Kenema/Freetown — We set off by jeep from the capital Freetown for Kenema, 240km away. While there are Stop Ebola posters all over the capital, we see very few en route. Every 15 minutes or so we're stopped at an Ebola monitoring checkpoint to have our temperatures taken and to wash our hands in chlorinated water. Thirteen in all - it's enough to make anyone paranoid.
Six Ebola-hit districts, including Kailahun, Kenema, Port Loko, Bombali, Mayambo and parts of Freetown, are "isolated" across the country, meaning locals need a special pass to leave them, and houses with confirmed Ebola cases are cordoned off, their inhabitants instructed not to leave unless they are sick. In those cases they must wait for an ambulance to take them to the nearest Ebola clinic.
The "isolation" followed a three-day government lock-down, in which all six million citizens were ordered to stay at home while contact tracers went to as many households as they could reach to identify the sick, and body collectors tried to gather up the dead: they brought in 300 corpses in total, according to the Ministry of Health. Another lock-down is being considered in coming days. Some international organizations were quietly dubious about the lock-down, fearing it would lead to mounting distrust among locals of health workers, but many say it has been a success.
Suafiatu Tunis, a volunteer community activist from Freetown, who has been travelling with a team from district to district to spread prevention and treatment messages, told IRIN: "The shift in attitude came after the three-day lockdown. That was the best idea that the Sierra Leone government initiated on its own." The lock-down was accompanied by intensive radio messaging - the primary source of information for 75 percent of Sierra Leoneans - and she said it helped to raise consciousness of the disease. "Before, when I went to villages, people said "no thanks". Now it's changing. People are listening. They are Ebola-aware."
She is one of the few women to go house and house and it makes a difference as women open up to her. They converse in local languages - Mende, Temne, Fular and Kriol - and people ask questions. In a village in Blama District that day a woman asked if survivors could transmit the disease (no), and how to disinfect the house if someone has it. Often it is as simple as showing a map of how Ebola is spreading across the region for them to put it into context.
The lock-down, of course, had an economic impact. Families trapped at home with little warning were unable to stock up on sufficient food to last three weeks, and in a country where over half of the population lives under the national poverty line, they could not afford to buy that quantity of food anyway. (The World Food Programme has been delivering food to quarantined neighbourhoods in the capital Freetown, Bombali District and Port Loko, and will begin in Kenema and Kailahun this week.)
Motorbike taxi drivers (known as Okada drivers) complain that the reduced trade means they bring in 25 percent per day of what they used to, now amounting to US$3 on average. The streets of Mayumbo are deserted as no one has been able to practice petty trade. Lavennta Konneh, a contact tracer working with the UN Population Fund (UNFPA) and the government, is one of the few individuals permitted to leave her house. "There is no business now. Our parents usually sell. Now vehicles can't even stop. Soldiers don't allow anyone out." As she was talking, a military officer positioned nearby asked us to drive on.
UNICEF's water, sanitation and hygiene manager, Patrick Okorth, said it is particularly difficult for communities that do not have ready access to clean water: which is the case for 60 percent of rural residents and most of Freetown's slum areas. In some areas people have to wrangle with police to pass through the barrier in order to reach a safe water source. Behaviour change messaging calling on people to wash hands with soap or chlorinated water as often as possible only works if soap and water is available.
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