Today Everyone in Sierra Leone is an Ebola Victim

Today Everyone in Sierra Leone is an Ebola Victim

People now ask me if the Ebola crisis is over. It’s certainly dropped out of the media here in the US.

But the answer is, no. The outbreak stubbornly hangs on in Freetown and three northern districts.  Getting to zero is proving to be more difficult than imagined. This is about changing human behavior on deeply seated traditions like burial practices.  Consistent behavior change across the country remains an elusive goal.

Today, March 18, the daily new Ebola case report had only one new case. That’s the lowest ever since the epidemic began. But yesterday was 14 new cases, and the last seven day total is 50. Ebola is not gone.

But much of the country is hanging on to their zeros. Bumpeh Chiefdom has now gone nearly 90 days without a new Ebola case. Their district, Moyamba District, is now 22 days Ebola free.

DSCN0453Today, however, everyone in Sierra Leone should be considered an Ebola victim.

The tragedy won’t end with eliminating the infectious outbreak. The economic and social impact on the country has been nothing less than disastrous. The majority of families’ livelihood is subsistence agriculture, and they are devastated. They depend on today’s market sale for tomorrow’s food.

The entire country’s economic growth has fallen by two-thirds. Mining and tourism are the two largest industries that brought foreign investment and cash into the country. Tourism is of course at a standstill. Little mining goes on.

IMG_0413For Bumpeh Chiefdom, incomes of farmers and small traders were cut in half when they couldn’t get crops to city markets. The three month chiefdom isolation order caused some people to just abandon farms and businesses. Others lost some of their harvest when seasonal laborers fled the chiefdom.

Prices for food, fuel and staples at the same time increased 30%. Feeding their families is now the priority. Things like sending kids to school is a luxury for many.

Bumpeh chiefdom has enough food to avoid starvation.  But the poorest families rely on cheap starchy foods like rice and yams. Not a balanced diet. This can cause developmental problems over time in small children like stunting.

Sierra Leone had the highest maternity and under-five mortality rates in the world even before Ebola hit.  In 2012, free health care for pregnant and nursing mothers and children under five started to change this. But with health care overwhelmed by Ebola, families avoided clinics and hospitals.

IMG_0097Many more people have likely become ill or died of common untreated illnesses like malaria, dysentery and typhoid than from Ebola, especially small children. Women and babies died because pregnant women did not seek health care, or they were turned away by health care workers fearful of the Ebola risk. The UN Population Fund estimated the Ebola epidemic may have caused 120,000 maternal deaths in the 3 countries affected by Ebola by late October when Ebola had not yet peaked. Children are not being vaccinated against dangerous diseases like small pox. HIV goes undiagnosed or untreated.

Schools have been closed for seven months and more than 60% of the population is school age children. Keeping kids out of school will have a long term effect on the country’s development.  The longer teenagers stay out of school, the less likely they will return.

Teenaged girls are especially affected. Pregnancy rates climbed during the Ebola crisis with over 30% of schoolgirls estimated pregnant nationwide. Sierra Leone President Koroma is calling for pregnant girls and new mothers to come back to school and complete their education.

IMG-20150108-WA0001So is all lost in Sierra Leone? No! The people are resilient. The world development community learned hard lessons from Ebola on the importance of targeting local solutions and local leadership.  And Sierra Leone mobilized thousands of young people eager to help their country who stay connected with social media.

IMG_2005Sherbro Foundation goes back to our mission of supporting practical grassroots projects that quickly benefit the poorest people. Bumpeh Chiefdom’s Paramount Chief Caulker said his top two priorities now  are restoring income for hungry people and sending girls back to school. So we are helping them with two urgent programs for these.

The first is a vegetable growing program, so farmers can raise fast growing cash crops like peppers and quickly earn income again.

Our second urgent program is helping girls get back in secondary school.  School is slated to reopen April 14. The Sierra Leone government has a grant that will cover school fees this year for all secondary school children. But the $30 school uniform and school supplies will still be barriers for most poor families.

Sherbro Foundation’s goal this year is to buy school uniforms for 300 girls.

More on both these programs in future posts.

You don’t have to wait to help Bumpeh Chiefdom. You can donate now at Your money helps restore livelihoods and build self sufficiency.

Arlene Golembiewski
Executive Director

Nat’l Geo: Why Freetown can’t conquer Ebola and the provinces are

A January 27th National Geographic article on the December – January  “surge” to fight Ebola is the first one I’ve read that really gets it.

It’s called “How Ebola found fertile ground in Sierra Leone’s chaotic capital – How poverty and fragmentation in Sierra Leone’s capital city fueled the spread of the deadly Ebola virus.”  I found this on the Nat’l Geo Twitter feed, so it’s up to date as of the end of January.

Starting in Freetown, the reporter notes the usual mix of urban density and poverty that fuels contagious disease outbreaks, and hinders eradication.

But he goes on to recognize an “overlooked factor (that) continues to complicate.” He notes Freetown has had 50% of all Ebola cases, but has only 30% of the country’s population.  And it’s a “mishmash of people” from all tribes and all parts of the country.  No unifying culture or leaders. Only elected councilors, short term by nature, who never really develop trust and respect with the people they represent. And it goes both ways; they often don’t show respect for people they represent either.

Traditional leaders tackle Ebola   The reporter then goes upcountry to Kenema and interviews paramount chiefs there. He hears a chief describe how he went on the radio when they succumbed to the epidemic. He demanded people isolate the sick and stop washing dead bodies before burial and other Secret Society rituals.  He arrested violators for eight days and fined them Le500,000 ($120), a huge sum there.  His translator commented, “the chief is the only person who could ever stop secret societies.”

Bumpeh Chiefdom Paramount Chief Charles Caulker announces gov't Ebola funding for all chiefdoms to his Ebola task force.  Dec 2014

Bumpeh Chiefdom Paramount Chief Charles Caulker announces gov’t Ebola funding for all chiefdoms to his Ebola task force.       December 2014

Kenema formed an aggressive Ebola task force with all local leaders. They went from being one of the two early hotspots in August, to declaring themselves free of Ebola in December.  They’ve since had a smattering of new cases, probably travelers coming from other outbreak areas. These were quickly contained.

With strong district and chiefdom Ebola committees, the epidemic is nearly stamped out beyond western and northern urban areas.  Strong hands-on leadership of traditional leaders was pivotal in influencing change in high risk behaviors among their residents. Chiefs have a good pipeline of information and authority to take action when unsafe behavior didn’t change.

Paramount chiefs united to take collective action, and with government funding in December for all chiefdoms, new Ebola cases rapidly plummeted in January.

To reach people in Freetown, the government is using elected councilors and hired monitors, most of whom don’t hold much sway with disparate groups of uneducated, Ebola weary urban dwellers.

It’s not hopeless. Monrovia managed it. But it’s going to take systematic and strong action – and done swiftly.




From Ebola Hotspot to Zero

From Ebola hotspot to zero new cases. This isn’t a dream.  It’s reality today in a number of  parts of Sierra Leone.

The media was blasting news through December about a country out of control with rising Ebola numbers.  Yes, the capital Freetown and northern cities like Port Loko have had high levels of new cases making Sierra Leone now the hardest hit country in the Ebola epidemic. They also put the whole country at continued risk because people continue to travel between districts.

So, am I an optimist talking about zero? I drafted this story a week ago and hesitated to post it for concern people would think this is just wishful thinking.  It isn’t.  In the last month, numbers have been steadily coming down. The Sierra Leone Ministry of Health’s daily postings of new Ebola cases have gone from 72 cases per day December 1, to 55 cases per day December 24, to 29 cases January 2.  January 12  was 19 new cases – for the entire country.

Eight of 12 districts in the country have achieved zero new Ebola cases for varying lengths of time.

So, what’s going on? I’m in weekly phone contact with Bumpeh Chiefdom in Moyamba District. I hear what Paramount Chief Caulker and paramount chiefs around the country have been doing in the last month. “Christmas was canceled.” Instead chiefs and other local leaders visited all parts of their chiefdoms with the task of influencing those resident behaviors that have been so resistant to change. In Sierra Leone’s culture, it’s the chiefs who have the authority to give people the difficult expectations on Ebola, like no traditional burials with washing of dead bodies  And chiefs can hold their people accountable.  More on this in another post.

Minister of Local Government and Rural Development, Hon. Diana Finda Konomanyi celebrates 42 days without Pujehun district recording a single new case of Ebola.

Minister of Local Government and Rural Development, Hon. Diana Finda Konomanyi celebrates 42 days without Pujehun district recording a single new case of Ebola.

Today, many parts of Sierra Leone have learned how to control Ebola, and they have achieved zero new cases.  Quarantines are lifted after 21 days. To be declared “Ebola free,”  the magic number is zero new cases for 42 days.

Pujehun District was just declared the first Sierra Leone district Ebola free, now more than 42 days.  Pujehun is in the southeast corner, away from current outbreak areas.  They’ve only had 31 cases total to date. But they note they share a border with Liberia, and only their strict procedures have kept Ebola out of the district.

Kailahun and Kenema districts are the two original Ebola hotspots in the East where the disease first crossed over from Guinea. They both declared themselves with no new Ebola cases for 21 days or more. A few cases returned, but with fast reporting and treatment facilities available, they’ve been able to stop further spread. Five other districts are at or near zero for a number of days.

This Reuters story describes where Kailahun district is today and how they did it.  The last 21-day quarantine on a home was lifted on December 30.

Opening new check point between Bumpeh & Ribbi chiefdoms

Opening new check point between Bumpeh & Ribbi chiefdoms

Bumpeh Chiefdom, where Sherbro Foundation does its work in Moyamba District, lifted a 21 day quarantine last week, leaving them today with no Ebola cases.  They had gone more than 42 days Ebola free.  Then a family in the remote SW corner of the chiefdom crossed back and forth between Bumpeh and neighboring Ribbi chiefdom, carrying Ebola with them. It resulted in two deaths in early December in Bumpeh Chiefdom, and more in Ribbi Chiefdom.

The village homes involved were quarantined. New chiefdom led check points were set up to stop movement between the chiefdoms with 24/7 monitoring .  Bumpeh Chiefdom’s Paramount Chief Caulker had no choice but to arrest and fine the Section chief and village chief involved for not reporting these Ebola cases.

This was the first instance in the country of chiefs being arrested for not carrying out their duties under the new Ebola by-laws.  They’re subject to six months imprisonment. It’s this kind of strict accountability that will stamp out Ebola.

It’s now been about 21 days and surprisingly, no new Ebola cases came out of the Bumpeh Chiefdom village quarantine.  Chief Caulker speculated that perhaps all the earlier sensitization training paid off. Perhaps villagers involved in the burial understood they could become infected and improvised ways to protect themselves.


Ebola treatment – doing it right

We could have used this approach to Ebola treatment in Sierra Leone a while ago. Small and decentralized – placed in the community where needed.  Fast start-up.  But we’ll take it now.  At least we’re learning from the whole Ebola experience and how to respond.


From Deputy Chief of Mission Kathleen FitzGibbon, US Embassy, Freetown

January 5, 2015

Today, we participated in the opening of a 20-bed Ebola Treatment Unit in Kontorloh Community, Wellington. With USAID’s Office of Foreign Disaster Assistance funded this collaborative effort with the local community, a local non-governmental organization called Lifeline, the Ministry of Health and Sanitation, Oxfam, and Med Air, an international NGO that will operate the facility. The U.K. government provided funding for construction. This facility is a “pilot” in the sense that it is a small facility, constructed in just a few weeks time, right in the heart of a deeply affected community. The scale of this operation allows us to be flexible and responsive to local needs. There are approximately 105 workers at the facility. I was inspired by the enthusiasm of the health care workers, who proudly showed off “scrubs” made by a local tailor. Most of these young health care workers are from the surrounding area and many of them are Ebola survivors. MedAir officials told us that they made hiring survivors a priority because they had been through Ebola and could provide motivation and encouragement to others going through the illness. The health care workers demonstrated for the community how patients are admitted and informed them that the decontamination solution does not spread Ebola. We hope that this local solution engenders trust and can convince residents to send sick relatives and neighbors to the treatment unit. What I saw today is a community determined to stop Ebola.

Do Good. Feel Good. #GivingTuesday – Dec 2


GT_Phone_2014Do Good. 
Feel Good.

Send help to
Sierra Leone
battling Ebola.

On Tuesday, December 2 people around the world will come together to celebrate generosity and to give.  #GivingTuesday

Help Bumpeh Chiefdom in Sierra Leone emerge from the Ebola crisis and build a better future.

Here’s why I give to Sherbro Foundation and what I want to see in their future.

Share the reason for the season.  Even small gifts make a BIG difference.

$25 pays for:

  •  A week’s food & transportation for a chiefdom Ebola Team Volunteer    
  •  Part of a solar panel bringing power to the Community Computer Center
  •  One girl’s scholarship to attend Jr High School for an entire year   

 It’s easy to Give.  


logo-segoe printDOUBLE your money now  –  1:1 matching!
Help Sierra Leone more.  Pass this on to a friend.




After All the Eating and Shopping ….It’s Time to Give Back



logo-segoe printGive to help Sierra Leone emerge from the Ebola Crisis and build a brighter future.  

Your donation is now DOUBLED with 1:1 matching.

Help Sierra Leone more. Pass this on to a friend.


P.C. Caulker interviewed on role of chiefs in Ebola crisis

Paramount Chief Caulker of Bumpeh Chiefdom talks about being a chief and their role during the Ebola crisis. As leader of the National Council of Paramount Chiefs in Sierra Leone, Chief Caulker was interviewed by Radio France Internationale.  Read the transcript here. 

Paramount Chief Charles Caulker

Paramount Chief Charles Caulker

Most Westerners don’t understand paramount chiefs are distinct from the Sierra Leone government.  They’re a separate form of governance that represents every Sierra Leone resident in every part of the country, and pre-dates colonial rule. They deal with local affairs and are the first level of action in addressing resident safety, including in time of disasters.  In a rural country with difficult roads and many remote villages, paramount chiefs are the first and often the only authority figure their residents will encounter.  Their role is critical for something like the current Ebola crisis.

Chiefdoms enact byelaws to document the customs and practices of the area. Two sets of byelaws on the paramount chief’s role in addressing the Ebola crisis were defined in recent months.  President Koroma has been admonishing paramount chiefs of late to fulfill their role in breaking the chain of Ebola transmission, as defined in the byelaws.  Chief Caulker discusses in the interview the need for adequate resources if chiefs are to deliver this role.

It’s working – No More Ebola Cases in Bumpeh Chiefdom!

December 8th Update:  55 Days & counting  –  No new Ebola Cases!

Chiefdom Ebola Task Force is doing a fantastic job – but they need our continued support.

There are no more Ebola cases in Bumpeh Chiefdom since they embarked on their Breaking-the-Chain-of-Transmission program  October 22nd. Even though they earlier lost 21 people to Ebola and the epidemic rages around them.

Setting up check point.

Setting up check point.

What’s changed? The single biggest intervention is rigorously managed checkpoints at the main roads to stop “strangers” from entering the chiefdom and carrying Ebola with them.  Village chiefs are the next level of defense going door to door daily to verify no one has taken ill and there are no unexpected visitors.  Reporting is real time with cell phones.

Imagine if every chiefdom in Sierra Leone mounted this kind of systematic offensive to identify and isolate Ebola cases for even 21 days.  It would literally break the chain of Ebola transmission and the outbreak would be on its way out.   Read the whole story here.

Sherbro Foundation continues to support Bumpeh Chiefdom in their Breaking-the-Chain-of- Ebola-Transmission program.  Without our donations, they could not have launched this comprehensive effort.

You can make a difference and help eliminate Ebola, too.  Join us and donate at We need your help to keep this effort going for the coming months.

You’ll know exactly where your money goes, and that it’s actually working to stop the spread of Ebola.

Bonus: 100% goes directly to the chiefdom Ebola program. Every penny. We’re an all-volunteer organization and our small administrative costs are paid by a separate donation.

2nd Bonus: It’s tax deductible for US residents. Sherbro Foundation is a 501(c)(3) tax exempt organization.

Help us even more – forward this to a friend.

It’s Working – No More Ebola Cases in Bumpeh Chiefdom

November 19 update – Ebola-free 32 days and counting

“Things are better, relatively speaking.” Rosaline Kaimbay emphasized the “relatively speaking” when I called yesterday for an update on Bumpeh Chiefdom. But it was the first positive news in some weeks. There are no more Ebola cases in the chiefdom since they embarked on their Breaking-the-Chain-of-Transmission program two weeks ago.

Yet Ebola is raging in Waterloo, a large town on the main highway and the source of recent Ebola cases in Bumpeh Chiefdom. There are reports of over 700 dead of Ebola in the Western Rural area in the last 5-6 weeks, most coming from Waterloo. Ebola “refugees” have been fleeing places like Waterloo and carrying Ebola to rural villages. Places like Bumpeh Chiefdom in close proximity.

Setting up check point.

Setting up a check point.

But today there’s no Ebola cases in Rotifunk or the rest of Bumpeh Chiefdom. Why? The single biggest intervention is rigorously managed checkpoints at the main roads to stop “strangers” from entering the chiefdom and possibly carrying Ebola with them.  There are also checkpoints on the Bumpeh River that traverses the chiefdom and is the main traffic route for many of its 208 villages “downriver” as they say.

Young chiefdom men volunteered to supplement government security forces at checkpoints and monitor all traffic in and out of the chiefdom. They’re the ones rigorously enforcing, keeping chiefdom borders tight, and ensuring outsiders are turned away. They’re the ones sitting up for all night vigils with nothing to protect them from mosquitos except a camp fire. They take turns for naps in a 3-sided palm branch lean-to on hard benches of split bamboo – their improvised shelter.

Rosaline Kaimbay interviewed at chiefdom meeting.

Rosaline Kaimbay interviewed at chiefdom meeting.

Rosaline visits the checkpoints daily to be sure all is going well and lend support. She is Executive Director of Sherbro Foundation’s partner organization, the Center for Community Empowerment and Transformation, CCET, and principal of Prosperity Girls High School. And now, she’s part of the chiefdom’s Ebola task force. Rosaline is a do-er. If you need something done, get Rosaline. If it’s important to Bumpeh Chiefdom, you won’t need to look for her. She’ll be there.

Rosaline said she goes to the checkpoints daily for at least 30 minutes, maybe an hour, to personally assess. She heads out each day with the CCET motorcycle and a driver, the only practical way to get around these days. Maybe the only way.

We have six chiefdom men assigned to each checkpoint, Rosaline said. They rotate through, with five days on and two days off. I talk with people, bring them drinks, something to boost morale.

And the checkpoints are working. I asked what they do if someone tries to enter the chiefdom who doesn’t live there. They send them back where they came from, she said, the way they came in.

Chiefs like Mr. Kamara monitor village families.

Chiefs like Mr. Kamara monitor village families.

It sounds rather medieval. But much of the country is under similar isolation orders, trying to isolate districts, and chiefdoms within districts, that have surges in new Ebola cases. This is Public Health 101 to isolate disease cases and keep them from spreading. It works.

Village chiefs are the next level of defense in the Breaking-the-Chain-of-Transmission program. Bumpeh Chiefdom chiefs are going door to door daily to verify no one has taken ill with Ebola-like symptoms, and there are no new visitors.  Reports are by cell phone real time, wherever possible.  Section Chiefs are responsible to report their village results to the Chiefdom task force.

Imagine if every chiefdom in the country mounted this kind of offensive to fight Ebola for even 21 days – the upper range for Ebola incubation. It would literally break the chain of Ebola transmission and the outbreak would be on its decline.

Identify – Isolate – Treat. If all three legs of the infectious disease control stool were reliably there, Ebola would come under control. Actively engaging and supporting traditional leaders to identify and isolate cases in their chiefdoms is the key. They play a role in getting cases promptly sent for treatment. No one else can do this systematically with cooperation of the people. No one else is already in place in every corner of the country.

There’s still a long uphill battle to eliminate Ebola. But for the first time in a long while, you get a sense the runaway train is starting to be controlled and slowing down.

Sherbro Foundation will continue to support Bumpeh Chiefdom in their Breaking-the-Chain-of- Transmission program. Our donations go to support the checkpoints teams with small weekly per diems, transportation costs and cell phone coverage. Village chiefs receive a $5 honorarium to recognize their service for three months of house to house checks. With gas at $5/gallon, transportation costs are high. Our support enables the Chiefdom task force to get around and ensure work gets done. We continue to supply villages with hand washing stations and disinfectant for public places.

You can make a difference and help eliminate Ebola, too.  Join us and donate at

You’ll know exactly where your money goes, and that it’s actually working to stop the spread of Ebola.

Bonus: 100% goes directly to the chiefdom Ebola program. Every penny. We’re an all-volunteer organization and our small administrative costs are paid by a separate donation.

2nd Bonus: It’s tax deductible for US residents. Sherbro Foundation is a 501(c)(3) tax exempt organization.

Help us even more – forward this to a friend.

Ebola – All We Need to Do

All we need to do to make this work is restrict movement (into the chiefdom) and don’t touch.

Setting up checkpoint at chiefdom border.

Setting up checkpoint at chiefdom border.

These were Chief Caulker’s words to me two days after he launched his “break-the-chain-of-transmission” program to stop Ebola in Bumpeh Chiefdom. He spent the previous evening at one of the key checkpoints set up to control anyone trying to enter or leave the chiefdom on a drivable road. Additional checkpoints are being set up at strategic points for river traffic and frequented footpaths.

Chief was there until nearly midnight to personally observe checkpoint activity. And I need to boost morale, he said, so I stayed there late into the night.

Chief Caulker (blue sports suit) inspecting checkpoint.

Chief Caulker (blue sports suit) inspecting checkpoint.

The chiefdom has been under a government isolation order for a month with no traffic in or out except those with an authorized pass. Waterloo and Moyamba Junction are both market towns on the main highway now decimated by Ebola. Many there have family and personal connections in Bumpeh Chiefdom. You turn off the highway at either of these points to reach the chiefdom. Both towns have been the source of three cases of Ebola infected people fleeing quarantine there to chiefdom villages. Each incident was isolated and contained, but Bumpeh Chiefdom’s proximity puts it at risk of a bigger outbreak.

Army or police manned checkpoints on roads are supposed to stop all traffic without authorized passes, including any vehicle, motorbike or foot traffic. But borders are “porous,” as they say. “Lots of compromising going on,” Chief said. These are nice ways of saying people can pay or otherwise talk their way through.

Checkpoint night watch.

Checkpoint night watch.

This is why Chief Caulker has added his own chiefdom volunteers. Young men committed to their chiefdom and willing to sit up all night in a palm lean-to with a camp fire, and actually stop traffic without an official pass. Four trucks per day are allowed to bring supplies to Rotifunk.

A week later Chief Caulker said, the checkpoints are being very effective. The presence of checkpoint volunteers is making the army or police personnel do their jobs.  Traffic is finally being halted and turned away. Volunteers call in reports on cell phones.

The only problem, chief said, is that the police and army personnel are asking for food and ”incentives.” In the local vernacular, this means money and things like cigarettes, because they’re not being paid by the government, or payments are skipped. I’m not using donations the chiefdom received to fight Ebola to pay staff the government is responsible for, Chief said.

I’ve come to better understand all the petty corruption from police, army and other government employees, trying to extract small bribes from local people. When they don’t get paid, they still need to eat and support their families. They’re in effect imposing their own tax. If that’s all that’s at stake it’s one thing. But allowing Ebola infected people to pass through checkpoints during this crisis in inexcusable.

On the no touch side, one of the biggest sources of new Ebola infections have been traditional burials – now considered unsafe. People now understand (at least in Bumpeh Chiefdom) the need to report all deaths to first check for Ebola.

We’re having a good response on our side on reporting, Chief said. I got five cases of natural deaths reported to me last week I wouldn’t normally get. We need to know cause of death in each case. Swabs are taken for Ebola testing  by the community health officer.  There’s been a better response now on testing requests.

Local chiefdom burial teams have been organized and started doing burials under the supervision of official burial teams from the district capital, Moyamba. This includes proper use of personal protective equipment they received a few days ago that’s WHO funded. Teams have to undress and throw the PPE into the grave, chief said, so the supply won’t last for long. The first few burials will be supervised; then local teams are on their own. Bodies won’t be waiting two, three or more days for burial. Or be thrown in the river, as was recently done.

Let’s hope the chiefdom program to stop Ebola results in few Ebola burials to come, and new protective equipment isn’t in demand. So far, so good.

Sherbro Foundation is proud to be supporting Bumpeh Chiefdom in their program to break the chain of Ebola transmission with helping fund the checkpoint teams.

Good News Among All the Bad

There is good news among all the bad news we hear daily on Ebola. It’s important to know there is hope for the future.  Here’s some things I read today.

Treatment – the Cure
To date, there’s not been any Ebola treatment that can be called a specific cure.  Patients can only be treated symptomatically, replacing lost fluids and electrolytes and treating secondary infections.  The body has to develop natural antibodies and fight the Ebola virus on its own.

The World Health Organization, WHO, indicates serum extracted from the blood of Ebola victims who survived the virus could be made available to patients in Liberia in the coming weeks.  Blood serum with its antibodies taken from Ebola survivors has been given to newly infected patients in recent weeks out of desperation and trying possible cures.  Results are now only anecdotal, without enough cases to demonstrate efficacy.  But they’re promising.

Success remains to be seen and can only be proven with greater use.  Blood serum from survivors was used with some success in previous Ebola outbreaks.  With more and more Ebola survivors now, it’s a treatment course that’s definitely feasible to try and may prove to work. Even if it proves to only be partially effective, that could make all the difference for some patients trying to climb their way back to health.

Major drug companies race to produce a vaccine for Ebola and have large quantities of doses ready for humans in 2015.  Johnson & Johnson is said to be leading the pack.  This video is encouraging in hearing J&J Chief Scientific Officer discuss not only J&J’s work, but how drug companies are in communication with each other to ensure their collective work is fast  tracked.

This work won’t help people currently infected with Ebola. But it definitely offers hope for the future for millions of at risk Africans.

Surviving Ebola today

msf 1000th survivor

1000th survivor – from MSF

It’s important to remember that people are surviving Ebola today with supportive care.

Doctors Without Borders celebrated their 1000th survivor in the current Ebola outbreak this week.

The Hastings Treatment Center just outside Freetown is a new one, only opening September 19 and staffed with Sierra Leonean doctors and nurses.  130 patients have been released after successful treatment there. Amidst all the headlines on insufficient numbers of treatment centers and inadequate centers, it’s important to remember many people are being treated and surviving.

Kargboro Chiefdom receives Ebola Prevention Supplies via Sherbro Foundation

Rev Williams load his motorcycle to carry supplies to Shenge

Rev Williams loads his motorcycle to carry Ebola prevention supplies to Shenge

Sherbro Foundation was happy to help former Shenge Peace Corps Volunteer, Ginny Fornillo send Ebola  aid to Kargboro Chiefdom, Moyamba District.  Ginny’s donation allowed Reverend Hubert Williams of Gomer Memorial Church, Shenge, buy hand washing stations to set up in chiefdom public places, as well as disinfectant and soap.

Frequent hand washing with basic soap and water remains an effective first line of defense to prevent Ebola and other diseases like cholera and dysentery.

Reverend Williams loaded up his motorcycle in Freetown to carry supplies back to Shenge.  Shenge is a coastal village at the end of one the worst dirt roads in Sierra Leone. Motorcycles are one of the only means of transportation to still get to Shenge.

Kargboro Chiefdom Ebola Committee ready to distribute hand washing stations

Kargboro Chiefdom Ebola Committee ready to distribute hand washing stations

Kargboro Chiefdom Ebola Committee members distributed hand washing stations and soap to public places in Shenge and surrounding villages.

Kargboro Paramount Chief, Madam Doris Lenga Koroma, sent her thanks and appreciation on behalf of chiefdom residents.

Reverend Williams had to again travel to a place where he could email back a message  with pictures to show that he successfully delivered supplies in Shenge:

” D figures of contacts 4 EBOLA is everyday increasing. I heard of a case few miles 2 Bambuibu, so I have 2 go back immediately 2 go and take care of my family. D entire country we are in a complete confusion and worries.

As 4 request 4 HELP, I am ALWAYS in need at every moment. D people of KARGBORO are also asking 4 more assistance.”

Ebola victims are now fleeing infected cities and towns to the care of family and friends in rural villages.  Family connections run deep, and even remote places like Kargboro Chiefdom are no longer safe from the Ebola virus.

Thanks again to Ginny Fornillo for coming to the aid of Kargboro Chiefdom with supplies to help prevent transmission of the Ebola virus.



Ebola – how life is unnecessarily lost

Oct 4  Sad update to this story: everyone, save three small children, in the three quarantined houses have contracted Ebola and passed away. 14 adults and the 17-yr old girl pictured here. The 3 children have reached the 21 day point with no symptoms, and are being released.

I was shocked to hear that all of Moyamba District was put under an Ebola isolation order last week, and Bumpeh Chiefdom was further isolated within the district. And worried about the welfare of my friends in Bumpeh Chiefdom where Sherbro Foundation does our work.

I soon learned more that shocked me, more than four months into the second and more rapidly growing wave of Ebola in Sierra Leone. My heart aches for these people so far away, and there’s so little we can do from here. But one important action is helping.

After a three-day national shutdown to try to contain Ebola cases, it may have seemed that the cities were starting to get a grip on the deadly virus, which is spread by contact with bodily fluids.

But there’s still no full logistical plan nor Ebola-equipped health care in rural areas –the majority of the country — to manage cases in new Ebola hot spots. What are the practical next steps, when there are so few resources, when there are so many obstacles in a subsistence society?

17-yr old gives birth aloneIsolation and quarantine are the government orders. But with no further plan and coordination of services, avoidable Ebola cases can happen — and more unnecessary deaths.

This 17-year old girl is another kind of Ebola victim.

Pregnant with her first baby and quarantined in a village just outside Rotifunk, she got no prenatal care in her last weeks. When the baby came, she was left to deliver on her own. Even her own mother was afraid to come to assist. The baby was stillborn. The young mother got no assistance to ensure the placenta was fully removed and she had no complications. She remains untended in quarantine.

“If there had been the opportunity of suing the state to court, I should have been the first person to do that,” Rotifunk Ebola task force team leader Ben Alpha’n Mansaray said via Facebook.

“Once you are quarantine, you are sentenced to death. They need care! They need hope!”

About 1.2 million people in the country are now under isolation orders in the Sierra Leone government’s efforts to stop the spread of the disease. Isolation means a cluster of new Ebola cases occurred, requiring a more drastic measure.  People can move around within the isolated area, but no one can come in or go out. Individual homes are quarantined to further isolate new cases.

Alpha Mansaray delivers hand washing stations and Ebola prevention message to villagers.

Alpha Mansaray delivers hand washing stations and Ebola prevention message to villagers.

Quick action by Bumpeh Chiefdom’s Paramount Chief Charles Caulker to quarantine contacts of the first Ebola case in early September has kept the disease contained to a small village on the outskirts of Rotifunk. Rotifunk itself, seat of the chiefdom of 40,000, remains safe.

Ten days ago, the dreaded virus emerged in new cases among the quarantined people. Eight people total have died, and two early cases made it to a treatment center.

Quarantine sounds like a straight-forward measure. You restrict people to their house who may have been exposed, and wait through the 21-day incubation period to see if they develop the disease. But in an impoverished rural area like Rotifunk, the logistics are anything but simple.

They are nightmarish.

  • There’s no local holding center to isolate new Ebola cases from those not sick until they can be carried to a treatment center. In close quarters of a quarantined house, the sick can quickly infect those not sick.
  • The few Ebola treatment centers (only in far-off cities) and ambulance service are beyond overloaded. Rotifunk made repeated calls for five days and got no response. With no Ebola-equipped local health care, the sick are left on their own. No one comes near. The sick only got sicker.  Three died waiting for an ambulance to arrive.  Three others made it to the district capital holding center — two hours to go only 17 miles on a pothole ridden dirt road  — but died waiting for a bed opening up in a treatment center.
  • Inexperienced ambulance teams that did finally appear are fearful even with some protective equipment, and wouldn’t assist Ebola patients into the ambulance. If sick patients could drag themselves 25 feet and climb in on their own, they were taken to a holding center. If not, they were left to die at the quarantine house.  One man died the following day.
  • People in quarantine have great difficulty getting adequate food or daily clean water. These are people who rely on their daily labor to buy their daily food. Some are lucky when family or friends send food. Others are at the mercy of generous local residents.
  • Water is especially important to keep the sick hydrated. When a water container is used in quarantine, it must be considered contaminated. Disposables are unheard of. If the quarantined are near a river, they can collect their own water. If not, they wait for a Good Samaritan to bring water and pour it into their container left outside.
  • Other medical emergencies like malaria, typhoid, maternity cases or increasingly common chronic conditions like hypertension get no care in quarantine – resulting in unnecessary complications or deaths.

When new Ebola cases appear in a quarantined house, the 21-day quarantine clock starts again for those showing no Ebola symptoms.  They could end up in quarantine for five, six or more weeks. When left in the same infected house, their likelihood of getting Ebola only grows.

The central government Health Service orders there be no movement of people under quarantine. Security (army or police) are stationed to enforce this. No safe houses have been provided despite repeated reports of Rotifunk’s situation. Some well people, like this pregnant girl, moved to an outdoor bathhouse (just concrete) in an effort to protect themselves while waiting out the remainder of their quarantine.

Bumpeh Chiefdom’s  isolation order came last week without notice, separating parent from children, farmer from fields needing planting, family from breadwinner who went to market and has the only money or food to feed the others.

When I read of whole villages being decimated by Ebola, I can now better understand why. Quarantine can lead to the sick quickly infecting those not sick with nowhere to go. Villages may self-impose quarantine to isolate the sick. With sick people and no indoor plumbing or easy to access water, houses quickly become filthy. Disease spreads. Mothers delivering babies and small children with malaria get no medical care.

How can this awful situation be improved?  One simple solution is to build temporary makeshift huts and pit latrines as local Ebola holding centers, to separate those becoming sick until they can be moved for treatment. With very minimal funding, these could be locally built. But they’re not forthcoming. Ambulance service calls need to be coordinated, and drivers trained and held accountable for delivering patients.

There is something important we in other countries can do: Help to buy simple hand-washing stations for Bumpeh ChiefdomSherbro Foundation paid for 200 such plastic stations and disinfectant in August. Forty stations were set up in public places around Rotifunk in one week.  160 more followed for chiefdom villages in August.  Chief Caulker said, “These have been very, very effective. You see them constantly in use with people washing their hands throughout the day.”

Chief Caulker would like 200 more hand-washing stations to supply remaining villages. Villagers get Ebola sensitization training and weekly reminders from Rotifunk volunteers on the importance of frequent washing to prevent Ebola and other diseases like cholera, typhoid and dysentery. Behaviors on personal hygiene and sanitation are changing.

Sherbro Foundation works directly with the Bumpeh Chiefdom Ebola task force to quickly send all donated dollars so they can buy these life-saving supplies. Please consider donating right now!  $20 buys one hand-washing station and two bottles of disinfectant.  Donate online here.

Nothing is easy about managing the Ebola outbreak in Sierra Leone. But coordination and common-sense local solutions could help. When coordination between the central Sierra Leone government and rural traditional leaders during emergencies is missing, key opportunities are lost.

Innocent people are the losers when critical decisions aren’t made quickly. It means unnecessary and tragic loss of life.

Paramount Chiefs Now Authorized to Enforce Community Ebola Practices

A systematic way to enforce community Ebola procedures has been missing in Sierra Leone’s Ebola outbreak, enabling the disease to spread around the country. Paramount Chiefs are now authorized by the Sierra Leone government to do this.

The National Council of Paramount Chiefs developed a national template for individual chiefdom byelaws on managing Ebola at the community level.

The “Byelaws on the Prevention of Ebola and other Diseases” were approved by the Honorable Minister of Local Government and Rural Development and made pursuant to the Public Health Emergency declared by the President of the Republic of Sierra Leone and approved by Parliament on Friday 8th August 2014 under section 29 of the Constitution of Sierra Leone Act No. 6 of 1991.

Paramount Chiefs are now expected to adopt these byelaws into their chiefdom byelaws and enforce the provisions.  Beyond imposing fines, chiefdom authorities have the right to pursue legal action in the Local Courts or courts of higher jurisdiction, for flagrant violations of these byelaws.

The Sierra Leone Government had identified many community practices and procedures necessary to stop the spread of Ebola.  But they did not have the ability to uniformly enforce them in all corners of the country, especially once you leave the few provincial cities.

???????????????????????????????Paramount chiefs are a long standing country institution that ensures basic law and order, management of local land rights and maintaining traditional practices. There are 149 chiefdoms that cover every part of the country, with cascading chiefdom authorities down to the village level. But they are an institution separate from the Sierra Leone Government, and were not directly authorized to enforce Ebola practices established by the government.

P.C. Charles Caulker, chair of the National Council of Paramount Chiefs, worked with the NCPC to harmonize byelaws some chiefdoms had started initiating on Ebola. They worked with the Honorable Minister of Local Government and Rural Development to finalize a national document , have it accepted by the Government Cabinet, and then approved by Parliament on August 8.

Paramount chiefs are now expected to introduce and enforce these provisions as chiefdom byelaws.  They include nineteen provisions and authorize chiefs to impose fines of up to Five Hundred Thousand Leones (Le.500, 000) and/or a term of Six (6) months imprisonment for any breach of these provisions.

The provisions include Communication of Ebola, where no one can harbor a person suspected of having contracted Ebola and all strangers arriving in any residential area shall be immediately reported by their host, guest house or hotel to the competent chiefdom authorities.

They continue to Treatment of Ebola  where only personnel part of recognized facilities for the treatment of these diseases can be involved in treatment of any Ebola patient. Provisions for quarantine and receiving recovered Ebola patients back into their communities are given.

Provisions for Death and Burial are defined. Miscellaneous provisions temporarily prohibit public gatherings, including Luma markets and Secret Society activities, and the hunting and selling bush meat. Public places, including those of worship, are encouraged to have hand washing buckets with chlorinated water.

Any chief, including paramount chiefs, found negligent in the application and enforcement of the Bye-laws is liable to a fine of Five Hundred Thousand Leones (Le.500,000) and / or summary suspension from office.

Directly engaging paramount chiefs and authorizing them to enforce community Ebola practices will go a long way to controlling the current outbreak.  This hopefully also represents a new level of working relationship between the government and the country’s traditional leaders.

Nine year-old Caitlin raises money for Ebola prevention

“Just because you can’t do everything doesn’t mean you can’t do something.” Olga Murray, founder of the Nepal Youth Foundation.  Nine year-old Caitlin found something she could do to help fight Ebola in Sierra Leone.

caitlinCaitlin came to me Friday with $18 she earned by making bracelets and selling them in a neighborhood business area.  She kept going until she collected $18 – the cost of one portable hand washing station being used to prevent Ebola transfer in Sierra Leone.

She set up her box of colorful rubber bands in a prominent place in the shopping district and proceeded to braid them into stretchy bracelets for sale. She was selling them for twenty five and fifty cents. When people saw her hand made sign saying she’s selling to help prevent Ebola, some people gave her a dollar.

"All funds go to help build hand sanitizing stations in Sierra Leone."

“All funds go to help build hand sanitizing stations in Sierra Leone.”

When I asked her why she decided to do this, she said she wanted to give kids in Sierra Leone a good place to wash their hands and not get Ebola.  I was touched beyond words.

I stole the above quote from friend Karen. It says so well what we’re doing with Sherbro Foundation. We can’t save the world, but we can do something to help one Sierra Leone community get through the Ebola crisis.

Frequent hand washing is one proven way to stop spread of the Ebola virus. The money we’re sending now goes for public hand washing stations in  Bumpeh Chiefdom in rural Sierra Leone where there is no running water.

Thanks to Caitlin for joining our effort to fight Ebola in Sierra Leone.  Thanks to many others who also joined in with their donations this month. These helped us place one hundred forty public hand washing stations in Bumpeh Chiefdom in the last two weeks.  They’re already being used.

Villagers are also getting an important personalized education on the importance of sanitation and hand washing in preventing disease.  The leader of our Bumpeh Chiefdom partner organization, Rosaline Kaimbay, told me, These hand washing stations are protecting against more than Ebola. It’s raining now. This is the cholera season, too.

The Ebola outbreak is unfortunately growing at the moment.  We will have to maintain these hand washing stations with chlorine bleach or disinfectant for months to come.  You can help.  Click here to donate.