Ebola crisis: Major concern in Sierra Leone as transmission remains high

Catherine Meredith, Ebola Response Communications Coordinator in West Africa, shares here the latest Oxfam Ebola response update, from 6 January 2015.

Crisis overview

This week the total number of Ebola cases has passed 20,000. Although overall the epidemic seems to have stabilized, the large number of new cases in Sierra Leone is a major concern. Transmission remains high, especially in Freetown and the Western Area, where a government led surge in searching for Ebola cases has been in place over the Christmas and New Year period along with a lock down on public gatherings and travel. Oxfam has supported the surge through our community health committees and construction of two new Ebola community care centers which are soon to be opened.

Key figures:

  • Oxfam has directly reached over 1.1 million people, through making house to house visits to raise to raise awareness about Ebola and other activities.
  • We've distributed 14,525 hygiene kits to individual households.
  • We've supported 35 health facilities, providing water and sanitation facilities in nine health facilities in Sierra Leone and four in Liberia, as well as providing clinical hygiene equipment for 18 health units.

Handwashing training, Claratown, Liberia. Photo: Pablo Tosco/Oxfam

Sierra Leone

There have been 9,633 Ebola cases reported and 2,877 deaths. The epidemic is most concentrated in three districts where Oxfam is working, Bombali, Port Loko and the Western Area, which includes the capital Freetown.

  • We've opened Masiaka community care center in Port Loko the first open of four centers Oxfam is constructing. The center is being managed by the International Rescue Committee.


There have been 8,018 Ebola cases reported and 3,423 deaths. Case numbers have been decreasing but a surge in new cases has been reported from Grand Cape Mount in Western Liberia. The other remaining hotspot areas are in and around the capital Monrovia.

  • Oxfam's active case finding is identifying up to a third of all new Ebola cases in the country and up to half of all Ebola cases identified around Monrovia. 30 suspected Ebola patients were referred by Oxfam in three weeks of December.
  • Our engineering team is focusing on drilling boreholes in Monrovia to provide clean water for communities and health facilities. This will help in the safe treatment of Ebola patients and provide for the long term.
  • Schools are scheduled to re-open in March. Oxfam is working to improve water and sanitation facilities in selected schools to make for a safer environment, before they reopen.


  • 2, 730 cases of Ebola and 1,739 deaths. Case incidence is fluctuating, transmission persists in the capital Conakry.

Mali, Senegal, Gambia and Guinea Bissau

There have been no new cases of Ebola in Mali since 6 December. Oxfam is working with young people to raise awareness about Ebola in communities and schools. We have distributed hygiene kits to 109 schools. In the at risk countries of Senegal, Gambia and Guinea Bissau Oxfam and partners are disseminating messages about Ebola via radio stations, through posters, text messages, hygiene kit distribution and door-to-door outreach.

Fatimata, at Lakka Ebola treatment center, Sierra Leone. Photo: Pablo Tosco/Oxfam


Stronger leadership and coordination of the international response is needed to ensure there is no duplication of efforts and that actors are working together effectively. Quarantined communities we work with in Liberia and Sierra Leone have reported that they are not receiving food or not enough food. Access to non-Ebola healthcare services, water and hygiene are further major concerns.

Oxfam is advocating on these issues; we have also distributed hygiene kits to quarantined communities and we are improving water supplies and sanitation in affected communities. The lack of bed capacity for Ebola patients in some locations, and the spread of the disease into hard-to-reach areas, raise further challenges. We are establishing rapid response teams to help control any new outbreaks anywhere in Liberia or Sierra Leone.

Community led mobilization

Barriers to overcoming the epidemic include stigma around Ebola, misconceptions, denial and traditional burial practices. We're working with influential community representatives, youth, religious leaders, midwives, chiefs and others to help improve understanding. In Sierra Leone our community health committees are selected by their community to lead the efforts to combat Ebola, they develop action plans for the specific barriers to stopping the spread of Ebola in their neighborhood. Around Freetown 120 committees are reaching out to 400 households each. The committees will also roll out an emergency interim care initiative to provide rapid rehydration for probable Ebola patients.

Oxfam’s Ebola response is focused on preventing the spread of the disease and supporting medical facilities with water, sanitation, cleaning equipment and protective clothing. We are aiming to spend $43mn (£28mn) in Sierra Leone, Liberia, Mali, Gambia, Guinea Bissau and Senegal to help over 3.2 million people at risk of catching the disease. So far, Oxfam has reached over 1 million beneficiaries in Liberia and Sierra Leone. For updates, follow @Oxfam.

Photos 1 and 3: Lakka Ebola treatment center - where people from the suburbs of Freetown come to seek testing and treatment. For each patient the center requires about 250 liters of water per day, with differing concentrations of chlorine depending on the use.

Photo 2: Handwashing training, Claratown, Liberia.

All photos: Pablo Tosco/Oxfam

What you can do now

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