On August 8, 2014, the World Health Organization declared a Public Health Emergency of International Concern. Reports of the rapidly spreading Ebola virus in western Africa convinced WHO’s Emergency Committee to alert the international community of impending danger. However, according to Krista Johnson, an assistant professor at Howard University Graduate School, Ebola’s warning signs were clear long before 2014.
“We certainly didn’t prepare the population to respond to this, but the United States government was doing research on this and had samples,” Johnson said. “It was not as though Ebola was off of the radar. In fact, they were looking to implement programs and have strategies that would combat disease–specifically Ebola and other diseases like that.”
Health professionals originally discovered the Ebola virus in Sudan and the Democratic Republic of the Congo in 1976. They considered it a tropical ailment, similar to the Lassa fever discovered in Nigeria in 1969. WHO estimates that more than 1500 people lost their lives to Ebola between the 1970s and 2012. It was not until the 2014 outbreak that Ebola gained international attention.
Johnson specifically researched the outbreak of Ebola in the Kailahun district of Sierra Leone. With her colleagues, she noted the effects of both the virus and the community and international responses to its dangers.
“When Ebola struck in 2014, Sierra Leone was a country that had recently recovered from an 11-year civil war [and] gone through political transition from a one-party state to the reintroduction of multiparty democracy,” Johnson said. “The healthcare system was very weak and ill-equipped to handle a disease of this nature given its rapid spread throughout the country.”
It is difficult to pinpoint the first case of Ebola in the district, but given its close proximity to both Liberia and Guinea, other key hotspots of Ebola, Johnson stated that Ebola probably arrived in Sierra Leona at about the same time as it appeared in the other countries. Yet, the government was slow to respond.
“Although its believed that Sierra Leone had Ebola cases as early as March of 2014, the government of Sierra Leone only declared a national health emergency at the end of May,” Johnson said. “Its initial plans only focused on quick fixes and not addressing the root causes of the epidemic.”
With a healthcare system left in shambles from a civil war that ended in 2002, the country was faced with a lack of basic supplies to fight the disease. Citizens ignored health measures adopted by the government and avoided treatment centers, believing them to be dangerous.
Despite the adverse situation facing the country, President Koroma remained adamant that Sierra Leone would not “export Ebola” to the international community. The illness became an issue of security, as Koroma called on the military and international organizations for help. He also set up NERC, the National Ebola Response Centre, to fight the illness.
“NERC had United Nations and WHO representatives on its highest level,” Johnson said. “It was largely being run out of the international agencies headquarters, so the response was largely ceded to the international community.”
In contrast, response to Ebola in the Kailahun district was local and swift. Doctors Without Borders helped create volunteer task forces throughout the region to alert officials to new cases and deaths. Leaders in the region quarantined certain villages and temporarily banned traditional social gatherings to stop the spread of the virus.
As a result of these measures, the region became one of the first to successfully beat Ebola. Sierra Leone as a whole was not as lucky. According to data from WHO, nearly 4000 people in the country died from Ebola as of March 2016.
Johnson suggested that the high number of deaths from the outbreak could have been prevented if the government had considered more of the strategies used by the Kailahun district.
“The community response really highlights the importance of democratic participation and respect for human rights,” Johnson said. “It’s a long process in terms of gaining people’s trust and getting people on board in terms of what an effective strategy is going to be, but that’s what is required for people to be informed and to understand.”