Doctors in Port Loko, a northwestern region of Sierra Leone outside Freetown, are reporting a significant drop in the number of mothers bringing their children to hospitals for routine vaccinations. The mothers, they say, fear exposing their children to a resurgent Ebola virus, and in keeping them from hospitals are risking triggering the spread of polio or measles.
Sierra Leone’s largest newspaper, the Awareness Times, cites the head of the region’s Health and Sanitation departments as sounding the alarm on families that appear to be sliding back to traditional ideas about Western medicine–namely, that it cannot be trusted. The official, Mohamed Sesay, tells the newspaper that “fear of Ebola has restricted women not to take their children to the vaccination center in Port Loko.” The vaccination program, run by UNICEF and the World Health Organization, is believed to be pivotal in eradicating diseases like polio and measles from the country.
The Awareness Times adds that this behavior is not just limited to vaccines, but that medical experts are finding patients generally refusing to visit medical professionals when suspecting that they have contracted a disease. “According to the information from the various centers a good number of patients don’t come to hospital when they are sick,” the newspaper reports.
The vaccine panic follows a week of setbacks for Sierra Leone and Guinea, where the number of Ebola cases began to rise just as both were closing in on completing a 21-day window Ebola-free, and thus being declared clear of the disease. Thirty-one new cases were documented two weeks ago in both nations, alarming residents and prompting the government of Sierra Leone to impose curfews on the affected area. “I have instructed the security to institute chiefdom-level curfew and restriction on movement from 6 p.m. to 6 a.m. in Kambia and Port Loko districts, with immediate effect,” President Ernest Koroma announced last week.
The curfew follows reports that at least one dozen Ebola patients have escaped quarantine, fearing medical professionals, and that traditional burials, banned last year due to the risk of spreading Ebola further, have begun to occur again. Traditional burials in Sierra Leone require family members to touch the contaminated bodily fluids of their dead relatives.
Doctors Without Borders head Joanne Liu has warned this week that medical professionals and the international community “are still making the same mistakes as we did in the past” regarding ensuring the trust of Ebola-afflicted communities. “We know now that engaging the community in the response is essential, but we also know that leadership at the government level … is absolutely essential,” she explained, not citing any government in particular, though believed to be a reference to Guinea.
Community outreach is essential in areas where Western-style medical doctors enjoy significantly less public trust than traditional herbalists, whose methods have contributed to the spread of disease in the past. Not only did many refuse to seek professional treatment for their disease when exhibiting Ebola symptoms, doctors struggled to convince locals that Ebola actually existed and was not a population control plot by the West.
Before this second wave of Ebola, Sierra Leone had begun showing signs of recovery, particularly in its economy. A study conducted with World Bank support found that employment in the nation had finally returned to pre-Ebola levels, even in densely populated Freetown. Salaries remained low, however, as businesses struggle to recover, but–perhaps the best sign for recovery in the study– the number of households willing to trust a hospital for medical services increased significantly.