided support to patients and to families who had lost loved ones.
  • As the virus quickly spread across the country, patients arrived by ambulance from locations up to 10 hours away. The EMC had a maximum capacity of 100 beds.
  • In addition, Médecins Sans Frontières constructed a small maternity unit in October where pregnant Ebola patients could receive specialised care within the high-risk zone.

 

Bo, Southern Province

  • In September, Médecins Sans Frontières opened a second EMC five kilometres outside Bo, which was more easily accessible from most parts of the country. The centre was extended to accommodate 104 beds.
  • Médecins Sans Frontières teams carried out outreach, health promotion and surveillance activities, trained local health staff and offered support to the Ministry of Health’s activities.
  • Also in Bo, Médecins Sans Frontières launched a third Ebola project focused on offering specific, structured and targeted training for other organisations to enable them run EMCs safely. The training sessions took place in Médecins Sans Frontières facilities or in those of the other NGOs to help them start activities. In total six other organisations were trained.

 

Freetown

  • In early December, as health facilities in the country’s capital, Freetown, became overwhelmed, Médecins Sans Frontières opened an EMC in the centrally located Prince of Wales secondary school.
  • A new design was used which meant that the intensive care ward could be viewed through Plexiglas and patients could therefore be better monitored by staff who did not have to wear protective gear.
  • Médecins Sans Frontières started conducting outreach, health promotion and surveillance activities in nine sub-districts of Freetown to support the government coordination body, National Ebola Response Centre (NERC), in mapping and following up on Ebola contacts. Teams also provided training on disinfecting houses.

 

Magburaka, Northern Province

  • On 15 December, Médecins Sans Frontières opened a fourth EMC in Magburaka, Tonkolili district, again, with critical complementary activities including outreach, health promotion, surveillance and training of local health staff.
  • A rapid response team was established in Magburaka to be deployed quickly wherever new cases appeared in the country.

 

Infection control issues, and antimalarial distributions

  • Many Sierra Leonean health staff on the frontline of the outbreak were infected as a result of caring for patients, because they lacked the necessary protective gear and knowledge about the transmission of the disease.
  • In October, Médecins Sans Frontières suspended its obstetric and paediatric projects in Gondama. Due to the strain on resources as a result of responding to the Ebola outbreak, Médecins Sans Frontières could not guarantee the extremely high quality of medical care needed to treat patients or the protection of its staff from Ebola infection.
  • Meanwhile, women suffering complications in childbirth and people sick with malaria and other diseases were reluctant to seek care at government hospitals for fear of contracting Ebola, and untold numbers of people are thought to have died from non-Ebola-related diseases in 2014.
  • In December, to address the threat of malaria and to avoid confusion with Ebola due the similarity of initial symptoms, Médecins Sans Frontières recruited and trained some 6,000 volunteers to carry out a four-day, door-to-door distribution of antimalarial treatments in partnership with the Ministry of Health. 

 

For the latest news on where we work visit: http://activityreport.msf.org/

Médecins Sans Frontières has worked in the country since 1986 and at the end of 2014, Médecins Sans Frontières had 959 staff in Sierra Leone. 

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