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{{Short description|none}}
{{Use dmy dates|date=July 2022}}
{{Infobox pandemic
| name = Ebola virus epidemic in Sierra Leone
| map1 = ]
| legend1 = Map of ]
| map2 = File:Sierra Leone sat.png
| legend2 = Cropped satellite view of S. Leone
| disease = Ebola virus
| virus_strain =
| deaths = 3,955
| confirmed_cases = 14,061 <small>({{As of |2015|10|25|lc=y}})</small><ref name="WHO2015_10_28">{{cite web|url=http://apps.who.int/iris/bitstream/10665/191299/1/ebolasitrep_28Oct2015_eng.pdf?ua=1|title=Ebola Situation Report – 28 October 2015 |publisher=World Health Organisation |date=28 October 2015 |access-date=30 October 2015}}</ref>
| suspected_cases =
| total_ili =
| website =
}}

An '''Ebola virus epidemic in Sierra Leone''' occurred in 2014, along with the neighbouring countries of ] and ]. At the time it was discovered, it was thought that Ebola virus was not ] to Sierra Leone or to the West African region and that the epidemic represented the first time the virus was discovered there.<ref>{{Cite journal |doi=10.1056/NEJMoa1411100|pmid=25244186|pmc=4235004|title=Ebola Virus Disease in West Africa — the First 9 Months of the Epidemic and Forward Projections|journal=New England Journal of Medicine|volume=371|issue=16|pages=1481–1495|year=2014|author1=WHO Ebola Response Team|last2=Aylward|first2=B|last3=Barboza|first3=P|last4=Bawo|first4=L|last5=Bertherat|first5=E|last6=Bilivogui|first6=P|last7=Blake|first7=I|last8=Brennan|first8=R|last9=Briand|first9=S |author-link9=Sylvie Briand |last10=Chakauya|first10=J. M|last11=Chitala|first11=K|last12=Conteh|first12=R. M|last13=Cori|first13=A|last14=Croisier|first14=A|last15=Dangou|first15=J. M|last16=Diallo|first16=B|last17=Donnelly|first17=C. A|last18=Dye|first18=C|last19=Eckmanns|first19=T|last20=Ferguson|first20=N. M|last21=Formenty|first21=P|last22=Fuhrer|first22=C|last23=Fukuda|first23=K|last24=Garske|first24=T|last25=Gasasira|first25=A|last26=Gbanyan|first26=S|last27=Graaff|first27=P|last28=Heleze|first28=E|last29=Jambai|first29=A|last30=Jombart|first30=T|display-authors=29}}</ref> However, US researchers pointed to lab samples used for Lassa fever testing to suggest that Ebola had been in Sierra Leone as early as 2006.<ref name="EurekAlert!"/>

==History of Ebola in Sierra Leone==
{{Ebola virus disease epidemic}} {{Ebola virus disease epidemic}}
In 2014, it was discovered that samples of suspected ] showed evidence of the Zaire strain of Ebola virus in Sierra Leone as early as 2006.<ref name="EurekAlert!">{{cite web|url=http://www.eurekalert.org/pub_releases/2014-07/uamr-sls071414.php|title=Sierra Leone samples: Ebola evidence in West Africa in 2006|date=14 July 2014|website=EurekAlert!|access-date=7 October 2014}}</ref> Prior to the current Zaire strain outbreak in 2014, Ebola had not really been seen in Sierra Leone, or even in West Africa among humans.<ref name="EurekAlert!"/> It is suspected that fruit bats are natural carriers of disease, native to this region of Africa including Sierra Leone and also a popular food source for both humans and wildlife.<ref name="EurekAlert!"/> The Gola forests in south-east Sierra Leone are a noted source of bushmeat.<ref>{{Cite book|chapter=Hunting and Trapping in Gola Forests, South-Eastern Sierra Leone: Bushmeat from Farm, Fallow and Forest|doi=10.1002/9780470692592.ch1|title=Bushmeat and Livelihoods: Wildlife Management and Poverty Reduction|pages=15–31|year = 2008|last1 = Davies|first1 = Glyn|last2=Schulte-Herbrüggen|first2=Björn|last3=Kümpel|first3=Noëlle F|last4=Mendelson|first4=Samantha|isbn=9780470692592}}</ref>
An ] of ] (EVD) is currently afflicting the ] nation of ]. By 2 October 2014, it was estimated 5 people an hour were being infected with the Ebola virus in Sierra Leone alone.<ref>{{cite web|url=http://www.theguardian.com/world/2014/oct/02/ebola-infecting-five-every-hour-sierra-leone|title=Ebola infecting five new people every hour in Sierra Leone, figures show|author=Matthew Weaver|work=the Guardian|accessdate=4 October 2014}}</ref> The number of infected has been doubling every 20 days.<ref>{{cite web|url=http://stanfordlawyer.law.stanford.edu/2014/10/ebola-the-tolling-bell/|title=Ebola: The Tolling Bell|publisher=|accessdate=6 October 2014}}</ref> Ebola virus is not ] to Sierra Leone or to the West Africa region and this epidemic represents the first time the virus has been discovered there.<ref>WHO Ebola Response Team. Ebola Virus Disease in West Africa — The First 9 Months of the Epidemic and Forward Projections. New England Journal of Medicine. September 23, 2014DOI: 10.1056/NEJMoa1411100</ref>


]
Bats are known to be carriers of at least 90 different viruses that can make transition to a human host.<ref name="cbsnews.com">{{cite news|url=http://www.cbsnews.com/news/bat-soup-blamed-as-deadly-ebola-virus-spreads/|title=Bat soup blamed as deadly Ebola virus spreads|date=27 March 2014|access-date=7 October 2014|work=CBS News}}</ref> However, the virus has different symptoms in humans.<ref name="cbsnews.com"/> It takes one to ten viruses to infect a human but there can be millions in a drop of blood from someone very sick from the disease.<ref>{{cite web|url=http://jid.oxfordjournals.org/content/early/2011/05/12/infdis.jir077.full|archive-url=https://archive.today/20141006005953/http://jid.oxfordjournals.org/content/early/2011/05/12/infdis.jir077.full|url-status=dead|archive-date=6 October 2014|title=Replication, Pathogenicity, Shedding, and Transmission of Zaire ebolavirus in Pigs|journal=The Journal of Infectious Diseases|volume=204|issue=2|pages=200–208|access-date=7 October 2014|doi=10.1093/infdis/jir077|pmid=21571728|year=2011|author1-link=Gary Kobinger|last1=Kobinger|first1=Gary P.|last2=Leung|first2=Anders|last3=Neufeld|first3=James|last4=Richardson|first4=Jason S.|last5=Falzarano|first5=Darryl|last6=Smith|first6=Greg|last7=Tierney|first7=Kevin|last8=Patel|first8=Ami|last9=Weingartl|first9=Hana M.}}</ref><ref>{{cite web|url=http://www.phac-aspc.gc.ca/lab-bio/res/psds-ftss/ebola-eng.php|title=Pathogen Safety Data Sheet – Infectious Substances|access-date=7 October 2014|date=17 September 2001}}</ref>
Transmission is believed to be by contact with the blood and body fluids of those infected with the virus, as well as by handling raw bushmeat such as bats and monkeys, which are important sources of protein in West Africa. Infectious body fluids include blood, sweat, semen, breast milk, saliva, tears, feces, urine, vaginal secretions, vomit, and diarrhea.<ref>{{Cite journal|last1=Bausch|first1=DG|last2=Towner|first2=JS|last3=Dowell|first3=SF|last4=Kaducu|first4=F|last5=Lukwiya|first5=M|last6=Sanchez|first6=A|last7=Nichol|first7=ST|last8=Ksiazek|first8=TG|last9=Rollin|first9=PE|date=November 2007|title=Assessment of the Risk of Ebola Virus Transmission from Bodily Fluids and Fomites|journal=The Journal of Infectious Diseases|volume=196|pages=S142–S147|doi=10.1086/520545|pmid=17940942|doi-access=free}}</ref>


Even after a successful recovery from an Ebola infection, semen may contain the virus for at least two months.<ref>{{cite web|url=http://www.livescience.com/47218-ebola-transmission-routes.html|title=Can You Get Ebola from Sex?|website=LiveScience.com|date=6 August 2014 |access-date=30 September 2014}}</ref> Breast milk may contain the virus for two weeks after recovery, and transmission of the disease to a consumer of the breast milk may be possible.<ref>{{cite web|url=http://jid.oxfordjournals.org/content/196/Supplement_2/S142.full|archive-url=https://web.archive.org/web/20140703120827/http://jid.oxfordjournals.org/content/196/Supplement_2/S142.full|url-status=dead|archive-date=3 July 2014|title=Assessment of the Risk of Ebola Virus Transmission from Bodily Fluids and Fomites|first=Daniel G.|last=Bausch|access-date=4 October 2014}}</ref> By October 2014, it was suspected that handling a piece of contaminated paper may be enough to contract the disease.<ref name="The Huffington Post">{{cite news|url=http://www.huffingtonpost.com/2014/10/03/ebola-west-africa-underestimated_n_5926634.html|title=Ebola Toll In West Africa Is Likely Hugely Underestimated|date=3 October 2014|work=The Huffington Post|access-date=4 October 2014}}</ref> Contamination on paper makes it harder to keep records in Ebola clinics, as data about patients written on paper that gets written down in a "hot" zone is hard to pass to a "safe" zone, because if there is any contamination it may bring Ebola into that area.<ref name="The Huffington Post"/>


One aspect of Sierra Leone that is alleged to have aided the disease, is the strong desire of many to have very involved funeral practices.<ref name="dailynews.com">{{cite web|url=http://www.dailynews.com/health/20141013/some-people-would-rather-die-of-ebola-than-stop-hugging-sick-loved-ones|title=Some people would rather die of Ebola than stop hugging sick loved ones|website=] |date=13 October 2014}}</ref> For example, for the ] who inhabit part of Sierra Leone, it is important to bury the bodies of the dead near them.<ref name="dailynews.com"/> Funeral practices include rubbing the corpses down with oil, dressing them in fine clothes, then having those at the funeral hug and kiss the dead body.<ref name="dailynews.com"/> This may aid the transmission of Ebola, because those that die from Ebola disease are thought to have high concentrations of the virus in their body, even after they have died.<ref name="dailynews.com"/>
===Spring 2014: Early cases===
In late March there were suspected but not confirmed cases in Sierra Leone.<ref>{{cite news | url = http://www.bbc.com/news/world-africa-26816438 |title=Ebola: Liberia confirms cases, Senegal shuts border |publisher = BBC News |date=31 March 2014}}</ref> However, the government announced on 31 March 2014 that there were no cases in Sierra Leone.<ref>{{cite web|url=http://news.sl/drwebsite/publish/article_200525069.shtml|title=Sierra Leone News: "No Ebola Virus in Sierra Leone" Health Minister assures|publisher=|accessdate=7 October 2014}}</ref>


For the 2001 outbreak of Sudan virus in Uganda, attending a funeral of an Ebola victim was rated by the Centers for Disease Control and Prevention (CDC) as one of the top three risk factors for contracting Ebola, along with contact with a family member with Ebola or providing medical care to someone with a case of Ebola virus disease.<ref>{{cite web|url=https://www.cdc.gov/vhf/ebola/outbreaks/history/chronology.html|title=Outbreaks Chronology: Ebola Virus Disease|date=17 July 2019}}</ref> The main start of the outbreak in Sierra Leone was linked to a single funeral in which the ] (WHO) estimates as many as 365 died from Ebola disease after getting the disease at the funeral.<ref name="who.int">{{Cite web|url=https://www.who.int/csr/disease/ebola/ebola-6-months/sierra-leone/en/|archive-url=https://web.archive.org/web/20140925090337/http://www.who.int/csr/disease/ebola/ebola-6-months/sierra-leone/en/|url-status=dead|archive-date=25 September 2014|title=WHO &#124; Sierra Leone: a traditional healer and a funeral|website=WHO}}</ref>
In April Gambia banned flights from Sierra Leone.<ref name="Business Day Live">{{cite web|url=http://www.bdlive.co.za/africa/africannews/2014/04/16/gambia-bans-flights-from-ebola-hit-countries|title=Gambia bans flights from Ebola-hit countries|work=Business Day Live|accessdate=7 October 2014}}</ref>


Bushmeat has also been implicated in spreading Ebola disease, either by handling the raw meat or through droppings from the animals.<ref>{{cite web|url=http://blog.cifor.org/23924/ebola-and-bushmeat-in-africa-qa-with-leading-researcher|title= Ebola and bushmeat in Africa: Q&A with leading researcher|date=2 September 2014|website=CIFOR Forests News Blog}}</ref> It is the raw blood and meat that is thought to be more dangerous, so it is those that hunt and butcher the raw meat that are more at risk as opposed to cooked meat sold at market.<ref>{{cite news|url=https://www.bbc.com/news/health-29604204|title=Ebola: Is bushmeat behind the outbreak?|date=19 October 2014|last1=Hogenboom|first1=Melissa}}</ref> Health care workers in Sierra Leone have been warned not to go to markets.<ref>{{cite web|url=https://www.theguardian.com/commentisfree/2014/oct/20/volunteered-fight-ebola-sierra-leone-msf|title=I volunteered to fight Ebola in Sierra Leone with MSF. Here's what happened|first=Natasha|last=Lewer|website=the Guardian|date=20 October 2014 }}</ref>
The epidemic is thought to have started in late May when 14 people returned from a funeral of a traditional healer, who had been trying to cure others with Ebola in ].<ref>{{cite web|url=http://www.nih.gov/researchmatters/september2014/09152014ebola.htm|title=Genetics of the 2014 Ebola Outbreak|publisher=|accessdate=30 September 2014}}</ref>
The first person reported infected was a ]. She had treated an infected person(s) and died on 26 May. According to tribal tradition, her body was washed for burial and this appears to have led to infections in women from neighboring towns.<ref name="Fox News">{{cite web | url=http://www.foxnews.com/health/2014/08/25/sierra-leone-hero-doctor-death-exposes-slow-ebola-response/ | title=Sierra Leone 'hero' doctor's death exposes slow Ebola response | publisher=Fox News | work=Sierra Leone 'hero' doctor's death exposes slow Ebola response | date=25 August 2014 | accessdate=25 August 2014}}</ref>


==2014: Outbreak started==
By 27 May 2014 it was reported 5 people died from the Ebola virus and there were 16 new cases of the disease.<ref>{{cite web|url=http://www.reuters.com/article/2014/05/26/us-ebola-leone-idUSKBN0E614G20140526|title= Five dead as Sierra Leone records first Ebola outbreak|work=Reuters|accessdate=30 September 2014}}</ref><ref>{{cite web|url=http://www.cidrap.umn.edu/news-perspective/2014/05/ebola-expands-guinea-sickens-more-sierra-leone|title=Ebola expands in Guinea, sickens more in Sierra Leone|work=CIDRAP|accessdate=7 October 2014}}</ref> Between 27 May 2014 and 30 May the number of confirmed, probable, or suspected cases of Ebola went from 16 to 50.<ref>{{cite web|url=http://www.cidrap.umn.edu/news-perspective/2014/05/ebola-cases-sierra-leone-triple-50|title=Ebola cases in Sierra Leone triple, to 50|work=CIDRAP|accessdate=7 October 2014}}</ref> By 9 June, the number cases had risen to 42 known and 113 being tested, with a total of 16 known to have died from the disease by that time.<ref>{{cite web|url=http://www.bbc.com/news/world-africa-27774233|title=Sierra Leone ebola death toll 'doubles to 12 in a week'|work=BBC News|accessdate=7 October 2014}}</ref>
{{Main|West African Ebola virus epidemic}}
In late March 2014, there were suspected but not confirmed cases in Sierra Leone.<ref>{{cite news | url = https://www.bbc.com/news/world-africa-26816438 |title=Ebola: Liberia confirms cases, Senegal shuts border |work = BBC News |date=31 March 2014}}</ref> The government announced on 31 March 2014, that there were no cases in Sierra Leone.<ref>{{cite web|url=http://news.sl/drwebsite/publish/article_200525069.shtml|title=Sierra Leone News: "No Ebola Virus in Sierra Leone" Health Minister assures|access-date=7 October 2014|url-status=dead|archive-url=https://web.archive.org/web/20141009204435/http://news.sl/drwebsite/publish/article_200525069.shtml|archive-date=9 October 2014}}</ref> Cases initially started appearing soon after the arrival of US researchers into the area. "After Ebola was first confirmed by laboratory tests in mid-March 2014, persistent rumours in the region linked the outbreak to a US-run research laboratory in Kenema, Sierra Leone ."<ref>{{cite web |url=https://www.independentsciencenews.org/health/did-west-africas-ebola-outbreak-of-2014-have-a-lab-origin/ |title=Did West Africa's Ebola Outbreak of 2014 Have a Lab Origin? |website =Independent Science News|date=25 October 2022}}</ref>


===Summer 2014: Continued growth, Khan dies=== ===Spring 2014: Early cases===
]; some values are interpolated.]]
].<ref name="Fox News"/> (shown highlighted on map)]]
Two U.S. doctors who "followed all CDC and WHO protocols to the letter" contracted Ebola, and it is not clear how they got infected.<ref>{{cite web|url=http://www.nbcnews.com/storyline/ebola-virus-outbreak/two-americans-stricken-deadly-ebola-virus-liberia-n166281|title=Two Americans Stricken With Deadly Ebola Virus in Liberia|author=Maggie Fox|website=NBC News|date=28 July 2014 |access-date=1 October 2014}}</ref>
On 12 June the country declared a state of emergency in the ], where it announced the closure of schools, cinemas, and nightlife places; the district borders both Guinea and Liberia, and all vehicles would be subject to screening at checkpoints.<ref>{{cite web|url=http://www.voanews.com/content/sierra-leone-declares-emergency-as-ebola-spreads/1935261.html|title=Sierra Leone Declares Emergency as Ebola Spreads|work=VOA|accessdate=7 October 2014}}</ref><ref name="uk.reuters.com">{{cite web|url=http://uk.reuters.com/article/2014/06/11/us-health-ebola-leone-idUKKBN0EM2CG20140611|title=Sierra Leone shuts borders, closes schools to fight Ebola|publisher=|accessdate=30 September 2014}}</ref> The government declared on 11 June that its country's borders would be closed to Guinea and Liberia; but many local people cross the borders on unofficial routes which are difficult for authorities to control.<ref>{{cite book|title=Sierra Leone|author=Katrina Manson, James Knight|publisher=Bradt Travel Guides|year=2009}}, page 275</ref><ref>{{cite web|url=http://www.theguardian.com/society/2014/aug/09/ebola-guinea-sierra-leone-liberia|title=Ebola crisis: Guinea closes borders with Sierra Leone and Liberia|publisher=theguardian.com|date=9 August 2014|accessdate=13 October 2014}}</ref> Seasonal rains that fall between June and August interfered with the fight against Ebola, and in some cases caused flooding in Sierra Leone.<ref>{{cite web|url=http://www.newsweek.com/ebola-frontline-flooding-sierra-leone-exacerbates-public-health-fears-263867|title=Ebola Frontline: Flooding in Sierra Leone Exacerbates Public Health Fears|publisher=|accessdate=7 October 2014}}</ref>

By 27 May 2014, it was reported 5 people died from the Ebola virus and there were 16 new cases of the disease.<ref>{{cite news|url=https://www.reuters.com/article/us-ebola-leone-idUSKBN0E614G20140526|title= Five dead as Sierra Leone records first Ebola outbreak|work=Reuters|access-date=30 September 2014|date=26 May 2014}}</ref><ref>{{cite web|url=http://www.cidrap.umn.edu/news-perspective/2014/05/ebola-expands-guinea-sickens-more-sierra-leone|title=Ebola expands in Guinea, sickens more in Sierra Leone|website=CIDRAP|date=28 May 2014 |access-date=7 October 2014}}</ref> Between 27 May 2014, and 30 May the number of confirmed, probable, or suspected cases of Ebola went from 16 to 50.<ref>{{cite web|url=http://www.cidrap.umn.edu/news-perspective/2014/05/ebola-cases-sierra-leone-triple-50|title=Ebola cases in Sierra Leone triple, to 50|website=CIDRAP|date=30 May 2014 |access-date=7 October 2014}}</ref> By 9 June, the number of cases had risen to 42 known and 113 being tested, with a total of 16 known to have died from the disease by that time.<ref>{{cite news|url=https://www.bbc.com/news/world-africa-27774233|title=Sierra Leone ebola death toll 'doubles to 12 in a week'|access-date=7 October 2014|date=9 June 2014}}</ref>

The disease spread rapidly in Kenema, and the local government hospital was overwhelmed.<ref name="who.int"/> At that hospital, 12 nurses died despite having the world's only Lassa fever isolation ward, according to the U.N.<ref name="who.int"/> Many health are workers were infected at the state hospital, including beloved physician and hemorrhagic fever expert, Dr. Sheik Humarr Khan, and chief nurse Mbalu Fonnie. Khan and his colleagues had bravely provided care to patients with this devastating illness. <ref>{{cite journal| title=A tribute to Sheik Humarr Khan and all the healthcare workers in West Africa who have sacrificed in the fight against Ebola virus disease: Mae we hush|journal=Antiviral Research|pages=33–35| date=November 2014| doi=10.1016/j.antiviral.2014.09.001| last1=Bausch| first1=Daniel G.| last2=Bangura| first2=James| last3=Garry| first3=Robert F.| last4=Goba| first4=Augustine| last5=Grant| first5=Donald S.| last6=Jacquerioz| first6=Frederique A.| last7=McLellan| first7=Susan L.| last8=Jalloh| first8=Simbirie| last9=Moses| first9=Lina M.| last10=Schieffelin| first10=John S.| volume=111| pmid=25196533| doi-access=free}}</ref>


===Summer 2014: Continued growth, Dr. Khan dies===
By July 11, 2014 the first case was reported in the capital of Sierra Leone, Freetown, however the person had travel to the capital from another area of the country.<ref name="Bloomberg">{{cite web|url=http://www.bloomberg.com/news/2014-07-12/ebola-spreads-to-sierra-leone-capital-of-freetown-as-deaths-rise.html|title=Ebola Spreads to Sierra Leone Capital of Freetown as Deaths Rise|date=12 July 2014|work=Bloomberg|accessdate=7 October 2014}}</ref> By this time there were over 300 confirmed cases and 99 were confirmed to have died from Ebola.<ref name="Bloomberg"/> There was another case before the end of the month.<ref name="Yahoo News">{{cite web|url=http://news.yahoo.com/first-ebola-victim-sierra-leone-capital-170621902.html|title=First Ebola victim in Sierra Leone capital|date=27 July 2014|work=Yahoo News|accessdate=7 October 2014}}</ref>
], samples were tested for Ebola. (Shown in June 2014)]]
On 12 June, the country declared a state of emergency in the ], where it announced the closure of schools, cinemas, and nightlife places; the district borders both Guinea and Liberia, and all vehicles would be subject to screening at checkpoints.<ref>{{cite web|url=http://www.voanews.com/content/sierra-leone-declares-emergency-as-ebola-spreads/1935261.html|title=Sierra Leone Declares Emergency as Ebola Spreads|website=VOA|date=12 June 2014 |access-date=7 October 2014}}</ref><ref name="uk.reuters.com">{{cite news|url=http://uk.reuters.com/article/us-health-ebola-leone-idUKKBN0EM2CG20140611|archive-url=https://web.archive.org/web/20160124121545/http://uk.reuters.com/article/us-health-ebola-leone-idUKKBN0EM2CG20140611|url-status=dead|archive-date=24 January 2016|title=Sierra Leone shuts borders, closes schools to fight Ebola|access-date=30 September 2014|work=Reuters|date=11 June 2014}}</ref> The government declared on 11 June, that its country's borders would be closed to Guinea and Liberia; but many local people cross the borders on unofficial routes which were difficult for authorities to control.<ref>{{cite book|title=Sierra Leone|author1=Katrina Manson |author2=James Knight |publisher=Bradt Travel Guides|year=2009|page=275}}</ref><ref>{{cite web|url=https://www.theguardian.com/society/2014/aug/09/ebola-guinea-sierra-leone-liberia|title=Ebola crisis: Guinea closes borders with Sierra Leone and Liberia|publisher=theguardian.com|date=9 August 2014|access-date=13 October 2014}}</ref> Seasonal rains that fall between June and August interfered with the fight against Ebola, and in some cases caused flooding in Sierra Leone.<ref>{{cite web|url=http://www.newsweek.com/ebola-frontline-flooding-sierra-leone-exacerbates-public-health-fears-263867|title=Ebola Frontline: Flooding in Sierra Leone Exacerbates Public Health Fears|website=] |access-date=7 October 2014|date=11 August 2014}}</ref>


By 11 July 2014, the first case was reported in the capital of Sierra Leone, Freetown, however the person had traveled to the capital from another area of the country.<ref name="Bloomberg">{{cite news|url=https://www.bloomberg.com/news/2014-07-12/ebola-spreads-to-sierra-leone-capital-of-freetown-as-deaths-rise.html|title=Ebola Spreads to Sierra Leone Capital of Freetown as Deaths Rise|date=12 July 2014|work=Bloomberg|access-date=7 October 2014|first=Silas|last=Gbandia}}</ref> By this time there were over 300 confirmed cases and 99 were confirmed to have died from Ebola.<ref name="Bloomberg"/> There was another case before the end of the month.<ref name="Yahoo News">{{cite web|url=https://news.yahoo.com/first-ebola-victim-sierra-leone-capital-170621902.html|title=First Ebola victim in Sierra Leone capital|date=27 July 2014|website=Yahoo News|access-date=7 October 2014}}</ref>
On 29 July, well-known physician ], Sierra Leone's only expert on hemorrhagic fever, died after contacting Ebola at his clinic in ]. Khan had long worked with ], a disease that kills over 5,000 a year in Africa. He had expanded his clinic to accept Ebola patients. Sierra Leone's President, Ernest Bai Koroma, celebrated Khan as a "national hero".<ref name="Fox News"/>


On 30 July, it declared a state of emergency and deployed troops to quarantine hot spots.<ref>{{cite news | url= http://www.news24.com/Africa/News/Sierra-Leone-Liberia-deploy-troops-for-Ebola-20140804 |title=Sierra Leone, Liberia deploy troops for Ebola = News 24 |date=4 August 2014}}</ref> On 29 July, well-known physician ], Sierra Leone's only expert on hemorrhagic fever, died after contracting Ebola at his clinic in ]. Khan had long worked with ], a disease that kills over 5,000 a year in Africa. He had expanded his clinic to accept Ebola patients. Sierra Leone's president, Ernest Bai Koroma, celebrated Khan as a "national hero".<ref name="Fox News">{{cite news | url=https://www.foxnews.com/health/sierra-leone-hero-doctors-death-exposes-slow-ebola-response/ | title=Sierra Leone 'hero' doctor's death exposes slow Ebola response | publisher=Fox News | date=25 August 2014 | access-date=25 August 2014}}</ref> On 30 July, Sierra Leone declared a state of emergency and deployed troops to quarantine hot spots.<ref>{{cite news | url= http://www.news24.com/Africa/News/Sierra-Leone-Liberia-deploy-troops-for-Ebola-20140804 |title=Sierra Leone, Liberia deploy troops for Ebola = News 24 |date=4 August 2014}}</ref>


In August, awareness campaigns in ], Sierra Leone's capital, were delivered over the radio and through loudspeakers.<ref>{{cite web|url=http://wvxu.org/post/skeptics-sierra-leone-doubt-ebola-virus-exists|title=Skeptics In Sierra Leone Doubt Ebola Virus Exists|publisher=WVXU|date=6 August 2014|author=Ofeibea Quist-Arcton}}</ref> Also in August, Sierra Leone passed a law that subjected anyone hiding someone believed to be infected to two years in jail. At the time the law was enacted, a top parliamentarian was critical of failures by neighboring countries to stop the outbreak.<ref>{{cite news |url=http://ibnlive.in.com/news/two-year-jail-terms-for-hiding-ebola-victims-in--sierra-leone/493712-17.html |title=Two year jail terms for hiding Ebola victims in Sierra Leone |publisher=IBNLIVE |date=22 August 2014 |accessdate=23 August 2014}}</ref> Also in early August Sierra Leone cancelled league football (soccer) matches.<ref>{{cite web|url=http://www.nydailynews.com/sports/soccer/sierra-leone-cancels-soccer-matches-ebola-outbreak-article-1.1892588|title=Sierra Leone cancels all soccer matches over Ebola outbreak |work=NY Daily News|accessdate=7 October 2014}}</ref> In August, awareness campaigns in ], Sierra Leone's capital, were delivered over the radio and through loudspeakers.<ref>{{cite web|url=http://wvxu.org/post/skeptics-sierra-leone-doubt-ebola-virus-exists|title=Skeptics In Sierra Leone Doubt Ebola Virus Exists|publisher=WVXU|date=6 August 2014|author=Ofeibea Quist-Arcton}}</ref> Also in August, Sierra Leone passed a law that subjected anyone hiding someone believed to be infected to two years in jail. At the time the law was enacted, a top parliamentarian was critical of failures by neighboring countries to stop the outbreak.<ref>{{cite news |url=http://ibnlive.in.com/news/two-year-jail-terms-for-hiding-ebola-victims-in--sierra-leone/493712-17.html |archive-url=https://web.archive.org/web/20140826220153/http://ibnlive.in.com/news/two-year-jail-terms-for-hiding-ebola-victims-in--sierra-leone/493712-17.html |url-status=dead |archive-date=26 August 2014 |title=Two year jail terms for hiding Ebola victims in Sierra Leone |publisher=IBNLIVE |date=22 August 2014 |access-date=23 August 2014}}</ref> Also in early August Sierra Leone cancelled league football (soccer) matches.<ref>{{cite news|url=http://www.nydailynews.com/sports/soccer/sierra-leone-cancels-soccer-matches-ebola-outbreak-article-1.1892588|title=Sierra Leone cancels all soccer matches over Ebola outbreak |work=NY Daily News|access-date=7 October 2014|location=New York|date=5 August 2014}}</ref>


===September 2014: Exponential growth, quarantines=== ===September 2014: Exponential growth, quarantines===
]
], ], and ] were added to the quarantine on September 25, 2014.]]
]
], Sierra Leone's capital city, 2004]]
Within 2 days of 12 September 2014, there were 20 lab-confirmed cases discovered in Freetown, Sierra Leone.<ref name="news.sl">{{cite web|url=http://news.sl/drwebsite/publish/article_200526208.shtml|title=President Koroma must realise right away that Ebola is no Playcook Business!!|publisher=|accessdate=7 October 2014}}</ref> One issue was that residents were leaving dead bodies in the street.<ref name="news.sl"/> By 6 September 2014 there were 60 cases of Ebola in Freetown, out of about 1100 nationwide at this time.<ref name="News24">{{cite web|url=http://www.news24.com/Africa/News/Ebola-ravages-health-care-in-Freetown-20140906|title=Ebola ravages health care in Freetown|work=News24|accessdate=7 October 2014}}</ref> However, not everyone was bringing cases to doctors, and they were not always being treated.<ref name="News24"/> One doctor said the Freetown health system was not functioning, and during this time, respected Freetown Doctor Olivette Buck fell ill and died from Ebola by 14 September 2014.<ref name="News24"/><ref name="ReferenceA">{{cite web|url=http://news.sl/drwebsite/publish/article_200526221.shtml|title=Sierra Leone News : How Ebola Killed a popular Freetown female doctor, Dr. Olivette Buck|publisher=|accessdate=7 October 2014}}</ref> The population of Freetown in 2011 was 941,000.<ref>{{cite web|url=http://www.indexmundi.com/sierra_leone/demographics_profile.html|title=Sierra Leone Demographics Profile 2014|publisher=|accessdate=7 October 2014}}</ref> Within 2 days of 12 September 2014, there were 20 lab-confirmed cases discovered in Freetown, Sierra Leone.<ref name="news.sl">{{cite web|url=http://news.sl/drwebsite/publish/article_200526208.shtml|title=President Koroma must realise right away that Ebola is no Playcook Business!!|access-date=7 October 2014|url-status=dead|archive-url=https://web.archive.org/web/20141007203116/http://news.sl/drwebsite/publish/article_200526208.shtml|archive-date=7 October 2014}}</ref> One issue was that residents were leaving dead bodies in the street.<ref name="news.sl"/> By 6 September 2014, there were 60 cases of Ebola in Freetown, out of about 1100 nationwide at this time.<ref name="News24">{{cite web|url=http://www.news24.com/Africa/News/Ebola-ravages-health-care-in-Freetown-20140906|title=Ebola ravages health care in Freetown|website=News24|access-date=7 October 2014}}</ref> However, not everyone was bringing cases to doctors, and they were not always being treated.<ref name="News24"/> One doctor said the Freetown health system was not functioning, and during this time, respected Freetown Doctor Olivette Buck fell ill and died from Ebola by 14 September 2014.<ref name="News24"/><ref name="ReferenceA">{{cite web|url=http://news.sl/drwebsite/publish/article_200526221.shtml|title=Sierra Leone News : How Ebola Killed a popular Freetown female doctor, Dr. Olivette Buck|access-date=7 October 2014|url-status=dead|archive-url=https://web.archive.org/web/20141009192511/http://news.sl/drwebsite/publish/article_200526221.shtml|archive-date=9 October 2014}}</ref> The population of Freetown in 2011 was 941,000.<ref>{{cite web|url=http://www.indexmundi.com/sierra_leone/demographics_profile.html|title=Sierra Leone Demographics Profile 2014|access-date=7 October 2014}}</ref>


By 18 September 2014 teams of people that bury the dead were struggling to keep up, as 20-30 bodies needed to be buried each day.<ref name="ReferenceB">{{cite web|url=http://www.businessweek.com/news/2014-09-17/sierra-leone-s-ebola-burial-teams-struggle-as-bodies-decompose|title=Sierra Leone Ebola Burial Teams Struggle as Bodies Decompose|work=Businessweek.com|accessdate=7 October 2014}}</ref> The teams drive on motor-bikes to collect samples from corpses to see if they died from Ebola.<ref name="ReferenceB"/> Freetown, Sierra Leone has one laboratory that can do Ebola testing.<ref name="ReferenceB"/> By 18 September 2014, teams of people that buried the dead were struggling to keep up, as 20–30 bodies needed to be buried each day.<ref name="ReferenceB">{{cite web|url=http://www.businessweek.com/news/2014-09-17/sierra-leone-s-ebola-burial-teams-struggle-as-bodies-decompose|title=Sierra Leone Ebola Burial Teams Struggle as Bodies Decompose|website=Businessweek.com|access-date=7 October 2014|url-status=dead|archive-url=https://web.archive.org/web/20141015171734/http://www.businessweek.com/news/2014-09-17/sierra-leone-s-ebola-burial-teams-struggle-as-bodies-decompose|archive-date=15 October 2014}}</ref> The teams drove on motor-bikes to collect samples from corpses to see if they died from Ebola.<ref name="ReferenceB"/> Freetown, Sierra Leone had one laboratory that could do Ebola testing.<ref name="ReferenceB"/>


WHO estimated on 21 September that Sierra Leone's capacity to treat EVD cases falls short by the equivalent of 532 beds.<ref name=sitrep_24Sept2014>{{cite web|title=Ebola Response Roadmap Situation Report|url=http://apps.who.int/iris/bitstream/10665/134771/1/roadmapsitrep_24Sept2014_eng.pdf?ua=1|publisher=World Heath Organisation|accessdate=25 September 2014|page=6}}</ref> Experts pushed for a greater response at this time noting that it may destroy Sierra Leone and Liberia.<ref>{{cite web|url=http://www.dw.de/ebola-threatens-to-destroy-sierra-leone-and-liberia/a-17915090|title=Ebola threatens to destroy Sierra Leone and Liberia|work=DW.DE|accessdate=30 September 2014}}</ref> At this time it was estimated that if it spreads through both Liberia and Sierra Leone up to 5 million could be killed.<ref>{{cite web|url=http://atlanta.cbslocal.com/2014/09/17/expert-5-million-people-could-die-from-ebola-outbreak/|title=Expert: 5 Million People Could Die From Ebola Outbreak|publisher=|accessdate=30 September 2014}}</ref> (The population of Liberia is about 4.3 million and Sierra Leone is about 6.1 million.) WHO estimated on 21 September, that Sierra Leone's capacity to treat Ebola cases fell short by the equivalent of 532 beds.<ref name=sitrep_24Sept2014>{{cite web|title=Ebola Response Roadmap Situation Report|url=http://apps.who.int/iris/bitstream/10665/134771/1/roadmapsitrep_24Sept2014_eng.pdf?ua=1|publisher=World Health Organisation|access-date=25 September 2014|page=6}}</ref> Experts pushed for a greater response at this time noting that it could destroy Sierra Leone and Liberia.<ref>{{cite web|url=http://www.dw.de/ebola-threatens-to-destroy-sierra-leone-and-liberia/a-17915090|title=Ebola threatens to destroy Sierra Leone and Liberia|website=DW.DE|access-date=30 September 2014}}</ref> At that time it was estimated that if it spread through both Liberia and Sierra Leone up to 5 million could be killed;<ref>{{cite web|url=http://atlanta.cbslocal.com/2014/09/17/expert-5-million-people-could-die-from-ebola-outbreak/|title=Expert: 5 Million People Could Die From Ebola Outbreak|access-date=30 September 2014|archive-url=https://web.archive.org/web/20141101011641/http://atlanta.cbslocal.com/2014/09/17/expert-5-million-people-could-die-from-ebola-outbreak/|archive-date=1 November 2014|url-status=dead}}</ref> the population of Liberia is about 4.3 million and Sierra Leone is about 6.1 million.


In an attempt to control the disease, Sierra Leone imposed a three-day lockdown on its population from 19 to 21 September. During this period 28,500 trained community workers and volunteers went door-to-door providing information on how to prevent infection, as well as setting up community Ebola surveillance teams.<ref>{{cite web|title=Sierra Leone launches three-day, door-to-door Ebola prevention campaign|url=http://www.unicef.org/media/media_75963.html|publisher=UNICEF|accessdate=24 September 2014}}</ref> The campaign was called the ''Ouse to Ouse Tak'' in Krio language.<ref>{{cite web|url=http://blogs.unicef.org/2014/09/25/inside-sierra-leones-campaign-to-stop-ebola/|title=Inside Sierra Leone’s campaign to stop Ebola|work=UNICEF Connect - UNICEF BLOG|accessdate=30 September 2014}}</ref> There was concern the 72 hour lock-down could backfire.<ref>{{cite web|url=http://abcnews.go.com/Health/sierra-leone-start-day-nationwide-lockdown-stop-ebola/story?id=25597357|title=Sierra Leone to Start 3-Day Nationwide Lockdown to Stop Ebola|work=ABC News|accessdate=30 September 2014}}</ref> In an attempt to control the disease, Sierra Leone imposed a three-day lockdown on its population from 19 to 21 September. During this period 28,500 trained community workers and volunteers went door-to-door providing information on how to prevent infection, as well as setting up community Ebola surveillance teams.<ref>{{cite web|title=Sierra Leone launches three-day, door-to-door Ebola prevention campaign|url=http://www.unicef.org/media/media_75963.html|publisher=UNICEF|access-date=24 September 2014|archive-date=7 September 2020|archive-url=https://web.archive.org/web/20200907112713/https://www.unicef.org/media/media_75963.html|url-status=dead}}</ref> The campaign was called the '']'' in ].<ref>{{cite web|url=http://blogs.unicef.org/2014/09/25/inside-sierra-leones-campaign-to-stop-ebola/|title=Inside Sierra Leone's campaign to stop Ebola|website=UNICEF Connect UNICEF BLOG|access-date=30 September 2014|url-status=dead|archive-url=https://web.archive.org/web/20140926022222/http://blogs.unicef.org/2014/09/25/inside-sierra-leones-campaign-to-stop-ebola/|archive-date=26 September 2014}}</ref> There was concern the 72-hour lock-down could backfire.<ref>{{cite web|url=https://abcnews.go.com/Health/sierra-leone-start-day-nationwide-lockdown-stop-ebola/story?id=25597357|title=Sierra Leone to Start 3-Day Nationwide Lockdown to Stop Ebola|website=ABC News|access-date=30 September 2014}}</ref>
]
On 22 September, Stephen Gaojia said that the three-day lock down had obtained its objective and would not be extended. Eighty percent of targeted households were reached in the operation. A total of around 150 new cases were uncovered, but the exact figures would only be known on the following Thursday as the health ministry was still awaiting reports from remote locations.<ref name= "SL_locdown_22sept">{{cite news | url=http://www.cbc.ca/news/health/ebola-virus-shutdown-in-sierra-leone-yields-massive-awareness-1.2774082 | title=Ebola virus shutdown in Sierra Leone yields 'massive awareness' | publisher=CBC News | date=22 September 2014 | access-date=22 September 2014 }}</ref> One incident during the lock-down was when a burial team was attacked.<ref>{{cite news|url=http://www.independent.ie/world-news/africa/sierra-leone-ebola-burial-team-attacked-despite-lockdown-30603152.html|title=Sierra Leone Ebola burial team attacked despite lockdown|work=Independent.ie|access-date=7 October 2014}}</ref>


On 24 September, President ] added three more districts under "isolation", in an effort to contain the spread. The districts included ], ], and ]. In the capital, Freetown, all homes with identified cases would be quarantined. This brought the total areas under isolation to 5, including the outbreak "hot spots" Kenema and Kailahun which were already in isolation. Only deliveries and essential services would be allowed in and out. A sharp rise in cases in these areas was also noted by WHO.<ref>{{cite news | url=https://www.washingtonpost.com/world/africa/sierra-leone-to-cordon-off-3-areas-to-stop-ebola/2014/09/25/13dad80e-4492-11e4-8042-aaff1640082e_story.html | archive-url=https://web.archive.org/web/20140925195225/http://www.washingtonpost.com/world/africa/sierra-leone-to-cordon-off-3-areas-to-stop-ebola/2014/09/25/13dad80e-4492-11e4-8042-aaff1640082e_story.html | archive-date=25 September 2014 | title=Sierra Leone cordons off 3 areas to control Ebola | newspaper=The Washington Post | date=25 September 2014 | access-date=25 September 2014 | url-status=dead}}</ref>
On Monday 22 September, Stephen Gaojia said that the three day lock down has obtained its objective and will not be extended. Eighty percent of targeted households were reached in the operation. A total of around 150 new cases have been uncovered, but the exact figures will only be known on Thursday as the health ministry is still awaiting reports from remote locations.<ref name= "SL_locdown_22sept">{{cite news | url=http://www.cbc.ca/news/health/ebola-virus-shutdown-in-sierra-leone-yields-massive-awareness-1.2774082 | title=Ebola virus shutdown in Sierra Leone yields 'massive awareness' | publisher=CBC News | date=22 September 2014 | accessdate=22 September 2014 }}</ref> One incident during the lock-down, was when a burial team was attacked.<ref>{{cite web|url=http://www.independent.ie/world-news/africa/sierra-leone-ebola-burial-team-attacked-despite-lockdown-30603152.html|title=Sierra Leone Ebola burial team attacked despite lockdown|work=Independent.ie|accessdate=7 October 2014}}</ref>


As of late September, about 2 million people were in areas of restricted travel,<ref>{{cite web|url=http://www.yorkshirepost.co.uk/news/main-topics/world/third-of-sierra-leone-population-now-under-quarantine-over-ebola-1-6861857|title=Third of Sierra Leone population now under quarantine over ebola|access-date=30 September 2014}}</ref> which included Kailahun, Kenema, Bombali, Tonkolili, and Port Loko Districts.<ref>{{cite web|url=http://news.sl/drwebsite/publish/article_200526223.shtml|title=Sierra Leone News : Africell Presents Second Consignment of Food to all Quarantined Homes|access-date=30 September 2014|url-status=dead|archive-url=https://web.archive.org/web/20141006141855/http://news.sl/drwebsite/publish/article_200526223.shtml|archive-date=6 October 2014}}</ref> The number of cases seemed to be doubling every 20 days, which led to the estimate that by January 2015 the number of cases in Liberia and Sierra Leone could grow to 1.4 million.<ref name="businessweek.com">{{cite news|url=http://www.businessweek.com/articles/2014-09-26/ebolas-deadly-math|archive-url=https://web.archive.org/web/20140926195312/http://www.businessweek.com/articles/2014-09-26/ebolas-deadly-math|url-status=dead|archive-date=26 September 2014|title=A Primer on the Deadly Math of Ebola|newspaper=Bloomberg.com|date=26 September 2014 |access-date=30 September 2014}}</ref>
On Wednesday 24 September, President ] added three more districts under "isolation," in an effort to contain the spread. The districts include ], ], and ]. In the capital, Freetown, all homes with identified cases will be quarantined. This brings the total areas under isolation to 5, including the outbreak "hot spots" Kenema and Kailahun which are already in isolation. Only deliveries and essential services will be allowed in and out. A sharp rise in cases in these areas was also noted by WHO.<ref>{{cite news | url=http://www.washingtonpost.com/world/africa/sierra-leone-to-cordon-off-3-areas-to-stop-ebola/2014/09/25/13dad80e-4492-11e4-8042-aaff1640082e_story.html | title=Sierra Leone cordons off 3 areas to control Ebola | publisher=The Washington Post | date=25 September 2014 | accessdate=25 September 2014 }}</ref>


On 25 September, there were 1940 cases and 587 deaths officially, however, many acknowledged under-reporting and there was an increasing number of cases in Freetown (the capital of Sierra Leone).<ref>{{cite web|url=https://www.nytimes.com/2014/09/26/world/africa/ebola-epidemic-sierra-leone-quarantine.html|title=Ebola Epidemic Worsening, Sierra Leone Expands Quarantine Restrictions|date=26 September 2014|website=]|access-date=9 June 2016}}</ref>
As of late September about 2 million people are in areas of restricted travel,<ref>{{cite web|url=http://www.yorkshirepost.co.uk/news/main-topics/world/third-of-sierra-leone-population-now-under-quarantine-over-ebola-1-6861857|title=Third of Sierra Leone population now under quarantine over ebola|publisher=|accessdate=30 September 2014}}</ref> which include Kailahun, Kenema, Bombali, Tonkolili, and Port Loko Districts.<ref>{{cite web|url=http://news.sl/drwebsite/publish/article_200526223.shtml|title=Sierra Leone News : Africell Presents Second Consignment of Food to all Quarantined Homes|publisher=|accessdate=30 September 2014}}</ref>


WHO estimated on 21 September, that Sierra Leone's capacity to treat Ebola cases fell short by the equivalent of 532 beds.<ref name=sitrep_24Sept2014 /> There were reports that political interference and administrative incompetence had hindered the flow of medical supplies into the country.<ref name=":1">{{cite news|title=Ebola Help for Sierra Leone Delayed on the Docks|url=https://www.nytimes.com/2014/10/06/world/africa/sierra-leone-ebola-medical-supplies-delayed-docks.html|work=The New York Times|access-date=6 October 2014|first=Adam|last=Nossiter|date=5 October 2014}}</ref>
The number of cases seemed to be doubling every 20 days, which led to the estimate that by January 2015 the number of cases in Liberia and Sierra Leone could grow to 1.4 million.<ref name="businessweek.com">{{cite web|url=http://www.businessweek.com/articles/2014-09-26/ebolas-deadly-math|title=A Primer on the Deadly Math of Ebola|work=Businessweek.com|accessdate=30 September 2014}}</ref> After January 2015 if that level of growth continued the number of cases could grow to 100 million by June 2015, 1 billion (1000 million) by August 2015, and to the rest of population before 2016.<ref name="businessweek.com"/> For comparison there are about 1 billion people in all of Africa.<ref>{{cite web|url=http://worldpopulationreview.com/continents/africa-population/|title=Africa Population 2014|publisher=|accessdate=30 September 2014}}</ref>


===October 2014: Responders overwhelmed===
On 25 September there were 1940 cases and 587 deaths officially, however, many acknowledged under-reporting and there was an increasing number of cases in Freetown (the capital of Sierra Leone).<ref></ref>
] to ]]]
By 2 October 2014, an estimated 5 people per hour were being infected with the Ebola virus in Sierra Leone.<ref>{{cite web|url=https://www.theguardian.com/world/2014/oct/02/ebola-infecting-five-every-hour-sierra-leone|title=Ebola infecting five new people every hour in Sierra Leone, figures show|author=Matthew Weaver|website=the Guardian|date=2 October 2014 |access-date=4 October 2014}}</ref> By this time it was estimated the number of infected had been doubling every 20 days.<ref>{{cite web|url=http://stanfordlawyer.law.stanford.edu/2014/10/ebola-the-tolling-bell/|title=Ebola: The Tolling Bell|access-date=6 October 2014|archive-url=https://web.archive.org/web/20141006034808/http://stanfordlawyer.law.stanford.edu/2014/10/ebola-the-tolling-bell/|archive-date=6 October 2014|url-status=dead}}</ref> On 4 October, Sierra Leone recorded 121 fatalities, the largest number in a single day.<ref>{{cite news|url=https://www.reuters.com/article/us-health-ebola-leone-idUSKCN0HU0ZT20141006|title=Sierra Leone records 121 Ebola deaths in a single day|work=Reuters|access-date=6 October 2014|date=6 October 2014}}</ref> On 8 October, Sierra Leone burial crews went on strike.<ref>{{cite news|url=https://www.foxnews.com/world/sierra-leone-burial-crews-reportedly-on-strike-leaving-ebola-victims-in-the-street/|title=Sierra Leone burial crews reportedly on strike, leaving Ebola victims in the street|work=Fox News|access-date=8 October 2014|date=8 October 2014}}</ref> On 12 October, it was reported that the UK would begin providing military support to Sierra Leone in addition to a major UK civilian operation in support of the Government of Sierra Leone.<ref>{{cite web|url=http://ewn.co.za/2014/10/12/British-military-to-provide-support-in-Ebola-hit-Sierra-Leone|title=British military to provide support in Ebola hit Sierra Leone|agency=Reuters|access-date=12 October 2014}}</ref>


In October, it was noted hospitals were running out of supplies in Sierra Leone.<ref>{{cite web|url=https://www.theguardian.com/world/2014/oct/03/ebola-sierra-leone-epidemic|title=Ebola: Sierra Leone hospitals running out of basic supplies, say doctors|author=Lisa O'Carroll|website=the Guardian|date=3 October 2014 |access-date=4 October 2014}}</ref> There were reports that political interference and administrative incompetence hindered the flow of medical supplies into the country.<ref name=":1"/> In the week prior to 2 October there were 765 new cases, and Ebola was spreading rapidly.<ref>{{cite news|url=https://www.bbc.com/news/world-africa-29470248|title=Ebola spreading fast in Sierra Leone, warns Save the Children|work=BBC News |access-date=4 October 2014}}</ref> At the start of October, there were nearly 2200 laboratory confirmed cases of Ebola and over 600 had died from it.<ref>{{cite web|url=https://www.cdc.gov/vhf/ebola/outbreaks/2014-west-africa/index.html|title=2014 Ebola Outbreak in West Africa|access-date=4 October 2014}}</ref> The epidemic also had claimed the life of 4 doctors and at least 60 nurses by the end of September 2014.<ref>{{cite web|url=http://allafrica.com/stories/201410021561.html|title=Sierra Leone: Ebola and Sierra Leone – Health Care At Breaking Point|website=allAfrica.com|access-date=4 October 2014}}</ref> Sierra Leone limited its reported deaths to laboratory confirmed cases in facilities, so the actual number of losses was known to be higher.<ref name="The Huffington Post"/>
The last district in Sierra Leone untouched by the Ebola virus has declared Ebola cases. According to Abdul Sesay, a local health official, 15 suspected deaths with 2 confirmed cases of the deadly disease were reported on 16 October in the village of Fakonya. The village is 60 miles from the town of ] in the center of mountainous region of the ] district. This was the last district free from the virus in Sierra Leone. All of the districts in this country have now confirmed cases of Ebola.<ref>{{cite web|url=http://www.foxnews.com/world/2014/10/16/ebola-cases-appear-in-last-untouched-district-in-sierra-leone|title=Ebola cases appear in last untouched district in Sierra Leone|publisher=Fox News|date=16 October 2014|accessdate=16 October 2014}}</ref>


Sierra Leone was considering making reduced care clinics, to stop those sick with Ebola from getting their families sick with the disease and to provide something in between home-care and the full-care clinics.<ref name="wdrb.com">{{cite web|url=http://www.wdrb.com/story/26685669/new-type-of-clinic-eyed-to-help-stop-ebola|title=New type of clinic eyed to help stop Ebola|date=2 October 2014|access-date=4 October 2014|url-status=dead|archive-url=https://web.archive.org/web/20141004013056/http://www.wdrb.com/story/26685669/new-type-of-clinic-eyed-to-help-stop-ebola|archive-date=4 October 2014}}</ref> These "isolation centers" would provide an alternative to the overwhelmed clinics.<ref name="wdrb.com"/> The problem the country was facing was 726 new Ebola cases but less than 330 beds available.<ref>{{cite web|url=https://nonprofitquarterly.org/policysocial-context/24925-ebola-aid-not-stemming-sky-high-infection-rates.html|title=Ebola Aid Not Stemming Sky-High Infection Rates |date=3 October 2014 |access-date=4 October 2014}}</ref>
===October 2014 : Responders overwhelmed===
]; some values are interpolated.]]
In October it was noted hospitals are running out of supplies in Sierra Leone.<ref>{{cite web|url=http://www.theguardian.com/world/2014/oct/03/ebola-sierra-leone-epidemic|title=Ebola: Sierra Leone hospitals running out of basic supplies, say doctors|author=Lisa O'Carroll|work=the Guardian|accessdate=4 October 2014}}</ref> In the week prior to 2 October there were 765 new cases, and Ebola was spreading rapidly.<ref>{{cite web|url=http://www.bbc.com/news/world-africa-29470248|title=Ebola spreading fast in Sierra Leone, warns Save the Children|work=BBC News|accessdate=4 October 2014}}</ref> At the start of October there were nearly 2200 laboratory confirmed cases of Ebola and over 600 had passed away from it.<ref>{{cite web|url=http://www.cdc.gov/vhf/ebola/outbreaks/2014-west-africa/index.html|title=2014 Ebola Outbreak in West Africa|publisher=|accessdate=4 October 2014}}</ref> The epidemic also claimed the life of 4 doctors and at least 60 nurses by the end of September 2014.<ref>{{cite web|url=http://allafrica.com/stories/201410021561.html|title=Sierra Leone: Ebola and Sierra Leone - Health Care At Breaking Point|work=allAfrica.com|accessdate=4 October 2014}}</ref> Sierra Leone limits its reported deaths to laboratory confirmed cases in facilities, so the actual number of losses is known to be higher.<ref>{{cite web|url=http://www.huffingtonpost.com/2014/10/03/ebola-west-africa-underestimated_n_5926634.html|title=Ebola Toll In West Africa Is Likely Hugely Underestimated|date=3 October 2014|work=The Huffington Post|accessdate=4 October 2014}}</ref>


More than 160 additional medical personnel from Cuba arrived in early October, building on about 60 that had been there since September.<ref>{{Cite magazine|title=Cuba's Ebola Diplomacy|url=https://www.newyorker.com/news/daily-comment/cubas-ebola-diplomacy|last=Anderson|first=Jon Lee|magazine=]|date=4 November 2014 |language=en|access-date=27 May 2020}}</ref> At that time there were about 327 beds for patients in Sierra Leone.<ref>{{cite news|url=http://www.huffingtonpost.com/2014/10/02/ebola-sierra-leone_n_5920170.html|title=5 People Are Infected With Ebola Every Hour In Sierra Leone|date=2 October 2014|work=The Huffington Post|access-date=4 October 2014}}</ref> Canada announced it was sending a 2nd mobile lab and more staff to Sierra Leone on 4 October 2014.<ref>{{cite news|url=http://www.cbc.ca/news/health/ebola-outbreak-canada-sends-2nd-mobile-lab-to-sierra-leone-1.2787817|title=Ebola outbreak: Canada sends 2nd mobile lab to Sierra Leone|date=4 October 2014|access-date=6 October 2014|work=CBC News}}</ref>
Sierra Leone was considering making reduced care clinics, to stop those sick with Ebola from getting their families sick with the disease and to provide something in between home-care and the full-care clinics.<ref name="wdrb.com">{{cite web|url=http://www.wdrb.com/story/26685669/new-type-of-clinic-eyed-to-help-stop-ebola|title=New type of clinic eyed to help stop Ebola|date=2 October 2014|publisher=|accessdate=4 October 2014}}</ref> These "isolation centers" would provide an alternative to the overwhelmed clinics.<ref name="wdrb.com"/> The problem the country is facing is 726 new Ebola cases but less than 330 beds available.<ref>{{cite web|url=https://nonprofitquarterly.org/policysocial-context/24925-ebola-aid-not-stemming-sky-high-infection-rates.html|title=Ebola Aid Not Stemming Sky-High Infection Rates |publisher=|accessdate=4 October 2014}}</ref>


There were reports of drunken grave-diggers making graves for Ebola patients too shallow, and as a result wildlife came and dug up and ate at the corpses.<ref>{{cite web|url=http://www.philly.com/philly/health/20141005_Visitors_tell_of_Ebola_struggles_in_Sierra_Leone.html|title=Visitors tell of Ebola struggles in Sierra Leone|website=Philly.com|date=5 October 2014 |access-date=6 October 2014}}</ref> In addition, in some cases bodies were not buried for days, because no one came to collect them.<ref>{{cite web|url=http://www.euronews.com/2014/10/05/sierra-leone-officials-struggle-to-recover-bodies-of-ebola-victims/|archive-url=https://web.archive.org/web/20141006103532/http://www.euronews.com/2014/10/05/sierra-leone-officials-struggle-to-recover-bodies-of-ebola-victims/|url-status=dead|archive-date=6 October 2014|title=Sierra Leone officials struggle to recover bodies of Ebola victims|website=euronews|access-date=6 October 2014}}</ref> One problem was that it was hard to care for local health care workers, and there was not enough money to evacuate them.<ref>{{cite magazine|url=https://time.com/3453429/ebola-healthcare-workers-fatality-rate/|title=Ebola Healthcare Workers Are Dying Faster Than Their Patients|author=Jack Linshi|magazine=]|access-date=6 October 2014}}</ref> Meanwhile, other diseases like malaria, pneumonia, and diarrhea were not being treated properly because the health system was trying to deal with Ebola patients.<ref>{{cite news|url=http://www.nzherald.co.nz/nz/news/article.cfm?c_id=1&objectid=11336701|title=Spread of Ebola: What happens when health systems can't cope|work=The New Zealand Herald|access-date=6 October 2014|date=4 October 2014}}</ref> On 7 October 2014, Canada sent a C-130 loaded with 128,000 face shields to Freetown.<ref>{{cite web|url=http://www.ctvnews.ca/health/canada-sends-military-transport-to-deliver-equipment-to-ebola-zone-1.2042725|title=Canada sends military transport to deliver equipment to Ebola zone |website=CTVNews|date=7 October 2014 |access-date=8 October 2014}}</ref>
More than 160 additional medical personnel from Cuba arrived in early October, building on about 60 that had been there since September.<ref>{{cite web|url=http://www.thehealthsite.com/news/ebola-in-sierra-leone-162-cuban-medical-experts-set-to-fight-ebola/|title=Ebola in Sierra Leone: 162 Cuban medical experts set to fight Ebola|publisher=|accessdate=4 October 2014}}</ref> At that time there were about 327 beds for patients in Sierra Leone.<ref>{{cite web|url=http://www.huffingtonpost.com/2014/10/02/ebola-sierra-leone_n_5920170.html|title=5 People Are Infected With Ebola Every Hour In Sierra Leone|date=2 October 2014|work=The Huffington Post|accessdate=4 October 2014}}</ref>


In early October 2014, a burial team leader said there were piles of corpses south of Freetown.<ref>{{cite news|url=http://in.reuters.com/article/health-ebola-leone-idINL6N0S24JY20141007|archive-url=https://web.archive.org/web/20160306174312/http://in.reuters.com/article/health-ebola-leone-idINL6N0S24JY20141007|url-status=dead|archive-date=6 March 2016|title=Sierra Leone's burial teams for Ebola victims strike over hazard pay|access-date=8 October 2014|work=Reuters|date=7 October 2014}}</ref> On 9 October, the ] was activated on Sierra Leone's behalf, the first time that its charitably repurposed satellite imaging assets had been deployed in an epidemiological role.<ref>{{cite web|url=https://www.disasterscharter.org/web/guest/-/other-in-sierra-leone?redirect=https://www.disasterscharter.org/web/guest/home?p_p_id=101_INSTANCE_F1SeOJT57fTb&p_p_lifecycle=0&p_p_state=normal&p_p_mode=view&p_p_col_id=column-1&p_p_col_pos=2&p_p_col_count=4|title=Ebola epidemic in West Africa - Charter Activations - International Disasters Charter|access-date=9 June 2016|archive-url=https://web.archive.org/web/20160603132730/https://www.disasterscharter.org/web/guest/-/other-in-sierra-leone?redirect=https%3A%2F%2Fwww.disasterscharter.org%2Fweb%2Fguest%2Fhome%3Fp_p_id%3D101_INSTANCE_F1SeOJT57fTb%26p_p_lifecycle%3D0%26p_p_state%3Dnormal%26p_p_mode%3Dview%26p_p_col_id%3Dcolumn-1%26p_p_col_pos%3D2%26p_p_col_count%3D4|archive-date=3 June 2016|url-status=dead}}</ref><ref>{{cite news|url=https://www.bbc.com/news/world-africa-29577175|title=/world-africa-29577175|work=BBC News |date=10 October 2014 |access-date=11 October 2014}}</ref> On 14 October 2014, 800 Sierra Leone peacekeepers due to relieve a contingent deployed in ], were placed under quarantine when one of the soldiers tested positive for Ebola.<ref>{{cite web|url=http://www.news24.com/Africa/News/Sierra-Leone-peacekeepers-quarantined-over-Ebola-20141014|title=Sierra Leone peacekeepers quarantined over Ebola|website=News24|access-date=15 October 2014}}</ref>
Canada announced it is sending a 2nd mobile lab and more staff to Sierra Leone on 4 October 2014.<ref>{{cite web|url=http://www.cbc.ca/news/health/ebola-outbreak-canada-sends-2nd-mobile-lab-to-sierra-leone-1.2787817|title=Ebola outbreak: Canada sends 2nd mobile lab to Sierra Leone|date=4 October 2014|publisher=|accessdate=6 October 2014}}</ref>


The last district in Sierra Leone untouched by the Ebola virus declared Ebola cases. According to Abdul Sesay, a local health official, 15 suspected deaths with 2 confirmed cases of the deadly disease were reported on 16 October, in the village of Fakonya. The village is 60 miles from the town of ] in the center of the mountainous region of the ] district. This was the last district free from the virus in Sierra Leone. All of the districts in this country had then confirmed cases of Ebola.<ref>{{cite news|url=https://www.foxnews.com/world/ebola-cases-appear-in-last-untouched-district-in-sierra-leone|title=Ebola cases appear in last untouched district in Sierra Leone|publisher=Fox News|date=16 October 2014|access-date=16 October 2014}}</ref>
There were reports of drunken grave-diggers making graves for Ebola patients too shallow, and as a result wildlife comes and digs up and eats at the corpses.<ref>{{cite web|url=http://www.philly.com/philly/health/20141005_Visitors_tell_of_Ebola_struggles_in_Sierra_Leone.html|title=Visitors tell of Ebola struggles in Sierra Leone|work=Philly.com|accessdate=6 October 2014}}</ref> In addition, in some cases bodies are not buried for days, because no one comes to collect them.<ref>{{cite web|url=http://www.euronews.com/2014/10/05/sierra-leone-officials-struggle-to-recover-bodies-of-ebola-victims/|title=Sierra Leone officials struggle to recover bodies of Ebola victims|work=euronews|accessdate=6 October 2014}}</ref> One problem is that it has been hard to care for local health care workers, and there is not enough money to evacuate them.<ref>{{cite web|url=https://time.com/3453429/ebola-healthcare-workers-fatality-rate/|title=Ebola Healthcare Workers Are Dying Faster Than Their Patients|author=Jack Linshi|work=TIME.com|accessdate=6 October 2014}}</ref> Meanwhile other diseases like malaria, pneumonia, and diarrhea are not being treated properly because the health system is trying to deal with Ebola patients.<ref>{{cite web|url=http://www.nzherald.co.nz/nz/news/article.cfm?c_id=1&objectid=11336701|title=
]
Spread of Ebola: What happens when health systems can't cope|work=The New Zealand Herald|accessdate=6 October 2014}}</ref>
In late October 2014, the United Kingdom sent one of their hospital ships, the Royal Navy's '']'', to help Sierra Leone.<ref>{{cite news|url=https://www.telegraph.co.uk/news/worldnews/ebola/11161534/RFA-Argus-loaded-with-supplies-for-Ebola-mission-to-Sierra-Leone.html|archive-url=https://web.archive.org/web/20141014200625/http://www.telegraph.co.uk/news/worldnews/ebola/11161534/RFA-Argus-loaded-with-supplies-for-Ebola-mission-to-Sierra-Leone.html|url-status=dead|archive-date=14 October 2014|title=Inside RFA Argus – the British ship on course to battle Ebola|date=15 October 2014|work=Telegraph.co.uk|location=London}}</ref> By late October Sierra Leone was experiencing more than twenty deaths a day from Ebola.<ref>{{cite web|url=http://www.news24.com/Africa/News/Ebola-cases-rise-sharply-in-western-Sierra-Leone-20141021|title=Ebola cases rise sharply in western Sierra Leone|website=News24}}</ref> In October 2014, officials reported that very few pregnant women were surviving Ebola disease.<ref>{{cite web|url=http://www.voanews.com/content/ebola-increases-threat-to-sierra-leone-pregnancies/2492783.html|title=Ebola Increases Threat to Sierra Leone Pregnancies|website=VOA|date=22 October 2014 |access-date=27 October 2014}}</ref> In previous outbreaks pregnant women were noted to have a higher rate of death with Ebola.<ref>{{cite journal|title=Ebola Hemorrhagic Fever and Pregnancy|author=Kibadi Mupapa|journal=The Journal of Infectious Diseases|volume=179|pages=S11-2|pmid=9988157|year=1999|issue=Suppl 1 |doi=10.1086/514289|doi-access=free}}</ref>


Officials struggled to maintain order in one town after a medical team trying to take a blood sample from a corpse were blocked by an angry machete-wielding mob. They allegedly believed the person had died from high-blood pressure and did not want the body being tested for Ebola. When security forces tried to defend the medical team, a riot ensued leaving two dead. The town was placed on a 24-hour ] and authorities tried to calm the situation down.<ref>{{cite web|url=http://www.news24.com/Africa/News/2-die-in-Sierra-Leone-riot-sparked-by-Ebola-tests-20141022|title=2 die in Sierra Leone riot sparked by Ebola tests|website=News24|access-date=27 October 2014}}</ref> Despite this several buildings were attacked.<ref>{{cite web|url=http://www.skynews.com.au/news/world/africa/2014/10/23/number-of-ebola-cases-nears-10-000.html|title=Number of Ebola cases nears 10,000|access-date=9 June 2016|url-status=dead|archive-url=https://web.archive.org/web/20141023143959/http://www.skynews.com.au/news/world/africa/2014/10/23/number-of-ebola-cases-nears-10-000.html|archive-date=23 October 2014}}</ref>
On 7 October 2014 Canada sent a C-130 loaded with 128,000 face shields to Freetown.<ref>{{cite web|url=http://www.ctvnews.ca/health/canada-sends-military-transport-to-deliver-equipment-to-ebola-zone-1.2042725|title=Canada sends military transport to deliver equipment to Ebola zone |work=CTVNews|accessdate=8 October 2014}}</ref>


On 30 October, the ship ''Argus'' arrived in Sierra Leone.<ref>{{cite news|url=https://www.bbc.com/news/world-africa-29831329|title=The Royal Navy's ship RFA Argus arrives in Sierra Leone|work=BBC News |access-date=7 November 2014}}</ref> It carried 32 off-road vehicles to support Ebola treatment units.<ref>{{cite news|url=https://www.telegraph.co.uk/news/worldnews/ebola/11199976/Watch-RFA-Argus-arrives-in-Sierra-Leone-to-aid-fight-against-Ebola.html|archive-url=https://web.archive.org/web/20141031071611/http://www.telegraph.co.uk/news/worldnews/ebola/11199976/Watch-RFA-Argus-arrives-in-Sierra-Leone-to-aid-fight-against-Ebola.html|url-status=dead|archive-date=31 October 2014|title=Watch: RFA Argus arrives in Sierra Leone to aid fight against Ebola|date=30 October 2014|work=Telegraph.co.uk|access-date=7 November 2014|location=London|first=Charlotte|last=Krol}}</ref> The ship also carried three transport helicopters to support operations against the epidemic.<ref>{{cite web|url=http://www.westbriton.co.uk/RFA-Argus-arrives-Africa-start-total-war-Ebola/story-23856902-detail/story.html|title=RFA Argus arrives in Africa to start "total war" on Ebola|website=West Briton|access-date=7 November 2014|url-status=dead|archive-url=https://web.archive.org/web/20141102044905/http://www.westbriton.co.uk/RFA-Argus-arrives-Africa-start-total-war-Ebola/story-23856902-detail/story.html|archive-date=2 November 2014}}</ref> By the end of October 2014 there were over 5200 laboratory confirmed cases of Ebola virus disease in Sierra Leone.{{citation needed|date=August 2021}}
In early October 2014, a burial team leader said there were piles of corpses south of Freetown.<ref>{{cite web|url=http://in.reuters.com/article/2014/10/07/health-ebola-leone-idINL6N0S24JY20141007|title=Sierra Leone's burial teams for Ebola victims strike over hazard pay|publisher=|accessdate=8 October 2014}}</ref>


]
On October 9 the ] was activated on Sierra Leone's behalf, the first time that its charitably repurposed satellite imaging assets have been deployed in an epidemiological role.<ref></ref><ref>{{cite web|url=http://www.bbc.com/news/world-africa-29577175|title=/world-africa-29577175|work=BBC News|accessdate=11 October 2014}}</ref>


On 14 October 2014, 800 Sierra Leone peacekeepers due to relieve a contingent deployed in ], were placed under quarantine when one of the soldiers tested positive for Ebola.<ref>{{cite web|url=http://www.news24.com/Africa/News/Sierra-Leone-peacekeepers-quarantined-over-Ebola-20141014|title=Sierra Leone peacekeepers quarantined over Ebola|work=News24|accessdate=15 October 2014}}</ref> On 31 October 2014, an ambulance driver in ] died of Ebola. His ambulance picked up Ebola patients (or suspected Ebola cases) and took them to treatment centers.<ref>{{cite web|url=http://awoko.org/2014/11/04/sierra-leone-news-bo-loses-an-ebola-ambulance-driver/|title=Sierra Leone News: Bo loses an Ebola Ambulance Driver|access-date=7 November 2014}}</ref>

===November 2014: Continuing struggle===
On 1 November, the United Kingdom announced plans to build three more Ebola laboratories in Sierra Leone. The labs helped to determine if a patient had been infected by the Ebola virus. At that time, it took as much as five days to test a sample because of the volume of samples that needed to be tested.<ref>{{cite news|url=https://www.telegraph.co.uk/news/worldnews/ebola/11203119/UK-to-build-three-new-Ebola-labs-in-Sierra-Leone.html|title=UK to build three new Ebola labs in Sierra Leone|date=1 November 2014|work=Telegraph.co.uk|access-date=7 November 2014|location=London|first=Colin|last=Freeman}}</ref>

On 2 November, a person with Ebola employed by the United Nations was evacuated from Sierra Leone to France for treatment. On 4 November, it was reported that thousands violated quarantine in search for food, in the town of Kenema.<ref>{{cite web|url=http://www.detroitnews.com/story/news/world/2014/11/04/ebola-west-africa/18463943/|title=Thousands in Sierra Leone break Ebola quarantine|author=Sarah DiLorenzoAssociated Press|date=4 November 2014|access-date=5 November 2014}}</ref> On 6 November, it was reported that the situation was "getting worse" due to "intense transmission" in Freetown as a contributing factor; the capital city reported 115 cases in the previous week alone. Food shortages and aggressive quarantines were reported to be making the situation worse, according to the Disaster Emergency Committee.<ref>{{cite web|url=https://news.vice.com/article/the-ebola-outbreak-is-getting-worse-in-sierra-leone|title=The Ebola Outbreak Is Getting Worse in Sierra Leone|website=VICE News|date=6 November 2014 |access-date=10 November 2014}}</ref> Sierra Leone established call centers in Port Loko and Kambia, according to MSSL Communications as reported on 21 November;<ref>{{cite web|url=http://awoko.org/2014/11/21/sierra-leone-news-marie-stopes-opens-ebola-call-centers/ |title=Sierra Leone News: Marie Stopes opens Ebola Call Centers " Awoko Newspaper |website=awoko.org |access-date=10 December 2014 |url-status=dead |archive-url=https://web.archive.org/web/20150319140309/http://awoko.org/2014/11/21/sierra-leone-news-marie-stopes-opens-ebola-call-centers/ |archive-date=19 March 2015 }}</ref> this was in addition to the June hotline originally established.<ref>{{cite web|url=http://news.sl/drwebsite/publish/article_200525509.shtml|title=Sierra Leone Health Ministry Answers Citizens Ebola Questions: Sierra Leone News|author=Sylvia Blyden|website=news.sl|access-date=10 December 2014|archive-url=https://web.archive.org/web/20150319062703/http://news.sl/drwebsite/publish/article_200525509.shtml|archive-date=19 March 2015|url-status=dead}}</ref>

On 12 November, more than 400 health workers went on strike over salary issues at one of the few Ebola treatment centers in the country.<ref>{{cite news|url=https://www.bbc.com/news/world-africa-30019895|title=BBC News – Ebola crisis: Sierra Leone health workers strike|work=BBC News |date=12 November 2014 |access-date=14 November 2014}}</ref> On 18 November, the supply ship '']'' of the ] (''Koninklijke Marine'') arrived in Freetown, with supplies. Its Captain-Commander, Peter van den Berg, took steps to reduce the chance of the crew contracting Ebola virus disease.<ref>{{cite web|url=http://www.nltimes.nl/2014/11/19/marines-ebola-relief-arrives-sierra-leone/|title=Marines' Ebola relief arrives in Sierra Leone |website=NL Times |date=19 November 2014 |access-date=28 November 2014}}</ref>

The Neini Chiefdom in ] was subject to isolation after Ebola cases.<ref>{{cite web|url=http://awoko.org/2014/10/31/sierra-leone-news-neini-chiefdom-isolated/|title=Sierra Leone News: Neini Chiefdom isolated|access-date=7 November 2014}}</ref> On 19 November, it was reported that the Ebola virus was spreading intensely; "much of this was driven by intense transmission in the country's west and north", the WHO said.<ref name=":2">{{cite news|url=http://www.huffingtonpost.com/2014/11/19/ebola-sierra-leone_n_6186566.html|title=Ebola Spreading Intensely In Sierra Leone As Death Toll Rises: WHO|work=The Huffington Post|access-date=20 November 2014|date=19 November 2014}}</ref>
] in 2014]]
A British-built Ebola Treatment Centre which started in ] during November, generated some controversy because of its initially limited capacity. However, this was because they were following guidelines of how to safely open an Ebola treatment unit. This was the first of six planned treatment centres which, when completed, would be staffed by a number of ]s.<ref name=Guardian_20_Nov_limited_capacity>{{cite web|title=British-built Ebola hospital in Sierra Leone only partly operational|date=20 November 2014 |url=https://www.theguardian.com/world/2014/nov/20/british-ebola-hospital-sierra-leone-partly-operational|publisher=Guardian|access-date=21 November 2014}}</ref>

In mid-November the WHO reported that while all cases and deaths continued to be under-reported, "there is some evidence that case incidence is no longer increasing nationally in Guinea and Liberia, but steep increases persist in Sierra Leone".<ref name="World Health Organization">{{cite web | url=https://www.who.int/csr/disease/ebola/situation-reports/en/?m=20141112&file=sitreps/20141112/20141112.html | archive-url=https://web.archive.org/web/20141112221345/http://www.who.int/csr/disease/ebola/situation-reports/en/?m=20141112&file=sitreps/20141112/20141112.html | url-status=dead | archive-date=12 November 2014 | title=Ebola response roadmap – Situation report | publisher=WHO | date=12 November 2014 | access-date=16 November 2014}}</ref> On 19 November, it was reported that the Ebola virus was spreading intensely; "much of this was driven by intense transmission in the country's west and north", the WHO said.<ref name=":2"/> The first Cuban doctor to be infected with the virus was flown to Geneva.<ref>{{cite news|url=https://www.telegraph.co.uk/news/worldnews/ebola/11240641/Cuban-doctor-in-Sierra-Leone-tests-positive-for-Ebola.html|title=Cuban doctor in Sierra Leone tests positive for Ebola|work=The Daily Telegraph|access-date=21 November 2014|date=21 November 2014|location=London}}</ref> On 26 November, it was reported that due to Sierra Leone's increased Ebola transmission, the country would surpass Liberia in the total cases count.<ref>{{cite news| url=https://www.nytimes.com/2014/11/27/world/africa/sierra-leone-to-eclipse-liberia-in-ebola-cases.html | work=The New York Times | first=Rick | last=Gladstone | title=Sierra Leone to Eclipse Liberia in Ebola Cases | date=26 November 2014}}</ref> On 27 November, Canada announced it would deploy military health staff to the infected region.<ref>{{cite news|url=https://www.reuters.com/article/us-health-ebola-canada-idUSKCN0JB26D20141127|title=Canada to deploy military health staff to Sierra Leone in Ebola fight|work=Reuters|access-date=29 November 2014|date=27 November 2014}}</ref> On 29 November, the President of Sierra Leone canceled a planned three-day shutdown in Freetown to curb the virus.<ref>{{cite news|url=http://www.news24.com/Africa/News/Sierra-Leone-president-cancels-3-day-business-shutdown-20141128|title=Sierra Leone president cancels 3-day business shutdown|website=News24|access-date=30 November 2014}}</ref>

===December 2014===
]
On 2 December, it was reported that the ] district had begun a two-week lockdown, "which was agreed in a key stakeholders meeting of cabinet ministers, parliamentarians and paramount chiefs of the district as part of efforts to stem the spread of the disease", according to a ministry spokesman. The move meant that a total of six districts, containing more than half of the population, were locked down.<ref>{{cite web|url=http://www.newdemocraticcoalition.org/history/|website=New Democratic Coalition|title=History|access-date=26 May 2020}}</ref>

Sierra Leone indicated, in a report on 5 December, that about 100 cases of the virus were now being reported daily.<ref>{{cite web|url=https://abcnews.go.com/US/wireStory/sierra-leone-80-100-ebola-cases-daily-27394068|title=Sierra Leone Seeing 80–100 New Ebola Cases Daily|author=ABC News|website=ABC News|access-date=6 December 2014}}</ref> On the same day, it was further reported that families caught taking part in burial washing rituals, which can spread the virus, would be taken to jail.<ref>{{cite web|url=http://america.aljazeera.com/articles/2014/12/5/sierra-leone-ebolaarrests.html|title=Sierra Leone threatens to jail families in Ebola crackdown|website=aljazeera.com|access-date=7 December 2014}}</ref> On 6 December, a report indicated that the Canadian Armed Forces would send a medical team to the country of Sierra Leone to help combat the Ebola virus epidemic.<ref>{{cite web|url=http://www.ctvnews.ca/health/caf-deploys-medical-team-to-ebola-stricken-sierra-leone-1.2136407|title=CAF deploys medical team to Ebola-stricken Sierra Leone|website=CTVNews|date=6 December 2014 |access-date=12 December 2014}}</ref>

On 8 December, the doctors in Sierra Leone went on strike, demanding better treatment for health care workers, according to Health Ministry spokesman Jonathan Abass Kamara.<ref>{{cite web|url=https://abcnews.go.com/Health/wireStory/sierra-leone-doctors-strike-ebola-care-27449276|title=Sierra Leone Doctors Strike for Better Ebola Care|website=ABC News|access-date=9 December 2014|date=8 December 2014}}</ref>

On 9 December, Sierra Leone authorities placed the Eastern ] in a two-week lock-down following the alarming rate of infection and deaths there. The lock down lasted until 23 December.<ref>{{cite web|url=https://abcnews.go.com/Health/wireStory/sierra-leone-area-hold-week-ebola-lockdown-27497818|title=Sierra Leone Area to Hold 2-Week Ebola 'Lockdown'|website=AB News|access-date=11 December 2014}}</ref> This followed the grim discovery of bodies piling up in the district. The WHO reported fear of a major breakout in the area. The district with 350,000 inhabitants buried 87 bodies in 11 days, with 25 patients dying in 5 days before the WHO arrived.<ref>{{cite news|url=http://www.abc.net.au/news/2014-12-11/sierra-leone-hit-by-largely-hidden-ebola-outbreak/5959596|title=Ebola crisis: Sierra Leone hit by largely hidden outbreak; WHO says scores of bodies piled up|website=ABC News|date=10 December 2014 |access-date=11 December 2014}}</ref>

On 12 December, Sierra Leone banned all public festivities for Christmas or New Year, because of the outbreak.<ref>{{cite news|url=https://www.bbc.com/news/world-africa-30455248|title=BBC News – Ebola crisis: Sierra Leone bans Christmas celebrations|work=BBC News |date=12 December 2014 |access-date=13 December 2014}}</ref> On 13 December, it was reported that the first Australian
facility had been opened; "operations will be gradually scaled up to full capacity at 100 beds under strict guidelines to ensure infection control procedures are working effectively and trained staff&nbsp;... are in place", one source indicated.<ref>{{cite web|url=https://www.theguardian.com/world/2014/dec/14/ebola-australian-run-centre-in-sierra-leone-opens-for-business|title=Ebola: Australian-run centre in Sierra Leone opens for business|author=Shalailah Medhora|website=the Guardian|date=14 December 2014 |access-date=15 December 2014}}</ref>

]/Doctors Without Borders, in partnership with the Ministry of Health, carried out during December the largest-ever distribution of ]s in Sierra Leone. Teams distributed 1.5 million antimalarial treatments in Freetown and surrounding districts with the aim of protecting people from ] during the disease's peak season. A spokesman said "In the context of Ebola, malaria is a major concern, because people who are sick with malaria have the same symptoms as people sick with Ebola. As a result, most people turn up at Ebola treatment centres thinking that they have Ebola, when actually they have malaria. It's a huge load on the system, as well as being a huge stress on patients and their families."<ref>{{cite web|title=Sierra Leone: MSF distribute 1.5m malaria drugs as part of Ebola response|url=http://www.msf.org.uk/article/sierra-leone-msf-distribute-1-5m-malaria-drugs-as-part-of-ebola-response|publisher=Médecins Sans Frontières/Doctors Without Borders|access-date=17 December 2014}}</ref>

Between 14 and 17 December Sierra Leone reported 403 new cases with a total of 8,759 cases on the latter date.<ref name="Ebola_Outbreak_total_sl_18_Dec">{{cite web| url=http://health.gov.sl/wp-content/uploads/2014/12/Ebola-Situation-Report_Vol-204.pdf| title=Ebola Virus Disease – Situation Report (Sit-Rep) –) 18 December, 2014| access-date=19 December 2014| date=18 December 2014| url-status=dead| archive-url=https://web.archive.org/web/20141219161011/http://health.gov.sl/wp-content/uploads/2014/12/Ebola-Situation-Report_Vol-204.pdf| archive-date=19 December 2014}}</ref><ref name="Ebola_Outbreak_total_sl_14_Dec">{{cite web| url=http://health.gov.sl/wp-content/uploads/2014/12/Ebola-Situation-Report_Vol-201.pdf| title=Sierra Leone: Ebola Outbreak Updates — December 15, 2014| access-date=15 December 2014| date=15 December 2014| url-status=dead| archive-url=https://web.archive.org/web/20141220203935/http://health.gov.sl/wp-content/uploads/2014/12/Ebola-Situation-Report_Vol-201.pdf| archive-date=20 December 2014}}</ref> On 25 December, Sierra Leone put the north area of the country on lockdown.<ref>{{cite web|url=https://www.npr.org/blogs/thetwo-way/2014/12/25/373077791/sierra-leone-puts-north-on-lockdown-amid-ebola-spread|title=Sierra Leone Puts North On Lockdown Amid Ebola Spread|publisher=NPR|access-date=11 January 2015 |date=24 December 2014}}</ref> By the end of December Sierra Leone again reported a surge in numbers, with 9,446 cases reported.<ref name="WHO2014_12_29">{{cite web |url=http://apps.who.int/gho/data/view.ebola-sitrep.ebola-summary-20141229?lang=en |title=Situation summary Data published 29 December 2014|publisher=World Health organization|date=26 December 2014|access-date =28 December 2014}}</ref><ref name="Ebola_Outbreak_total_sl_28_Dec">{{cite web| url=http://health.gov.sl/wp-content/uploads/2014/12/Ebola-Situation-Report_Vol-215.pdf| title=Sierra Leone: Ebola Outbreak Updates — December 28, 2014| access-date=30 December 2014| date=29 December 2014| archive-url=https://web.archive.org/web/20141230083951/http://health.gov.sl/wp-content/uploads/2014/12/Ebola-Situation-Report_Vol-215.pdf| archive-date=30 December 2014| url-status=dead}}</ref>

On 29 December 2014, ], a British aid worker who had just returned to ] from working at the treatment centre in Kerry Town, was diagnosed with Ebola at Glasgow's ].<ref name=guardian2014dec29>{{cite web|url=https://www.theguardian.com/world/2014/dec/29/ebola-case-confirmed-glasgow-healthcare-worker|title=Ebola case confirmed in Glasgow|work=The Guardian|date=29 December 2014|author1=Severin Carrell |author2=Libby Brooks |author3=Lisa O'Carroll }}</ref><ref name="Ebola_UK_29_12">{{cite news|title=Hero nurse Pauline Cafferkey could have contracted deadly Ebola at Christmas Day service|url=https://www.telegraph.co.uk/news/uknews/scotland/11317226/Ebola-in-Scotland-Hero-nurse-Pauline-Cafferkey-spoke-movingly-of-saving-lives.html|work=The Daily Telegraph|date=30 December 2014|location=London|first=Robert|last=Mendick}}</ref>

==2015: Outbreak continues==

===January 2015===

On 4 January, the lockdown was extended for two weeks.<ref>{{cite web|url=https://news.yahoo.com/ebola-lockdown-sierra-leone-airport-checks-upped-191625879.html|title=New Ebola lockdown in Sierra Leone as airport checks upped|date=4 January 2015|website=Yahoo News|access-date=7 January 2015}}</ref> On this day the country reported 9780 cases with 2943 deaths. Among healthcare workers there were 296 cases with 221 fatalities reported.<ref name="WHO2015_01_04">{{cite web |url=http://apps.who.int/iris/bitstream/10665/147112/1/roadmapsitrep_7Jan2015_eng.pdf?ua=1 |title=Ebola Situation report on 7 January 2015 |publisher=World Health organization|date=7 January 2015|access-date =8 January 2015}}</ref>

On 8 January, MSF admitted its first patients to a Treatment Centre (ETC) in ], an Ebola hotspot on the outskirts of Freetown. Once the ETC is fully operational it will include specialist facilities for pregnant women.<ref>{{cite web|title=Ebola: MSF opens new treatment centre in Kissy, Sierra Leone|url=http://www.msf.org.uk/article/ebola-msf-opens-new-treatment-centre-in-kissy-sierra-leone|publisher=Médecins Sans Frontières/Doctors without Borders}}</ref> By 9 January, the case load in the country exceeded 10,000, with 10,074 cases and 3,029 deaths reported.<ref name="Ebola_Outbreak_total_sl_9_Jan_15">{{cite web| url=http://health.gov.sl/wp-content/uploads/2015/01/Ebola-Situation-Report_Vol-227.pdf| title=Sierra Leone: Ebola Virus Disease – Situation Report (Sit-Rep) 10 January 2015| access-date=11 January 2015| date=10 January 2015| archive-url=https://web.archive.org/web/20150111123840/http://health.gov.sl/wp-content/uploads/2015/01/Ebola-Situation-Report_Vol-227.pdf| archive-date=11 January 2015| url-status=dead}}</ref> On 9 January, it was reported that South Korea would send a medical team to ].<ref>{{cite web|url=http://english.yonhapnews.co.kr/news/2015/01/09/0200000000AEN20150109001200315.html|title=Seoul set to send 2nd medical team to Ebola-hit Sierra Leone|access-date=9 January 2015}}</ref>

On 10 January, Sierra Leone declared its first Ebola-free district. The Pujehun district in the south east of the country reported no new cases for 42 days.<ref>{{cite news|title=Sierra Leone declares first Ebola-free district|url=https://www.theguardian.com/world/2015/jan/10/sierra-leone-first-ebola-free-district-who|work=The Guardian|date=10 January 2015|access-date=11 January 2015}}</ref>

===February 2015===
A worker at ] clinic was evacuated to the United Kingdom on 2 February 2015, after a ].<ref>{{cite web|url=http://www.scotsman.com/news/health/brit-flown-back-to-uk-after-exposure-to-ebola-1-3676180|title=Brit flown back to UK after exposure to Ebola|website=scotsman.com|access-date=6 February 2015}}</ref> On 5 February, it was reported that there was a rise in weekly cases for the first time this year.<ref>{{cite news|url=https://www.usatoday.com/story/news/world/2015/02/05/ebola-liberia-sierra-leone-guinea-infections-increase/22935171/|title=Downward Ebola trend suddenly reverses itself|last=Zoroya|first=Gregg|date=5 February 2015|work=USA Today|access-date=6 February 2015}}</ref><ref>{{cite web|url=http://www.voanews.com/content/ebola-hit-sierra-leone-to-reopen-schools-march-3oth/2629854.html|title=Ebola-hit Sierra Leone to Reopen Schools March 30|website=VOA|date=5 February 2015 |access-date=7 February 2015}}</ref> The U.N. indicated that the sharp drop in cases had "flattened out" raising concern about the virus.<ref>{{cite web|url=http://www.philstar.com/world/2015/02/21/1426253/decline-ebola-cases-flattens-raising-un-concern|title=Decline in Ebola cases flattens, raising UN concern|website=philstar.com|access-date=22 February 2015}}</ref>

===March 2015===
]
On 5 March, a report indicated cases in Sierra Leone continued to rise.<ref>{{cite web|url=http://www.gnnliberia.com/articles/2015/03/05/more-ebola-guinea-sierra-leone-last-week-no-liberia-cases-says-who|title=More Ebola in Guinea, Sierra Leone last week, no Liberia cases says WHO|website=gnnliberia.com|access-date=7 March 2015|url-status=dead|archive-url=https://web.archive.org/web/20150402093450/http://www.gnnliberia.com/articles/2015/03/05/more-ebola-guinea-sierra-leone-last-week-no-liberia-cases-says-who|archive-date=2 April 2015}}</ref> The government of Sierra Leone declared a three-day country-wide lock-down including 2.5 million people on 18 March.<ref>{{cite web|url=https://www.usnews.com/news/world/articles/2015/03/18/sierra-leone-plans-another-shutdown-to-stop-ebolas-spread|title=Sierra Leone plans another shutdown to stop Ebola's spread – US News|website=U.S. News & World Report|access-date=19 March 2015}}</ref><ref>{{cite news|url=https://www.bbc.com/news/world-africa-31966989|title=BBC News – Ebola crisis: Sierra Leone lockdown to hit 2.5m people|work=BBC News |date=19 March 2015 |access-date=20 March 2015}}</ref> The U.N. indicates the outbreak will be over by August of this year.<ref>{{cite news|url=https://www.bbc.com/news/health-32009508|title=Ebola outbreak 'over by August', UN suggests|access-date=24 March 2015|work=BBC News|date=23 March 2015|last1=Mundasad|first1=Smitha}}</ref>

The 3-day lock-down of over 6 million inhabitants revealed a 191% increase in possible Ebola cases. In Freetown alone 173 patients meeting the criteria for Ebola were discovered according to Obi Sesay from the National Ebola Response Center.<ref>{{cite news|url=https://www.foxnews.com/health/sierra-leone-ebola-lockdown-exposes-hundreds-of-suspected-cases/|title=Sierra Leone Ebola lockdown exposes hundreds of suspected cases|work=Fox News|access-date=31 March 2015|date=31 March 2015}}</ref>

===Spring 2015===
As of 12 May, Sierra Leone had gone 8 days without an Ebola case, and was down to two confirmed cases of Ebola.<ref>{{cite web|url=http://www.nbcnews.com/storyline/ebola-virus-outbreak/ebola-epidemic-slows-even-more-n358376|title=Ebola Epidemic Slows Even More, World Health Organization Says|author=Maggie Fox|website=NBC News|date=13 May 2015 |access-date=5 August 2015}}</ref> The WHO weekly update for 29 July reported a total of only three new cases, the lowest total in more than a year.<ref name=":4"/> On 17 August, the country had its first week with no new cases,<ref>{{cite magazine|url=https://time.com/4000158/sierra-leone-no-new-ebola/|title=Sierra Leone Has First Week of No New Ebola Cases|author=Alexandra Sifferlin|magazine=Time|access-date=19 August 2015|date=17 August 2015}}</ref> and one week later the last patients were released.<ref>. ''UN News Center''. 26 August 2015.</ref>

===August/September 2015===
A new death was reported on 1 September after a patient from Sella Kafta village in Kambia District was tested positive for the disease after her death.<ref>{{cite news|url=http://www.news24.com/Africa/News/New-Ebola-death-in-Sierra-Leone-sets-back-efforts-to-beat-epidemic-20150831|title=New Ebola death in Sierra Leone sets back efforts to beat epidemic|work=News 24|access-date=1 September 2015|date=1 September 2015 }}</ref> On 5 September, another case of Ebola was identified in the village among the approximately 1000 people currently under quarantine. A woman tested positive for the virus. The "]" has been administered by a WHO team in the village since Friday 5 September.<ref>{{cite news|url=https://news.yahoo.com/ebola-case-sierra-leone-quarantine-village-president-013552935.html|title=New Ebola case in Sierra Leone quarantine village: president|work=Yahoo News |access-date=7 September 2015|date=7 September 2015 }}</ref> On 8 September the head of the National Ebola Response Center confirmed new cases of Ebola. This brought the total from the village to four cases, with all of them being under the "high risk" contact cases with the death of the new index case in the village. In total four cases were then confirmed including the dead woman.<ref>{{cite news|url=https://www.usnews.com/news/world/articles/2015/09/08/sierra-leone-officials-confirm-3-new-cases-of-ebola|title=Sierra Leone officials confirm 3 new cases of Ebola among high risk contacts with fatal case|agency=Associated Press |access-date=9 September 2015|date=8 September 2015 }}</ref>

On 14 September, the National Ebola Response Center confirmed the death of a 16-year-old in a village in the Bombali district. Swabs taken from the body tested positive for the disease. The village was placed under quarantine.<ref>{{cite news|url=http://www.ctvnews.ca/health/new-ebola-death-reported-in-northern-sierra-leone-1.2562302|title=New Ebola death reported in northern Sierra Leone|work=CTV News|access-date=14 September 2015|date=14 September 2015 }}</ref> She had no history of traveling outside the village, and it is suspected that she contracted the disease from the semen of an Ebola survivor who was discharged in March 2015. Seven of her immediate contacts were taken to an Ebola treatment center, with a further three patients she had contact with at a health clinic.<ref>{{cite news|url=https://www.reuters.com/article/us-health-ebola-leone-idUSKCN0RE1P620150914|title=Hundreds quarantined as Ebola returns to north Sierra Leone district|work=Reuters|access-date=14 September 2015|date=14 September 2015 }}</ref> A new study to be published in the ''New England Journal of Medicine'' indicates the possibility that the virus may lurk in the semen of survivors for up to six months. Nearly half of 200 patients tested had traces of the virus in their semen six months after surviving the disease.<ref>{{cite news|url=http://uk.reuters.com/article/us-health-ebola-semen-idUKKCN0R922G20150909|archive-url=https://web.archive.org/web/20160410073941/http://uk.reuters.com/article/us-health-ebola-semen-idUKKCN0R922G20150909|url-status=dead|archive-date=10 April 2016|title=Sex and masturbation may hamper Ebola eradication efforts|work=Reuters|access-date=14 September 2015|date=9 September 2015 }}</ref> On 7 November, the World Health Organization declared Sierra Leone Ebola-free.<ref>{{cite web|url=http://apps.who.int/ebola/current-situation/ebola-situation-report-11-november-2015 |archive-url=https://web.archive.org/web/20151111211316/http://apps.who.int/ebola/current-situation/ebola-situation-report-11-november-2015 |url-status=dead |archive-date=11 November 2015 |title=Ebola Situation Report - 11 November 2015|access-date=2 December 2019}}</ref>

===January 2016===
Sierra Leone entered a 90-day period of enhanced surveillance which was scheduled to conclude on 5 February 2016, but due to a new case in mid-January it did not.<ref>{{cite web|url=http://apps.who.int/ebola/current-situation/ebola-situation-report-9-december-2015|archive-url=https://web.archive.org/web/20151211130610/http://apps.who.int/ebola/current-situation/ebola-situation-report-9-december-2015|url-status=dead|archive-date=11 December 2015|title=Ebola Situation Report – 9 December 2015|access-date=17 December 2015}}</ref> On 14 January, it was reported there had been a fatality linked to the Ebola virus. The case occurred in the Tonkolili district.<ref>{{cite news|url=https://www.bbc.com/news/world-africa-35320363|title=Ebola virus: New case emerges in Sierra Leone|work=BBC News|date=15 January 2016}}</ref> Prior to this case WHO had advised, "we anticipate more flare-ups and must be prepared for them&nbsp;... massive effort is underway to ensure robust prevention, surveillance and response capacity across all three countries by the end of March."<ref>{{cite web|url=https://www.who.int/mediacentre/news/releases/2016/ebola-zero-liberia/en/|title=WHO – Latest Ebola outbreak over in Liberia; West Africa is at zero, but new flare-ups are likely to occur|website=World Health Organization}}</ref> On 16 January, it was reported that the woman who died of the virus may have exposed several individuals; the government announced that 100 people had been quarantined.<ref>{{cite web|url=https://www.theguardian.com/world/2016/jan/15/ebola-victim-in-sierra-leone-feared-to-have-exposed-27-others-to-virus|title=Sierra Leone puts more than 100 people in quarantine after new Ebola death|website=the Guardian|date=17 January 2016 }}</ref> On the same day, WHO released a statement, indicating that originally the 90-day enhanced surveillance period was to end on 5 February. Investigations indicate the female case was a student at Lunsar in Port Loko district, who had gone to Kambia district on 28 December until returning symptomatic. Bombali district was visited by the individual, for consultation with an herbalist, later going to a government hospital in Magburaka. WHO indicates there are 109 contacts, 28 of which are high risk, furthermore, there are three missing contacts.The source or route of transmission which caused the fatality is still unknown.<ref>{{cite web |url=http://www.afro.who.int/en/sierra-leone/press-materials/item/8281-government-press-statement-confirmation-of-evd-death-in-sierra-leone-–-16-january-2016.html |title=Government Press Statement: Confirmation of EVD Death in Sierra Leone – 16 January 2016 |website=WHO |date=16 January 2016 |access-date=21 January 2016 |url-status=dead |archive-url=https://web.archive.org/web/20160122004724/http://www.afro.who.int/en/sierra-leone/press-materials/item/8281-government-press-statement-confirmation-of-evd-death-in-sierra-leone-%E2%80%93-16-january-2016.html |archive-date=22 January 2016 }}</ref> A second new case was confirmed on 20 January; the patient had contact with the previous fatality.<ref>{{cite news |url= http://www.itv.com/news/update/2016-01-20/sierra-leone-confirms-second-case-of-ebola-in-a-week/ |title=Sierra Leone confirms second case of Ebola in a week |work=Yahoo News |date=20 January 2016 |access-date=21 January 2016}}</ref> On 17 March, the WHO declared the country Ebola-free.<ref>{{cite web|url=http://apps.who.int/ebola/current-situation/ebola-situation-report-16-march-2016|archive-url=https://web.archive.org/web/20160318125119/http://apps.who.int/ebola/current-situation/ebola-situation-report-16-march-2016|url-status=dead|archive-date=18 March 2016|title=Ebola Situation Report - 16 March 2016 - Ebola|access-date=9 June 2016}}</ref>


==Healthcare capacity== ==Healthcare capacity==
Long-term political factors contributed to the Ebola crisis including the acute dependency on external health assistance, patron-client politics, corruption and a weak ].<ref>{{cite journal|last1=Anderson|first1=E.L.|last2=Beresford|first2=A|title= Infectious injustice: the political foundations of the Ebola crisis in Sierra Leone |journal=Third World Quarterly| date=2016|volume=37|issue=3|pages= 468–486|doi=10.1080/01436597.2015.1103175|s2cid=73696543|url=http://eprints.whiterose.ac.uk/90600/3/Anderson%20%2526%20Beresford%20%20%27Infectious%20Injustice%20-%20The%20political%20foundations%20of%20the%20Ebola%20crisis%20in%20Sierra%20Leone%27%20%282%29.pdf}}</ref> Prior to the Ebola epidemic Sierra Leone had about 136 doctors and 1,017 nurses/midwives for a population of about 6 million people.<ref>{{cite news |url=https://www.bbc.com/news/world-africa-29324595 |title=BBC News – Ebola drains already weak West African health systems |work=BBC News |date=24 September 2014 |access-date=4 December 2014}}</ref> On 26 August, the WHO (World Health Organisation) shut down one of two laboratories after a health worker became infected. The laboratory was situated in the ] district, one of the worst-affected areas. It was thought by some that this move would disrupt efforts to increase the global response to the outbreak of the disease in the district.<ref name = WHO_infected_SL>{{cite news |url=https://www.reuters.com/article/us-health-ebola-idUSKBN0GQ17920140826 |title=WHO pulls staff after worker infected with Ebola in Sierra Leone |publisher=Reuters |date=26 August 2014 |access-date=26 August 2014}}</ref>
], samples are tested for Ebola.]]

On 26 August, the WHO shut down one of two laboratories after a health worker became infected. The laboratory was situated in the ] district, one of the worst-affected areas. It was thought by some that this move would disrupt efforts to increase the global response to the outbreak of the disease in the district.<ref name = WHO_infected_SL>{{cite news |url=http://www.reuters.com/article/2014/08/26/us-health-ebola-idUSKBN0GQ17920140826 |title=WHO pulls staff after worker infected with Ebola in Sierra Leone |publisher=Reuters |date=26 August 2014 |accessdate=26 August 2014}}</ref> "It's a temporary measure to take care of the welfare of our remaining workers," WHO spokesperson Christy Feig announced. He did not specify how long the closure would last, but said they would return after an assessment of the situation by the WHO. The medical worker, one of the first WHO staff infected by the Ebola Virus, was treated at a hospital in Kenema and then evacuated to ].<ref name = WHO_infected_SL/><ref name="NBC News">{{cite news |url=http://www.nbcnews.com/storyline/ebola-virus-outbreak/ebola-patient-arrives-germany-treatment-n190006 |title=Ebola Patient Arrives in Germany for Treatment |publisher=NBC News |date=27 August 2014 |accessdate=28 August 2014}}</ref> By 4 October 2014, it was announced he has recovered and left Germany.<ref name="hosted.ap.org">{{cite web|url=http://hosted.ap.org/dynamic/stories/E/EU_GERMANY_EBOLA|title= German hospital: Scientist treated for Ebola cured|publisher=|accessdate=6 October 2014}}</ref>
"It's a temporary measure to take care of the welfare of our remaining workers", WHO spokesperson Christy Feig announced. He did not specify how long the closure would last, but said they would return after an assessment of the situation by the WHO. The medical worker, one of the first WHO staff infected by the Ebola Virus, was treated at a hospital in Kenema and then evacuated to ].<ref name = WHO_infected_SL/><ref name="NBC News">{{cite news |url=http://www.nbcnews.com/storyline/ebola-virus-outbreak/ebola-patient-arrives-germany-treatment-n190006 |title=Ebola Patient Arrives in Germany for Treatment |work=NBC News |date=27 August 2014 |access-date=28 August 2014}}</ref> By 4 October 2014, it was announced he has recovered and left Germany.<ref name="hosted.ap.org">{{cite web|url=http://hosted.ap.org/dynamic/stories/E/EU_GERMANY_EBOLA|title= German hospital: Scientist treated for Ebola cured|access-date=6 October 2014}}</ref>

As the Ebola epidemic grew it damaged the health care infrastructure, leading to increased deaths from other health issues including malaria, diarrhoea, and pneumonia because they were not being treated.<ref>{{cite news|url=https://www.reuters.com/article/us-health-ebola-collateral-idUSKCN0HL0TU20140926|title= 'Collateral' death toll expected to soar in Africa's Ebola crisis|work=Reuters|access-date=30 September 2014|date=26 September 2014}}</ref> The WHO estimated on 21 September that Sierra Leone's capacity to treat Ebola cases fell short by the equivalent of 532 beds.<ref name="sitrep_24Sept2014"/>

=== Death of health workers ===
], also known as Mabesseneh Hospital,<ref>{{cite web|url=http://politicosl.com/2014/10/mabesseneh-hospital-up-against-ebola/|title=Mabesseneh Hospital up against Ebola|access-date=27 October 2014|url-status=dead|archive-url=https://web.archive.org/web/20141031223857/http://politicosl.com/2014/10/mabesseneh-hospital-up-against-ebola/|archive-date=31 October 2014}}</ref> near ]. This is one of the hospitals operated in part by the Spanish aid organization ], which lost multiple health workers to Ebola including two evacuated to Spain.]]
On 27 August 2014, Dr. Sahr Rogers died from Ebola after contracting it working in Kenema.<ref>{{cite web|url=http://bigstory.ap.org/article/3rd-doctor-dies-ebola-sierra-leone|title=US official warns Ebola outbreak will get worse|website=The Big Story|access-date=8 October 2014|archive-date=18 October 2014|archive-url=https://web.archive.org/web/20141018230721/http://bigstory.ap.org/article/3rd-doctor-dies-ebola-sierra-leone|url-status=dead}}</ref> Sierra Leone lost three of its top doctors by the end of August to Ebola.<ref>{{cite news|url=http://www.cbc.ca/news/health/ebola-infected-doctor-in-sierra-leone-sahr-rogers-dies-1.2748090|title=Ebola-infected doctor in Sierra Leone, Sahr Rogers, dies|date=27 August 2014|access-date=30 September 2014|work=CBC News}}</ref>

A fourth doctor, Dr. Olivette Buck, became ill with Ebola in September and died later that month.<ref>{{cite web|url=http://www.oudaily.com/news/sierra-leone-requests-funds-for-ebola-evacuation/article_1aa37b22-3ce1-11e4-9d85-0017a43b2370.html|title=Sierra Leone requests funds for Ebola evacuation|website=OUDaily.com|date=15 September 2014 |access-date=30 September 2014}}</ref> Dr. Olivette Buck was a Sierra Leone doctor who worked in Freetown, who tested positive for Ebola on 9 September 2014, and died on 14 September 2014.<ref name="ReferenceA"/> Her staff believes she was exposed in August. She eventually went to Lumley Hospital on 1 September 2014, with a fever, thinking it was malaria.<ref name="ReferenceA"/> After a few more days of illness she was admitted to ].<ref name="ReferenceA"/>

By 23 September 2014, out of 91 health workers known to have been infected with Ebola in Sierra Leone, approximately 61 had died.<ref>{{cite news|url=https://www.foxnews.com/health/who-revises-up-number-of-health-workers-killed-by-ebola-in-sierra-leone/|title=WHO revises up number of health workers killed by Ebola in Sierra Leone|work=Fox News|access-date=30 September 2014|date=23 September 2014}}</ref>

On 19 October, the WHO reported 129 cases with 95 deaths of healthcare workers (125 / 91 confirmed).<ref name="Ebola_Outbreak_total_sl_24_Oct">{{cite web| url=http://health.gov.sl/wp-content/uploads/2014/10/Ebola-Situation-Report_Vol-150.pdf| title=Sierra Leone: Ebola Virus Disease – Situation Report (Sit-Rep) – 25 October 2014| access-date=25 October 2014| date=24 October 2014| archive-url=https://web.archive.org/web/20141028114305/http://health.gov.sl/wp-content/uploads/2014/10/Ebola-Situation-Report_Vol-150.pdf| archive-date=28 October 2014| url-status=dead| df=dmy-all}}</ref> On 2 November 2014, a fifth doctor, Dr. Godfrey George, a ] of ] died as a result of Ebola infection.<ref>{{cite web|url=http://www.msnbc.com/msnbc/fifth-doctor-sierra-leone-dies-ebola|title=Fifth doctor in Sierra Leone dies of Ebola|website=MSNBC|access-date=7 November 2014|date=3 November 2014}}</ref> On 17 November 2014, a sixth doctor, Dr Martin Salia, died as a result of Ebola infection, after being transported by medevac to Nebraska Medical Center in the United States.<ref name="N241117">{{cite web|url=http://www.news24.com/World/News/Doctor-with-Ebola-dies-at-Nebraska-hospital-20141117-2|title=Doctor with Ebola dies at Nebraska hospital|website=News24|access-date=21 November 2014|date=17 November 2014}}</ref>


On 18 November 2014, a seventh doctor, Dr Michael Kargbo, died in Sierra Leone. He worked at the ].<ref>{{cite news|url=https://www.reuters.com/article/health-ebola-leone-idUSL6N0T85I020141118|title=Update 1-Seventh Sierra Leone doctor killed by Ebola -source|work=Reuters|access-date=4 December 2014|date=18 November 2014}}</ref>
As the Ebola epidemic grew it damaged the health care infrastructure, leading to increased deaths from other health issues including malaria, diarrhoea, and pneumonia because they were not being treated.<ref>{{cite web|url=http://www.reuters.com/article/2014/09/26/us-health-ebola-collateral-idUSKCN0HL0TU20140926|title= 'Collateral' death toll expected to soar in Africa's Ebola crisis|work=Reuters|accessdate=30 September 2014}}</ref> Sierra Leone lost three of its top doctors by the end of August, because they died from Ebola.<ref>{{cite web|url=http://www.cbc.ca/news/health/ebola-infected-doctor-in-sierra-leone-sahr-rogers-dies-1.2748090|title=Ebola-infected doctor in Sierra Leone, Sahr Rogers, dies|date=27 August 2014|publisher=|accessdate=30 September 2014}}</ref> A fourth doctor became ill with Ebola in September and died that month.<ref>{{cite web|url=http://www.oudaily.com/news/sierra-leone-requests-funds-for-ebola-evacuation/article_1aa37b22-3ce1-11e4-9d85-0017a43b2370.html|title=Sierra Leone requests funds for Ebola evacuation|work=OUDaily.com|accessdate=30 September 2014}}</ref>


Dr. Aiah Solomon Konoyeima was reported to have Ebola in late November 2014, which would make him the eighth physician to contract Ebola.<ref>{{cite web|url=http://www.democracynow.org/2014/11/26/headlines/8th_doctor_infected_with_ebola_in_sierra_leone_burial_workers_dump_corpses_in_protest|title=8th Doctor Infected with Ebola in Sierra Leone; Burial Workers Dump Corpses in Protest over Pay|website=Democracy Now!|access-date=4 December 2014}}</ref> He was reported to have died from the disease on 7 December 2014, becoming what was reported as the tenth doctor to die from Ebola.<ref>{{cite web|url=https://abcnews.go.com/Health/wireStory/10th-sierra-leonean-doctor-dies-ebola-27424222|title=Health News & Articles – Healthy Living – ABC News|author=ABC News|website=ABC News|access-date=25 December 2014}}</ref>
By 23 September 2014 about 61 health workers had died out of 91 known to have been infected with Ebola in Sierra Leone.<ref>{{cite web|url=http://www.foxnews.com/health/2014/09/23/who-revises-up-number-health-workers-killed-by-ebola-in-sierra-leone/|title=WHO revises up number of health workers killed by Ebola in Sierra Leone|work=Fox News|accessdate=30 September 2014}}</ref>


On 26 November 2014, a ninth doctor, Dr. Songo Mbriwa, was reported to be sick with Ebola disease.<ref name=":3">{{cite web|url=https://abcnews.go.com/Health/wireStory/sierra-leone-official-ebola-worst-27199617|title=Sierra Leone Official: Ebola May Have Reached Peak|author=ABC News|website=ABC News|access-date=4 December 2014}}</ref> He was working at an Ebola treatment centre in Freetown.<ref name=":3"/> He was one of the doctors that cared for the late Dr Martin Salia, who experienced a ] Ebola test, but did indeed have it and may have exposed others.<ref>{{cite news|url=https://www.washingtonpost.com/world/sierra-leone-physician-who-treated-martin-salia-diagnosed-with-ebola/2014/11/27/af1fbd54-7627-11e4-a755-e32227229e7b_story.html|title=Sierra Leone physician who treated doctor with Maryland ties is diagnosed with Ebola|newspaper=The Washington Post|access-date=4 December 2014|first=Kevin|last=Sieff|date=27 November 2014}}</ref>
WHO estimated on 21 September that Sierra Leone's capacity to treat EVD cases falls short by the equivalent of 532 beds.<ref name="sitrep_24Sept2014"/>


On Friday 5 December, a senior health official announced the death of two of the country's doctors in one day. This brings the total number of doctors who have died from the disease in Sierra Leone to ten. Dr Dauda Koroma and Dr Thomas Rogers are the latest deaths among healthcare workers.<ref>{{cite news|url=http://www.sabc.co.za/news/a/86d18d804675f64491709365674106c3/Two-Sierra-Leone-doctors-die-of-Ebola-20140612|title=Two Sierra Leone doctors die of Ebola|work=SABC|access-date=6 December 2014|date=6 December 2014|archive-url=https://web.archive.org/web/20141210165610/http://www.sabc.co.za/news/a/86d18d804675f64491709365674106c3/Two-Sierra-Leone-doctors-die-of-Ebola-20140612|archive-date=10 December 2014|url-status=dead}}</ref> The two doctors were not in the front line of the Ebola battle and did not work in an Ebola treatment hospital.<ref>{{cite news|url=http://www.chicagotribune.com/news/nationworld/chi-ebola-20141205-story.html|title=2 Sierra Leone doctors die of Ebola in 1 day |agency=Reuters|access-date=6 December 2014 |date=6 December 2014}}</ref>
On 27 August 2014 Dr. ] died from Ebola after contracting it working in Kenema.<ref>{{cite web|url=http://bigstory.ap.org/article/3rd-doctor-dies-ebola-sierra-leone|title=US official warns Ebola outbreak will get worse|work=The Big Story|accessdate=8 October 2014}}</ref><ref>{{cite web|url=http://www.cbc.ca/news/health/ebola-infected-doctor-in-sierra-leone-sahr-rogers-dies-1.2748090|title=Ebola-infected doctor in Sierra Leone, Sahr Rogers, dies|date=27 August 2014|publisher=|accessdate=8 October 2014}}</ref>


On 18 December, Dr. Victor Willoughby died from the disease after being tested positive for the disease on Saturday 6 December. The doctor died hours before he was to receive ZMAb, an experimental treatment from Canada, according to Dr. Brima Kargbo the country's chief medical officer. Dr. Victor Willoughby is the 11th doctor, and a top physician, to succumb to the disease.<ref>{{cite news|url=https://abcnews.go.com/Health/wireStory/11th-sierra-leonean-doctor-dies-ebola-27684697|title=11th Sierra Leonean Doctor Dies From Ebola |work=ABC News|access-date=18 December 2014 |date=18 December 2014}}</ref>
Dr. ] was a Sierra Leone doctor who worked in Freetown, who tested positive for Ebola on 9 September 2014 and passed away on the morning of 14 September 2014.<ref name="ReferenceA"/> Her staff thought she got exposed in August and eventually went to Lumley Hospital on 1 September 2014 with a fever, thinking it was malaria.<ref name="ReferenceA"/> After a few more days of sickness she was admitted to ].<ref name="ReferenceA"/>


==Evacuations== ==Evacuations==
Since the beginning of the outbreak in Sierra Leone in late May 2014, several people have been evacuated. An increasing lack of ]s, medical equipment, and health care personnel made treatment difficult.{{citation needed|date=June 2016}}On 24 August ], a British nurse, was evacuated from Sierra Leone. He was released on 3 September 2014.<ref name = united_Kingdom_Ebola>{{cite news|url=https://www.bbc.com/news/uk-28919831 |title=British Ebola patient arrives in UK for hospital treatment |work=BBC News |date=24 August 2014|access-date=25 August 2014}}</ref><ref>{{cite news|url=http://www.theweek.co.uk/world-news/ebola/57952/ebola-british-nurse-makes-full-recovery-and-leaves-hospital|title=Ebola:British nurse makes 'full recovery' and leaves hospital|publisher=he Week|date=3 September 2014|access-date=5 September 2014|archive-date=5 September 2014|archive-url=https://web.archive.org/web/20140905022612/http://www.theweek.co.uk/world-news/ebola/57952/ebola-british-nurse-makes-full-recovery-and-leaves-hospital|url-status=dead}}</ref> In October 2014, he announced he would return to Sierra Leone.<ref>{{cite web|url=https://www.theguardian.com/uk-news/2014/oct/19/will-pooley-ebola-returns-to-sierra-leone|title=Will Pooley told he may not be immune to Ebola as he returns to Sierra Leone|author=Lisa O'Carroll|website=the Guardian|date=19 October 2014 }}</ref>
Since the beginning of the outbreak in Sierra Leone in late May 2014, several people have been evacuated. An increasing lack of ]s, medical equipment, and health care personnel makes treatment difficult.


On 21 September 2014, Spain evacuated a Catholic priest who had contracted Ebola while working in Sierra Leone with Hospital Order of San Juan de Dios.<ref>{{cite web|url=http://www.newsweek.com/spain-repatriate-priest-diagnosed-ebola-sierra-leone-272058|title=Spain to Repatriate Priest Diagnosed with Ebola in Sierra Leone|website=] |date=21 September 2014 |access-date=30 September 2014}}</ref> He died on 25 September in Madrid.<ref>{{cite web|url=http://www.mysanantonio.com/news/medical/article/Second-Spanish-priest-with-Ebola-dies-in-Madrid-5780384.php|title=Second Spanish priest with Ebola dies in Madrid|website=San Antonio Express-News|access-date=30 September 2014|url-status=dead|archive-url=https://web.archive.org/web/20141006123916/http://www.mysanantonio.com/news/medical/article/Second-Spanish-priest-with-Ebola-dies-in-Madrid-5780384.php|archive-date=6 October 2014}}</ref> On 6 October 2014, a nurse who treated the priest tested positive for Ebola.<ref>{{cite news|url=https://www.bbc.com/news/world-europe-29514920|title=Nurse 'infected with Ebola' in Spain|access-date=7 October 2014|work=BBC News|date=6 October 2014}}</ref> By 20 October 2014, the nurse seemed to have recovered after many days battling the disease in the hospital, with tests coming back negative.<ref>{{cite web|url=http://www.dw.de/spanish-nurse-tests-negative-for-ebola-after-treatment/a-18007275|title=Spanish nurse tests negative for Ebola after treatment|website=DW.DE|access-date=27 October 2014}}</ref>
On 24 August ], a British nurse, was evacuated from Sierra Leone. He was released on September 3, 2014.<ref name = united_Kingdom_Ebola>{{cite news|url=http://www.bbc.com/news/uk-28919831 |title=British Ebola patient arrives in UK for hospital treatment |publisher=Bbc News |date=24 August 2014|accessdate=25 August 2014}}</ref><ref>{{cite news|url=http://www.theweek.co.uk/world-news/ebola/57952/ebola-british-nurse-makes-full-recovery-and-leaves-hospital |title=Ebola:British nurse makes 'full recovery' and leaves hospital|publisher=he Week |date=3 September 2014|accessdate=5 September 2014}}</ref>


On 21 September 2014 Spain evacuated a Catholic priest who had contracted Ebola while working in Sierra Leone with Hospital Order of San Juan de Dios.<ref>{{cite web|url=http://www.newsweek.com/spain-repatriate-priest-diagnosed-ebola-sierra-leone-272058|title=Spain to Repatriate Priest Diagnosed with Ebola in Sierra Leone|publisher=|accessdate=30 September 2014}}</ref> By 25 September 2014 the priest passed away in Madrid, Spain.<ref>{{cite web|url=http://www.mysanantonio.com/news/medical/article/Second-Spanish-priest-with-Ebola-dies-in-Madrid-5780384.php?|title=Second Spanish priest with Ebola dies in Madrid|work=San Antonio Express-News|accessdate=30 September 2014}}</ref> On 6 October 2014 a nurse who treated the priest tested positive for Ebola.<ref>{{cite web|url=http://www.bbc.com/news/world-europe-29514920|title=Nurse 'infected with Ebola' in Spain|work=BBC News|accessdate=7 October 2014}}</ref> A doctor from Senegal contracted Ebola while working in Sierra Leone for the WHO, and was evacuated to Germany at the end of August 2014.<ref>{{cite magazine|url=http://time.com/3191746/third-doctor-dies-from-ebola-in-sierra-leone/ |title=Third Doctor Dies From Ebola in Sierra Leone |magazine=Time |access-date=30 September 2014 |url-status=dead |archive-url=https://web.archive.org/web/20140923165934/http://time.com/3191746/third-doctor-dies-from-ebola-in-sierra-leone/ |archive-date=23 September 2014 }}</ref> By 4 October 2014, it was announced he has recovered and returned to Senegal.<ref name="hosted.ap.org"/>


A doctor from Senegal contracted Ebola while working in Sierra Leone for the WHO, and was evacuated to Germany at the end of August 2014.<ref>{{cite web|url=http://time.com/3191746/third-doctor-dies-from-ebola-in-sierra-leone/|title=Third Doctor Dies From Ebola in Sierra Leone|work=TIME.com|accessdate=30 September 2014}}</ref> By 4 October 2014, it was announced he has recovered and returned to Senegal.<ref name="hosted.ap.org"/> In late September, a doctor working for an International Aid organization in Sierra Leone, was evacuated to Switzerland after potentially being exposed. He later tested negative for the disease.<ref>{{cite web|url=http://www.thelocal.ch/20140922/bite-sends-ebola-virus-doctor-to-geneva|title=Bite sends Ebola virus doctor to Geneva|access-date=30 September 2014}}</ref>


In late September 2014, an American doctor working in Sierra Leone was evacuated to Maryland, USA, after being exposed to Ebola.<ref name="Washington Post">{{cite news|url=https://www.washingtonpost.com/national/health-science/nih-expected-to-admit-patient-exposed-to-ebola-virus/2014/09/27/0deee7a4-4673-11e4-b437-1a7368204804_story.html|title=NIH expected to admit American patient exposed to Ebola virus|newspaper=The Washington Post|access-date=30 September 2014|first=Christian|last=Davenport|date=27 September 2014}}</ref> "Just because someone is exposed to the deadly virus, it doesn't necessarily mean they are infected", said ], director of the ] at the ].<ref name="Washington Post"/> He was evacuated after a needle sticking accident and even developed a fever, but he was determined not to have Ebola and was released the first week in October 2014. After being discharged he remained at home under medical observation, checking his temperature twice a day for 21 days.<ref>{{cite web|url=http://www.somdnews.com/article/20141008/NEWS/141009201&template=southernMaryland|title=NIH discharges patient who was exposed to Ebola|website=Southern Maryland Newspapers Online - SoMdNews.com|access-date=27 October 2014|url-status=dead|archive-url=https://archive.today/20141023125447/http://www.somdnews.com/article/20141008/NEWS/141009201&template=southernMaryland|archive-date=23 October 2014}}</ref>
In late September, a doctor working for an International Aid organization in Sierra Leone, was evacuated to Switzerland after potentially being exposed. He later tested negative for the disease.<ref>{{cite web|url=http://www.thelocal.ch/20140922/bite-sends-ebola-virus-doctor-to-geneva|title=Bite sends Ebola virus doctor to Geneva|publisher=|accessdate=30 September 2014}}</ref>


In early October, a Ugandan doctor who contracted Ebola while working in Sierra Leone was evacuated for treatment to Frankfurt, Germany.<ref>{{cite news|url=https://www.foxnews.com/health/ebola-patient-arrives-in-germany-from-sierra-leone/|title=Ebola patient arrives in Germany from Sierra Leone|work=Fox News|access-date=4 October 2014|date=3 October 2014}}</ref> The doctor was working at Lakaa Hospital and flown out from ].<ref>{{cite web|url=http://www.newvision.co.ug/news/660412-ugandan-doctor-with-ebola-named.html|title=Ugandan doctor with Ebola named|access-date=6 October 2014}}</ref>
In late September 2014, an American doctor working in Sierra Leone was evacuated to Maryland, USA, after being exposed to Ebola.<ref name="Washington Post">{{cite web|url=http://www.washingtonpost.com/national/health-science/nih-expected-to-admit-patient-exposed-to-ebola-virus/2014/09/27/0deee7a4-4673-11e4-b437-1a7368204804_story.html|title=NIH expected to admit American patient exposed to Ebola virus|work=Washington Post|accessdate=30 September 2014}}</ref> "Just because someone is exposed to the deadly virus, it doesn’t necessarily mean they are infected”, said ], director of the ] at the ].<ref name="Washington Post"/>


On 6 October 2014, a female Norwegian MSF worker tested positive for Ebola virus and was subsequently evacuated to Norway.<ref>{{cite web|url=http://www.vg.no/nyheter/utenriks/ebola/norwegian-woman-infected-with-ebola/a/23310487/|title=Norwegian woman infected with Ebola|website=VG|date=6 October 2014 |access-date=7 October 2014}}</ref> Norwegian authorities reported that they had been granted a dose of the experimental biopharmaceutical drug ], a variant of ].<ref>{{cite news |url=http://www.thelocal.no/20141006/ebola-virus-victim-arrives-in-norway |title=Ebola virus victim arrives in Norway by special jet |location=Norway |date=6 October 2014 |access-date=8 October 2014}}</ref><ref>{{cite news |url=http://norwaytoday.info/home_view.php?id=13335 |title=The Ebola Infected women will not get ZMapp |location=Norway |date=8 October 2014 |access-date=8 October 2014 |url-status=dead |archive-url=https://web.archive.org/web/20141217185445/http://norwaytoday.info/home_view.php?id=13335 |archive-date=17 December 2014 }}</ref><ref>{{cite web|url=http://article.wn.com/view/2014/10/07/Ebola_Infected_woman_gets_last_dose_of_medicine_in_the_world/|title=Ebola Infected woman gets last dose of medicine in the world|website=World News (WN) Network|access-date=7 October 2014}}</ref> ZMapp has previously been used on 3 Liberian health workers, of which 2 survived.<ref>{{cite web|url=http://www.newsweek.com/how-it-feels-have-ebola-its-your-body-doesnt-belong-you-anymore-275615|title=How It Feels to Have Ebola: 'It's Like Your Body Doesn't Belong to You Anymore'|website=] |date=6 October 2014 |access-date=8 October 2014}}</ref> It was also used on 4 evacuated westerners, of which 3 survived.<ref>{{cite news|url=https://www.bbc.co.uk/news/health-28939550|title=UK Ebola patient gets experimental drug|publisher=BBC News, Health |date=26 August 2014|access-date=26 August 2014}}</ref><ref>{{cite news |last=Dassanayake |first=Dion |url=http://www.express.co.uk/news/uk/505931/Ebola-William-Pooley-Briton-recovering-well-ZMapp |title=First British Ebola victim recovering 'pretty well' after being given experimental drug |work=Express |location=UK |date=1 September 2014 |access-date=11 September 2014 }}</ref><ref>{{cite news|url=https://www.usatoday.com/story/news/world/2014/08/12/priest-ebola-dies/13939545/|title=Spanish missionary doctor infected with Ebola dies|date=12 August 2014|work=USA Today}}</ref><ref name=LATsp>{{cite news| url=http://www.latimes.com/nation/nationnow/la-na-nn-ebola-kent-brantly-cdc-20140803-story.html| title=Ebola patient got experimental serum, missionary group says| date=3 August 2014| work=]| first=Connie| last=Stewart}}</ref><ref>{{cite news| url=https://www.reuters.com/article/us-health-ebola-american-idUSKBN0GL0W020140821| title=American doctor treated for Ebola released from hospital| publisher=Reuters| date=21 August 2014}}</ref><ref>{{cite news|url=https://www.telegraph.co.uk/news/worldnews/ebola/11050129/Can-you-really-recover-from-Ebola.html|title=Can you really recover from Ebola?|date=22 August 2014|work=The Daily Telegraph|location=London}}</ref> A U.N. employee was evacuated to France in early November 2014 after contracting Ebola.<ref>{{cite news|url=https://www.telegraph.co.uk/news/worldnews/ebola/11203746/UN-Ebola-victim-being-treated-in-French-hospital.html|title=UN Ebola victim being treated in French hospital|date=2 November 2014|work=Telegraph.co.uk|access-date=7 November 2014|location=London}}</ref>
In early October, a Ugandan doctor who contracted Ebola while working in Sierra Leone was evacuated for treatment to Frankfurt, Germany.<ref>{{cite web|url=http://www.foxnews.com/health/2014/10/03/ebola-patient-arrives-in-germany-from-sierra-leone/|title=Ebola patient arrives in Germany from Sierra Leone|work=Fox News|accessdate=4 October 2014}}</ref> The doctor was working at ] and flown out from ].<ref>{{cite web|url=http://www.newvision.co.ug/news/660412-ugandan-doctor-with-ebola-named.html|title=Ugandan doctor with Ebola named|publisher=|accessdate=6 October 2014}}</ref>


On 12 November 2014, Dr Martin Salia, a permanent resident of the United States, tested positive for Ebola while working as a ] at the ] in ]. He is the sixth Sierra Leone doctor to have contracted Ebola virus disease. Initially he preferred to be treated at the Hastings Holding Centre by Sierra Leonean medical personnel, however on 15 November 2014, he was evacuated to the ] where his condition was reported as "still extremely critical" on 16 November.<ref>{{cite web|url=http://cocorioko.info/?p=13808|title=Dr. Martin Salia Battling Between Life and Death at the Hastings Holding Centre|website=Cocorioko International Newspaper|access-date=15 November 2014}}</ref><ref>{{cite web|url=https://abcnews.go.com/Health/ebola-america-doctor-contracted-ebola-flown-nebraska-treatment/story?id=26900298|title=Ebola in America: US Doctor Contracts Ebola in Sierra Leone, Will be Flown to Nebraska for Treatment – ABC News|author=ABC News|website=ABC News|access-date=15 November 2014}}</ref><ref>{{cite web|url=http://www.news24.com/World/News/Ebola-infected-doctor-extremely-critical-in-US-20141117|title=Ebola-infected doctor 'extremely critical' in US|website=News24|access-date=21 November 2014}}</ref> On 16 November the hospital released a statement that he "passed away as a result of the advanced symptoms of the disease".<ref name="N241117" />
On 6 October 2014, a female Norwegian MSF worker tested positive for Ebola virus and was subsequently evacuated.<ref>{{cite web|url=http://www.vg.no/nyheter/utenriks/ebola/norwegian-woman-infected-with-ebola/a/23310487/|title=Norwegian woman infected with Ebola|work=VG|accessdate=7 October 2014}}</ref> On the afternoon of 7 October, a ] carrying the infected patient landed in the military perimeter of the ], ]. From there, medical personnel equipped with ]s transferred the patient to a specially-equipped and ] ambulance. The convoy, which was accompanied by two reserve ambulances and a multi-vehicular police escort, moved the patient to the ], where she was placed in ].<ref>{{cite web|url=http://www.newsinenglish.no/2014/10/07/ebola-patient-finally-home|title=Treatment starts for ebola doctor|work=World News (WN) Network|accessdate=7 October 2014}}</ref> A team consisting of about 30 doctors and experts, some of which are specially trained in the treatment of ]s, were assigned to the supervision and treatment of the patient. Shortly after the medevac's arrival, Norwegian authorities reported that they had been granted a dose of the experimental biopharmaceutical drug ZMAb, a variant of ZMapp.<ref>{{cite news |url=http://www.thelocal.no/20141006/ebola-virus-victim-arrives-in-norway |title=Ebola virus victim arrives in Norway by special jet |location=Norway |date=6 October 2014 |accessdate=2014-10-08}}</ref><ref>{{cite news |url=http://norwaytoday.info/home_view.php?id=13335 |title=The Ebola Infected women will not get ZMapp |location=Norway |date=8 October 2014 |accessdate=2014-10-08}}</ref> <ref>{{cite web|url=http://article.wn.com/view/2014/10/07/Ebola_Infected_woman_gets_last_dose_of_medicine_in_the_world/|title=Ebola Infected woman gets last dose of medicine in the world|work=World News (WN) Network|accessdate=7 October 2014}}</ref> ZMapp has previously been used on 3 Liberian health workers, of which 2 survived.<ref>{{cite web|url=http://www.newsweek.com/how-it-feels-have-ebola-its-your-body-doesnt-belong-you-anymore-275615|title=How It Feels to Have Ebola: ‘It’s Like Your Body Doesn't Belong to You Anymore’|publisher=|accessdate=8 October 2014}}</ref> It was also used on 4 evacuated westerners, of which 3 survived.<ref>{{cite web|url=http://www.bbc.co.uk/news/health-28939550|title=UK Ebola patient gets experimental drug|publisher=BBC News, Health |date=August 26, 2014|accessdate=August 26, 2014}}</ref><ref>{{cite news |last=Dassanayake |first=Dion |url=http://www.express.co.uk/news/uk/505931/Ebola-William-Pooley-Briton-recovering-well-ZMapp |title=First British Ebola victim recovering 'pretty well' after being given experimental drug |work=Express |location=UK |date=1 September 2014 |accessdate=2014-09-11 }}</ref><ref>{{cite web|url=http://www.usatoday.com/story/news/world/2014/08/12/priest-ebola-dies/13939545/|title=Spanish missionary doctor infected with Ebola dies|date=August 12, 2014|author=USA Today}}</ref><ref name=LATsp>{{cite web| url=http://www.latimes.com/nation/nationnow/la-na-nn-ebola-kent-brantly-cdc-20140803-story.html| title=Ebola patient got experimental serum, missionary group says| date=August 3, 2014| publisher=Los Angeles Times}}</ref><ref>{{cite web| url=http://www.reuters.com/article/2014/08/21/us-health-ebola-american-idUSKBN0GL0W020140821| title=American doctor treated for Ebola released from hospital| publisher=Reuters| date=August 21, 2014}}</ref><ref>{{cite web|url=http://www.telegraph.co.uk/news/worldnews/ebola/11050129/Can-you-really-recover-from-Ebola.html|title=Can you really recover from Ebola?|date=August 22, 2014|publisher=The Telegraph}}</ref> (see ])


On 18 November a ] doctor, Felix Baez, tested positive for Ebola and was due to be sent to ] for treatment. He later recovered. Baez was one of 165 Cuban doctors and nurses in Sierra Leone helping treat Ebola patients. There were a further 53 Cubans in Liberia and 38 in Guinea, making this the largest single country medical team mobilized during the outbreak.<ref>{{cite web|url=http://www.news24.com/Africa/News/Cuban-doctor-in-Sierra-Leone-tests-positive-for-Ebola-20141119-3|title=Cuban doctor in Sierra Leone tests positive for Ebola|website=News24|access-date=21 November 2014}}</ref><ref>{{cite web|url=https://www.who.int/features/2014/cuban-ebola-team/en/|archive-url=https://web.archive.org/web/20140914045119/http://www.who.int/features/2014/cuban-ebola-team/en/|url-status=dead|archive-date=14 September 2014|title=WHO – Cuban medical team heading for Sierra Leone|access-date=21 November 2014}}</ref>
==Travel restrictions==
]]]
There are various restrictions and quarantines within Sierra Leone, and a state of emergency was declared on July 31, 2014.<ref name="Irish Times">{{cite web|url=http://www.irishtimes.com/news/world/africa/sierra-leone-declares-state-of-emergency-as-ebola-spreads-1.1883633|title=Sierra Leone declares state of emergency as Ebola spreads|work=Irish Times|accessdate=7 October 2014}}</ref> Countries at higher risk for Ebola in Africa include Benin, Burkina Faso, Côte d’Ivoire, Guinea-Bissau, Mali, and Senegal.<ref>{{cite web|url=http://rt.com/news/183808-ebola-senegal-outbreak-spread/|title=First Ebola case in Senegal, five more states at risk of outbreak spread|publisher=|accessdate=7 October 2014}}</ref>
*In April ] banned air travel from Sierra Leone.<ref name="Business Day Live"/>
*By June 11, 2014 Sierra Leone closed its border with Liberia and Guinea.<ref name="uk.reuters.com"/>
*In July airlines of Nigeria and Togo cancelled flights to Freetown.<ref name="Irish Times"/>
*On August 1, 2014 ] banned air travel from several Ebola impacted countries including Sierra Leone.<ref>{{cite web|url=http://saharareporters.com/2014/08/01/ghana-bans-flights-nigeria-sierra-leone-and-liberia-over-ebola-concerns|title=Ghana Bans Flights From Nigeria, Sierra Leone, And Liberia Over Ebola Concerns |work=Sahara Reporters|accessdate=7 October 2014}}</ref>
*On August 10, 2014 ] blocked entry of citizens of Sierra Leone.<ref>{{cite web|url=http://www.middleeasteye.net/news/mauritania-bans-entry-citizens-ebola-hit-states-1430665455|title=Mauritania bans entry of citizens from Ebola-hit states |work=Middle East Eye|accessdate=7 October 2014}}</ref>
*On August 11, 2014 ] blocked travel from Sierra Leone, Liberia, and Guinea.<ref>{{cite web|url=http://www.bbc.com/news/world-africa-28746020|title=Ebola outbreak: Ivory Coast bans flight from three states|work=BBC News|accessdate=7 October 2014}}</ref> The restriction was lifted on 26 September 2014.<ref>{{cite web|url=http://www.macleans.ca/news/world/ivory-coast-lifts-travel-restrictions-on-ebola-stricken-countries/|title=Ivory Coast lifts travel restrictions on Ebola-stricken countries|work=Macleans.ca|accessdate=7 October 2014}}</ref>
*On August 21, 2014 ] banned travelers from Sierra Leone, Liberia, and Guinea, but its own citizens were allowed to return from these places.<ref>{{cite web|url=https://www.premiumtimesng.com/news/167096-ebola-south-africa-bans-travellers-from-guinea-liberia-sierra-leone.html|title=bola: South Africa bans travellers from Guinea, Liberia, Sierra Leone|work=Premium Times Nigeria|accessdate=7 October 2014}}</ref>
*On August 22 a Kenyan airline put temporary restrictions Sierra Leone, saying the Ebola outbreak was underestimated.<ref>{{cite web|url=http://www.theguardian.com/society/2014/aug/22/ebola-airlines-cancel-flights-guinea-liberia-sierra-leone|title=Ebola: airlines cancel more flights to affected countries|work=the Guardian|accessdate=7 October 2014}}</ref>
*On August 22 ] blocked air travel to Sierra Leone, Liberia, and Guinea.<ref>{{cite web|url=http://www.foxnews.com/health/2014/08/22/senegal-blocks-ebola-aid-flight/|title=Senegal blocks Ebola aid flight, imposes travel curbs|work=Fox News|accessdate=7 October 2014}}</ref>
*In September 2014 bans on the Sierra Leone hosting federation football (soccer) games continued.<ref>{{cite web|url=http://awoko.org/2014/09/23/sierra-leone-sports-ebola-football-ban-on-west-african-countries-still-remain/|title=Sierra Leone Sports: Ebola football ban on West African countries still remain|publisher=|accessdate=8 October 2014}}</ref>


== Confounding factors ==
==Concurrent events==
]
The outbreak was noted for increasing hand washing stations, and reducing the prevalence of physical greetings such as hand-shakes between members of society.<ref>{{cite web|url=http://www.bbc.com/news/health-29507673|title=Devastating news from the Ebola clinic|work=BBC News|accessdate=8 October 2014}}</ref>


=== Sierra Leonean government intransigence ===
In June 2014 all schools were closed because of the spread of ].<ref>{{cite web|url=http://uk.reuters.com/article/2014/06/11/us-health-ebola-leone-idUKKBN0EM2CG20140611|title=Sierra Leone shuts borders, closes schools to fight Ebola|publisher=|accessdate=8 October 2014}}</ref>


On 5 October, '']'' reported that a ] full of protective gowns, gloves, stretchers, mattresses and other medical supplies had been allowed to sit unopened on the docks in Freetown, Sierra Leone, since 9 August.<ref name="nytimes.com">, ''The New York Times'', Adam Nossiter, 5 October 2014.</ref> The $140,000 worth of equipment included 100 bags and boxes of hospital linens, 100 cases of protective suits, 80 cases of face masks and other items, and were donated by individuals and institutions in the United States.<ref name="nytimes.com"/>
In August 2014 the S.L. Health Minister was removed from that office.<ref>{{cite web|url=http://www.thesierraleonetelegraph.com/?p=7208|title=Health minister Miatta Kargbo sacked|publisher=|accessdate=8 October 2014}}</ref> (see ])


The shipment was organised by Mr Chernoh Alpha Bah, a Sierra Leonean opposition politician, who comes from Sierra Leonean President ]'s hometown, ].<ref name="nytimes.com"/> ''The New York Times'' reported that political tensions may have contributed to the government delay in clearing the shipping container, to prevent the political opposition from trumpeting the donations.<ref name="nytimes.com"/>
In October 2014 Sierra Leone launched a school by radio program, that will be transmitted on 41 of the local radio stations as well as on the only local TV station.<ref>{{cite web|url=http://www.ndtv.com/article/world/ebola-hit-sierra-leone-launches-school-by-radio-603358|title=Ebola-hit Sierra Leone Launches School by Radio|work=NDTV.com|accessdate=8 October 2014}}</ref> There will be a variety of subjects on the 6 day a week, 4 hour shows. ] ] raised concerns on the difficulty of reaching many of the school children with a 25% radio ownership and less than 2% TV. However schools are not expected to open until early 2015.<ref>{{cite web|url=http://www.news24.com/Africa/News/Ebola-hit-Sierra-Leone-starts-school-by-radio-20141008|title=Ebola-hit Sierra Leone starts school by radio|work=News24|accessdate=8 October 2014}}</ref>


Government officials stated that the shipping container could not be cleared through customs, as proper procedures had not been followed.<ref name="nytimes.com"/> The Sierra Leonean government refused to pay the shipping fee of $6,500.<ref name="nytimes.com"/> ''The New York Times'' noted that the government had already received well over $40 million in cash from international donors to fight Ebola.<ref name="nytimes.com"/> ''The New York Times'' noted that in the 2 months that the shipping container remained on the docks in Freetown, health workers in Sierra Leone endured severe shortages of protective supplies, with some nurses having to wear street clothes.<ref name="nytimes.com"/>
September through October is the "] season", which may complicate efforts to treat Ebola.<Ref>{{cite web|url=http://www.bbc.com/news/health-29060239|title=Ebola: How bad can it get?|work=BBC News|accessdate=8 October 2014}}</ref> For example, one Freetown doctor did not immediately quarantine herself because she thought she had malaria not Ebola.<ref name="ReferenceA"/> The doctor was eventually diagnosed with Ebola and died in September 2014.<ref name="ReferenceA"/>


David Tam-Baryoh, a ], was held for 11 days when he and a talk show guest, an opposition party spokesperson, criticised how President ] handled the Ebola outbreak in a live broadcast on 1 November 2014. The weekly show ''Monologue'' was taken off-air mid-show from the independently run Citizen FM.<ref>{{cite news| url=https://www.nytimes.com/2014/11/07/world/africa/sierra-leone-reportedly-detains-journalist-for-criticism-of-ebola-response.html | work=The New York Times | first=Robert | last=Mackey | title=Sierra Leone Detains Journalist for Criticism of Ebola Response | date=6 November 2014}}</ref> He was arrested on 3 November and sent to the Pademba Road jail, after an executive order was signed by the president. On 14 November Sierra Leone's Deputy Information Minister Theo Nicol gave a statement that Baryoh had "been put on a ten thousand dollar bail by the Criminal Investigation Department after a statement has been taken from him".<ref>{{cite web|url=http://www.news24.com/Africa/News/Sierra-Leone-talk-show-host-released-from-jail-20141115-2|title=Sierra Leone talk show host released from jail|website=News24|access-date=21 November 2014}}</ref>
==Culture==
A Sierra Leone DJ uses his program which is transmitted on 35 stations in Sierra Leone to share knowledge about the Ebola.<Ref>{{cite web|url=http://www.theguardian.com/global-development/2014/oct/09/ebola-myths-sierra-leone-dj-tackles-rumours|title=Ebola myths: Sierra Leonean DJ tackles rumours and lies over the airwaves|work=the Guardian|accessdate=9 October 2014}}</ref> This helps inform people in rural areas about the disease.<Ref>{{cite web|url=http://www.theguardian.com/global-development/2014/oct/09/ebola-myths-sierra-leone-dj-tackles-rumours|title=Ebola myths: Sierra Leonean DJ tackles rumours and lies over the airwaves|work=the Guardian|accessdate=9 October 2014}}</ref> An example of radio station in Sierra Leone is ].


Amid concerns for his health, Tam-Baryoh apparently signed a confession to ensure his release from the prison, engineered by a committee made up of his lawyer, 2 journalists and a ] ] of the ]. Rightsway International, an independent human rights group, has condemned President Koroma for allegedly dictating to the committee about obtaining the confession. A statement later released by the group read:<ref>{{cite web|url=http://www.thesierraleonetelegraph.com/?p=8025&cpage=1|title=David Tam Baryoh's forced signed confession to freedom|access-date=21 November 2014}}</ref>{{blockquote|Rightsway is disappointed that Tam Baryoh's forced confession has been published widely by pro-government media outlets and social networks. The publication of forced confessions is often used to discredit dissident news and information providers. This is a media propaganda tool used by dictatorial regimes, to avoid being exposed, investigated and punished for the grave violations of human rights.}}
"Ebola in Town", a ] by a group of West African rappers warning people of the dangers of the Ebola virus and explaining how to react, became popular in Guinea and Liberia during the first quarter of 2014.<ref>{{cite web|url=http://www.theguardian.com/world/2014/may/27/ebola-virus-outbreak-infectious-dance-tune|title=Ebola virus causes outbreak of infectious dance tune|date=27 May 2014|author=Monica Mark|work=The Guardian}}</ref><ref>{{cite web|url=http://www.telegraph.co.uk/news/worldnews/africaandindianocean/liberia/10860045/Ebola-rap-warns-West-Africans-of-viruss-dangers.html|title=Ebola rap warns West Africans of virus's dangers |work=Daily Telegraph|date=28 May 2014|author=Mike Pflanz}}</ref>


=== Local conspiracy theories ===
In August 2014, ] and Ghanaian musician Sidney produced a song to raise awareness about Ebola.<ref>{{cite web|title=Liberian soccer star George Weah records Ebola song|url=http://www.capitalfm.co.ke/lifestyle/2014/08/12/liberian-soccer-star-george-weah-records-ebola-song/|publisher=Capital Group Limited|accessdate=19 August 2014|date=12 August 2014}}</ref>
* "The Ebola outbreak was sparked by a bewitched aircraft that crashed in a remote part of Sierra Leone, casting a spell over three West African countries – but a heavily alcoholic drink called ] can cure the virus."<ref name="no1">{{cite web|url=https://www.theguardian.com/global-development/2014/oct/09/ebola-myths-sierra-leone-dj-tackles-rumours|title=Ebola myths: Sierra Leonean DJ tackles rumours and lies over the airwaves|website=the Guardian|date=9 October 2014 |access-date=15 October 2014}}</ref>
* "Some members of the community thought it was a bad spirit, a devil or poisoning."<ref name="no5">{{cite web|url=https://www.who.int/features/2014/ebola-through-music/en/|archive-url=https://web.archive.org/web/20140821213451/http://www.who.int/features/2014/ebola-through-music/en/|url-status=dead|archive-date=21 August 2014|title=WHO – Spreading the word about Ebola through music|access-date=15 October 2014}}</ref>
* At the beginning of the outbreak, many did not believe that the disease existed. "I thought it was a lie (invented) to collect money because at that moment I hadn't seen people affected in my community."<ref name="no5" />


=== Community violence ===
There are a number of Ebola-themed jokes circulating in West Africa to spread awareness.<ref>{{cite web|title=Tell Me the One About Ebola: How Jokes Spread Awareness|url=http://www.bloomberg.com/news/2014-08-27/tell-me-the-one-about-ebola-how-jokes-spread-awareness.html|website=Bloomberg|accessdate=31 August 2014}}</ref>
On 21 October, there was Ebola related violence and rioting in the eastern town of ], with police imposing a curfew.<ref name="news.yahoo.com">{{cite web|url=https://news.yahoo.com/curfew-sierra-leone-town-rioting-shooting-over-ebola-185916473--finance.html|title=Curfew in Sierra Leone town after rioting, shooting over Ebola case|date=21 October 2014|website=Yahoo News|access-date=6 February 2015}}</ref> Local youth fired at police with shotguns after a former youth leader refused health authorities permission to take her relative for an Ebola test.<ref name="news.yahoo.com"/> Several buildings were attacked and youth gangs roamed the streets shouting "No more Ebola!"<ref name="Ebola riot in S. Leone"/>

A local leader reported seeing two bodies with gunshot wounds in the aftermath. Police denied that anyone had been killed.<ref name="news.yahoo.com"/> Doctors reported two dead.<ref name="Ebola riot in S. Leone">{{cite web|url=https://news.yahoo.com/two-die-sierra-leone-riot-sparked-ebola-blood-112629395.html|title="Ebola riot in S. Leone kills two as WHO to launch vaccine trials", Rod Mac Johnson, AFP, October 22, 2014|date=22 October 2014|website=Yahoo News|access-date=7 November 2014}}</ref> The local district medical officer said he had been forced to abandon the local hospital because of the rioting.<ref name="news.yahoo.com"/>

==Effects==

===Travel restrictions===

]
There are various restrictions and quarantines within Sierra Leone, and a state of emergency was declared on 31 July 2014.<ref name="Irish Times">{{cite news|url=http://www.irishtimes.com/news/world/africa/sierra-leone-declares-state-of-emergency-as-ebola-spreads-1.1883633|title=Sierra Leone declares state of emergency as Ebola spreads|newspaper=] |access-date=7 October 2014}}</ref> Countries at higher risk for Ebola in Africa include Benin, Burkina Faso, Côte d'Ivoire, Guinea-Bissau, Mali, and Senegal.{{citation needed|date=December 2020}}
* In April 2014, ] banned air travel from several West African countries including Sierra Leone.<ref name="Business Day Live">{{cite web|url=http://www.bdlive.co.za/africa/africannews/2014/04/16/gambia-bans-flights-from-ebola-hit-countries|title=Gambia bans flights from Ebola-hit countries|website=Business Day Live|access-date=7 October 2014}}</ref>
* By 11 June 2014, Sierra Leone closed its border with Liberia and Guinea.<ref name="uk.reuters.com"/>
* In July airlines of ] and ] cancelled flights to Freetown.<ref name="Irish Times"/>
* On 1 August 2014, ] banned air travel from several Ebola impacted countries including Sierra Leone.<ref>{{cite web|url=http://saharareporters.com/2014/08/01/ghana-bans-flights-nigeria-sierra-leone-and-liberia-over-ebola-concerns|title=Ghana Bans Flights From Nigeria, Sierra Leone, And Liberia Over Ebola Concerns |website=Sahara Reporters|date=August 2014 |access-date=7 October 2014}}</ref>
* On 8 August 2014, ] banned travelers from Sierra Leone and Ebola-affected countries and also banned Zambians from going to those places.<ref>{{cite web|url=http://www.news24.com/Africa/News/Zambia-bans-travellers-from-countries-hit-by-Ebola-20140810|title=Zambia bans travellers from countries hit by Ebola|website=News24|access-date=27 October 2014}}</ref>
* On 10 August 2014, ] blocked entry of citizens of Sierra Leone.<ref>{{cite web|url=http://www.middleeasteye.net/news/mauritania-bans-entry-citizens-ebola-hit-states-1430665455|title=Mauritania bans entry of citizens from Ebola-hit states |website=Middle East Eye|access-date=7 October 2014}}</ref>
* On 11 August 2014, ] blocked travel from Sierra Leone, Liberia, and Guinea.<ref>{{cite news|url=https://www.bbc.com/news/world-africa-28746020|title=Ebola outbreak: Ivory Coast bans flight from three states|work=BBC News |date=11 August 2014 |access-date=7 October 2014}}</ref> The restriction was lifted on 26 September 2014.<ref>{{cite web|url=http://www.macleans.ca/news/world/ivory-coast-lifts-travel-restrictions-on-ebola-stricken-countries/|archive-url=https://web.archive.org/web/20140928060409/http://www.macleans.ca/news/world/ivory-coast-lifts-travel-restrictions-on-ebola-stricken-countries/|url-status=dead|archive-date=28 September 2014|title=Ivory Coast lifts travel restrictions on Ebola-stricken countries|website=Macleans.ca|access-date=7 October 2014}}</ref>
* On 12 August 2014, ] banned travel of all non-Botswanans from Sierra Leone, Guinea, Liberia, and Nigeria; they also added the D.R. Congo later that month.<ref name=":4">{{cite web|url=https://www.internationalsos.com/ebola/index.cfm?content_id=435|title=Ebola|website=internationalsos.com|access-date=4 December 2014}}</ref>
* On 18 August 2014, ] banned travelers from several countries including Sierra Leone.<ref name=":4"/>
* On 21 August 2014, ] banned travelers from Sierra Leone, Liberia, and Guinea, but its own citizens were allowed to return from these places.<ref>{{cite web|url=https://www.premiumtimesng.com/news/167096-ebola-south-africa-bans-travellers-from-guinea-liberia-sierra-leone.html|title=Ebola: South Africa bans travellers from Guinea, Liberia, Sierra Leone|website=] |date=21 August 2014 |access-date=7 October 2014}}</ref>
* On 22 August 2014, a Kenyan airline put temporary restrictions Sierra Leone, saying the Ebola outbreak was underestimated.<ref>{{cite web|url=https://www.theguardian.com/society/2014/aug/22/ebola-airlines-cancel-flights-guinea-liberia-sierra-leone|title=Ebola: airlines cancel more flights to affected countries|website=the Guardian|date=22 August 2014 |access-date=7 October 2014}}</ref>
* On 22 August 2014, ] blocked air travel to Sierra Leone, Liberia, and Guinea.<ref>{{cite news|url=https://www.foxnews.com/health/senegal-blocks-ebola-aid-flight-imposes-travel-curbs/|title=Senegal blocks Ebola aid flight, imposes travel curbs|work=Fox News|access-date=7 October 2014|date=22 August 2014}}</ref>
* On 22 August 2014, ] banned travelers who had been to Sierra Leone, Guinea, and Liberia in the previous 22 days.<ref name=":4"/>
* On 11 September 2014, ] banned travelers from 'Ebola affected countries'.<ref name=":4"/>
* In September 2014, bans on the Sierra Leone hosting federation football (soccer) games continued.<ref>{{cite web|url=http://awoko.org/2014/09/23/sierra-leone-sports-ebola-football-ban-on-west-african-countries-still-remain/|title=Sierra Leone Sports: Ebola football ban on West African countries still remain|access-date=8 October 2014}}</ref>
* In October 2014, ] banned travelers from the Ebola-stricken West African countries, including Sierra Leone.<ref>{{cite web|url=http://www.trinidadexpress.com/news/TT-orders-Ebola-travel-ban-279473602.html|title=T&T orders Ebola travel ban|website=Trinidad Express Newspaper|access-date=19 October 2014|archive-url=https://web.archive.org/web/20141018235743/http://www.trinidadexpress.com/news/TT-orders-Ebola-travel-ban-279473602.html|archive-date=18 October 2014|url-status=dead}}</ref>
* In October 2014, ], ], ] and ] banned travelers from Sierra Leone and other affected West African countries.<ref>{{cite web|url=https://www.theguardian.com/world/2014/oct/17/jamaica-ebola-travel-ban-west-africa-epidemic|title=Jamaica bans travellers who have been to Ebola-affected nations|website=the Guardian}}</ref>
* In mid October 2014, ] banned Sierra Leone nationals and those from some other West African nations.<ref>{{cite web|url=http://dominicanewsonline.com/news/homepage/news/regional/st-vincent-bans-nationals-three-west-african-states-due-ebola/|title=St Vincent bans nationals from three West African States due to Ebola|website=Dominica News Online}}</ref>
* In late October 2014, ] banned anyone coming from, or had been in Sierra Leone, Liberia, or Guinea in the previous 21 days.<ref>{{cite web|url=http://www.trust.org/item/20141022214205-lsvob/|title=Panama bars travelers from three Ebola-hit African countries|access-date=27 October 2014|archive-date=12 November 2014|archive-url=https://web.archive.org/web/20141112134711/http://www.trust.org/item/20141022214205-lsvob|url-status=dead}}</ref>
* On 18 October 2014, ] banned travelers from Sierra Leone, and also banned those that had been there or Guinea or Liberia in the previous 21 days.<ref name=":4"/>
* Suriname banned travelers who had been to Sierra Leone, Guinea, or Liberia in the previous 21 days unless they have a health certificate.<ref name=":4"/>
* By 21 October 2014, the ] banned foreigners who had been to Sierra Leone or other Ebola-affected nations in the previous 30 days.<ref>{{cite web|url=https://news.yahoo.com/dominican-republic-bans-entry-visitors-ebola-affected-countries-183508086.html|title=Dominican Republic joins entry ban for Ebola-affected countries|date=21 October 2014|website=Yahoo News|access-date=27 October 2014}}</ref>
* On 11 November 2014, The Gambia opened its borders again to travelers from Sierra Leone, Liberia, Nigeria and Guinea.<ref name=":4"/>

===Additional effects===
]
The outbreak was noted for increasing hand washing stations, and reducing the prevalence of physical greetings such as hand-shakes between members of society.<ref>{{cite news|url=https://www.bbc.com/news/health-29507673|title=Devastating news from the Ebola clinic|work=BBC News |date=6 October 2014 |access-date=8 October 2014}}</ref>

In June 2014 all schools were closed because of the spread of Ebola.<ref>{{cite news|url=http://uk.reuters.com/article/us-health-ebola-leone-idUKKBN0EM2CG20140611|archive-url=https://web.archive.org/web/20160124121545/http://uk.reuters.com/article/us-health-ebola-leone-idUKKBN0EM2CG20140611|url-status=dead|archive-date=24 January 2016|title=Sierra Leone shuts borders, closes schools to fight Ebola|access-date=8 October 2014|work=Reuters|date=11 June 2014}}</ref>

In August 2014 the S.L. Health Minister was removed from that office.<ref>{{cite web|url=http://www.thesierraleonetelegraph.com/?p=7208|title=Health minister Miatta Kargbo sacked|date=29 August 2014 |access-date=8 October 2014}}</ref> (see ]) In October 2014 the Defense Minister was placed in charge of the anti-Ebola efforts.<ref name="BBC News">{{cite news|url=https://www.bbc.com/news/world-africa-29673633|title=Ebola crisis: Sierra Leone revamps response team|work=BBC News |date=18 October 2014 }}</ref> The president at this time was ].<ref name="BBC News"/>

On 13 October, the UN's International Fund for Agricultural Development stated up to 40% of farms had been abandoned in the worst Ebola-hit areas of Sierra Leone.<ref>, ], Unclassified report, 14 October 2014, p.2.</ref>

In October 2014 Sierra Leone launched a school by radio program, that will be transmitted on 41 of the local radio stations as well as on the only local TV station.<ref>{{cite web|url=http://www.ndtv.com/article/world/ebola-hit-sierra-leone-launches-school-by-radio-603358|title=Ebola-hit Sierra Leone Launches School by Radio|website=NDTV.com|access-date=8 October 2014}}</ref> {{small|(See ])}}

September through October is the ] season, which may complicate efforts to treat Ebola.<ref>{{cite news|url=https://www.bbc.com/news/health-29060239|title=Ebola: How bad can it get?|work=BBC News |date=6 September 2014 |access-date=8 October 2014}}</ref> For example, one Freetown doctor did not immediately quarantine herself because she thought she had malaria not Ebola.<ref name="ReferenceA"/> The doctor was eventually diagnosed with Ebola and died in September 2014.<ref name="ReferenceA"/>

===Local works derived from the Ebola crisis===
{{main|Cultural effects of the Ebola crisis}}
* A Sierra Leone DJ, Amara Bangura, shares knowledge about Ebola in his weekly show which is transmitted on 35 stations in Sierra Leone. He takes selected questions from the text messages sent in and gets answers from health experts and government officials.<ref>{{cite web|url=https://www.theguardian.com/global-development/2014/oct/09/ebola-myths-sierra-leone-dj-tackles-rumours|title=Ebola myths: Sierra Leonean DJ tackles rumours and lies over the airwaves|website=the Guardian|date=9 October 2014 |access-date=9 October 2014}}</ref>
* ''"White Ebola"'', a political song by Mr. Monrovia, AG Da Profit and Daddy Cool, centered on the general mistrust of foreigners.<ref name="no10">{{cite web|url=http://www.culanth.org/fieldsights/592-beats-rhymes-and-ebola|title=Beats, Rhymes and Ebola|access-date=15 October 2014|archive-url=https://web.archive.org/web/20141014201629/http://www.culanth.org/fieldsights/592-beats-rhymes-and-ebola|archive-date=14 October 2014|url-status=dead}}</ref>
* ''"Ebola in Town"'', a dance tune by a group of West African rappers, D-12, Shadow and Kuzzy Of 2 Kings warns people of the dangers of the Ebola virus and explaining how to react, became popular in Guinea and Liberia during the first quarter of 2014.<ref name="no2">{{cite web|url=https://www.theguardian.com/world/2014/may/27/ebola-virus-outbreak-infectious-dance-tune|title=Ebola virus causes outbreak of infectious dance tune|website=the Guardian|date=27 May 2014 |access-date=15 October 2014}}</ref><ref name="no9">{{cite news|url=http://www.cbc.ca/news/arts/ebola-pop-music-a-surprising-weapon-against-the-killer-virus-1.2795181|title=Ebola: Pop music a surprising weapon against the killer virus|date=11 October 2014|access-date=15 October 2014|work=CBC News}}</ref> A dance was developed in which no body contact was required, a rare occurrence in African dance.<ref name="no3">{{cite news|url=https://www.telegraph.co.uk/news/worldnews/africaandindianocean/liberia/10860045/Ebola-rap-warns-West-Africans-of-viruss-dangers.html|title=Ebola rap warns West Africans of virus's dangers|date=28 May 2014|work=Telegraph.co.uk|access-date=15 October 2014|location=London|first=Mike|last=Pflanz}}</ref> Some health care workers from the ] had concerns that the ''Ebola In Town'' song's warning "don't touch your friend" may worsen the stigma.<ref name="no3" /><ref>{{Cite web|url=https://www.ifrc.org/ar/news-and-media/news-stories/africa/guinea/battling-fear-and-stigma-over-ebola-in-west-africa-65367/|title=Battling fear and stigma over Ebola in West Africa - IFRC|website=www.ifrc.org}}</ref>
* In August 2014, ] and Ghanaian musician Sidney produced a song to raise awareness about Ebola.<ref name="n011">{{cite web|url=http://africasacountry.com/ebola-in-perspective/|title=Ebola in Perspective: The role of popular music in crisis situations in West Africa|website=Africa Is a Country|access-date=20 October 2014|archive-url=https://web.archive.org/web/20141016200151/http://africasacountry.com/ebola-in-perspective/|archive-date=16 October 2014|url-status=dead}}</ref> All proceeds from the track been donated to the Liberian Health Ministry.<ref name="no4">{{cite web|url=http://www.capitalfm.co.ke/lifestyle/2014/08/12/liberian-soccer-star-george-weah-records-ebola-song/|title=Liberian soccer star George Weah records Ebola song|website=Capital Lifestyle|date=12 August 2014 |access-date=15 October 2014}}</ref>
* There are a number of Ebola-themed jokes circulating in West Africa to spread awareness.<ref name="no8">{{cite news|url=https://www.bloomberg.com/news/2014-08-27/tell-me-the-one-about-ebola-how-jokes-spread-awareness.html|title=Tell Me the One About Ebola: How Jokes Spread Awareness|date=27 August 2014|work=Bloomberg|access-date=15 October 2014|first=Pauline|last=Bax}}</ref>


==See also== ==See also==
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==References== ==References==
{{reflist|2}} {{reflist|3}}


==External links== ==Further reading==
{{columns-list|colwidth=30em|
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*{{cite book|last1=Qureshi|first1=Adnan|title=Ebola Virus Disease: From Origin to Outbreak|date=2016|publisher=Academic Press|isbn=9780128042427|url=https://books.google.com/books?id=7zyXCgAAQBAJ&pg=PA72|access-date=15 July 2016}}
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*{{cite journal|last1=Bower|first1=Hilary|last2=Smout|first2=Elizabeth|last3=Bangura|first3=Mohamed S.|last4=Kamara|first4=Osman|last5=Turay|first5=Cecilia|last6=Johnson|first6=Sembia|last7=Oza|first7=Shefali|last8=Checchi|first8=Francesco|last9=Glynn|first9=Judith R.|title=Deaths, late deaths, and role of infecting dose in Ebola virus disease in Sierra Leone: retrospective cohort study|journal=BMJ|date=17 May 2016|volume=353|pages=i2403|doi=10.1136/bmj.i2403|pmid=27188404|pmc=4870382|url=|issn=1756-1833}}
*
*{{cite journal|last1=Betancourt|first1=Theresa S.|last2=Brennan|first2=Robert T.|last3=Vinck|first3=Patrick|last4=VanderWeele|first4=Tyler J.|last5=Spencer-Walters|first5=Dayo|last6=Jeong|first6=Joshua|last7=Akinsulure-Smith|first7=Adeyinka M.|last8=Pham|first8=Phuong|title=Associations between Mental Health and Ebola-Related Health Behaviors: A Regionally Representative Cross-sectional Survey in Post-conflict Sierra Leone|journal=PLOS Med|date=9 August 2016|volume=13|issue=8|pages=e1002073|doi=10.1371/journal.pmed.1002073|pmid=27505186|pmc=4978463|issn=1549-1676 |doi-access=free }}
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*{{cite journal|last1=Owada|first1=Kei|last2=Eckmanns|first2=Tim|last3=Kamara|first3=Kande-Bure O'Bai|last4=Olu|first4=Olushayo Oluseun|title=Epidemiological Data Management during an Outbreak of Ebola Virus Disease: Key Issues and Observations from Sierra Leone|journal=Frontiers in Public Health|date=8 August 2016|volume=4|pages=163|doi=10.3389/fpubh.2016.00163|issn=2296-2565|pmid=27551675|pmc=4976087|doi-access=free }}
*{{Cite journal|last1=Haaskjold|first1=Yngvar Lunde|last2=Bolkan|first2=Håkon Angell|last3=Krogh|first3=Kurt Østhuus|last4=Jongopi|first4=James|last5=Lundeby|first5=Karen Marie|last6=Mellesmo|first6=Sindre|last7=Garcés|first7=Pedro San José|last8=Jøsendal|first8=Ola|last9=Øpstad|first9=Åsmund|last10=Svensen|first10=Erling|last11=Fuentes|first11=Luis Matias Zabala|last12=Kamara|first12=Alfred Sandy|last13=Riera|first13=Melchor|last14=Arranz|first14=Javier|last15=Roberts|first15=David P.|last16=Stamper|first16=Paul D.|last17=Austin|first17=Paula|last18=Moosa|first18=Alfredo J.|last19=Marke|first19=Dennis|last20=Hassan|first20=Shoaib|last21=Eide|first21=Geir Egil|last22=Berg|first22=Åse|last23=Blomberg|first23=Bjørn|title=Clinical Features of and Risk Factors for Fatal Ebola Virus Disease, Moyamba District, Sierra Leone, December 2014–February 2015|journal=Emerging Infectious Diseases|volume=22|issue=9|pages=1537–1544|doi=10.3201/eid2209.151621|pmid=27268303|pmc=4994367|year=2016}}
*{{cite journal|last1=Cancedda|first1=Corrado|last2=Davis|first2=Sheila M.|last3=Dierberg|first3=Kerry L.|last4=Lascher|first4=Jonathan|last5=Kelly|first5=J. Daniel|last6=Barrie|first6=Mohammed Bailor|last7=Koroma|first7=Alimamy Philip|last8=George|first8=Peter|last9=Kamara|first9=Adikali Alpha|last10=Marsh|first10=Ronald|last11=Sumbuya|first11=Manso S.|last12=Nutt|first12=Cameron T.|last13=Scott|first13=Kirstin W.|last14=Thomas|first14=Edgar|last15=Bollbach|first15=Katherine|last16=Sesay|first16=Andrew|last17=Barrie|first17=Ahmidu|last18=Barrera|first18=Elizabeth|last19=Barron|first19=Kathryn|last20=Welch|first20=John|last21=Bhadelia|first21=Nahid|last22=Frankfurter|first22=Raphael G.|last23=Dahl|first23=Ophelia M.|last24=Das|first24=Sarthak|last25=Rollins|first25=Rebecca E.|last26=Eustis|first26=Bryan|last27=Schwartz|first27=Amanda|last28=Pertile|first28=Piero|last29=Pavlopoulos|first29=Ilias|last30=Mayfield|first30=Allan|last31=Marsh|first31=Regan H.|last32=Dibba|first32=Yusupha|last33=Kloepper|first33=Danielle|last34=Hall|first34=Andrew|last35=Huster|first35=Karin|last36=Grady|first36=Michael|last37=Spray|first37=Kimberly|last38=Walton|first38=David A.|last39=Daboh|first39=Fodei|last40=Nally|first40=Cora|last41=James|first41=Sahr|last42=Warren|first42=Gabriel S.|last43=Chang|first43=Joyce|last44=Drasher|first44=Michael|last45=Lamin|first45=Gina|last46=Bangura|first46=Sherry|last47=Miller|first47=Ann C.|last48=Michaelis|first48=Annie P.|last49=McBain|first49=Ryan|last50=Broadhurst|first50=M. Jana|last51=Murray|first51=Megan|last52=Richardson|first52=Eugene T.|last53=Philip|first53=Ted|last54=Gottlieb|first54=Gary L.|last55=Mukherjee|first55=Joia S.|last56=Farmer|first56=Paul E.|title=Strengthening Health Systems While Responding to a Health Crisis: Lessons Learned by a Nongovernmental Organization During the Ebola Virus Disease Epidemic in Sierra Leone|journal=Journal of Infectious Diseases|date=28 September 2016|pages=S153–S163|doi=10.1093/infdis/jiw345|pmid=27688219|pmc=5050485|language=en|issn=0022-1899|volume=214|issue=suppl 3}}
*{{cite journal |last1=Howlett |first1=Patrick J. |last2=Walder |first2=Anna R. |last3=Lisk |first3=Durodami R. |last4=Fitzgerald |first4=Felicity |last5=Sevalie |first5=Stephen |last6=Lado |first6=Marta |last7=N'jai |first7=Abdul |last8=Brown |first8=Colin S. |last9=Sahr |first9=Foday |last10=Sesay |first10=Foday |last11=Read |first11=Jonathon M. |last12=Steptoe |first12=Paul J. |last13=Beare |first13=Nicholas A.V. |last14=Dwivedi |first14=Reena |last15=Solbrig |first15=Marylou |last16=Deen |first16=Gibrilla F. |last17=Solomon |first17=Tom |last18=Semple |first18=Malcolm G. |last19=Scott |first19=Janet T. |title=Case Series of Severe Neurologic Sequelae of Ebola Virus Disease during Epidemic, Sierra Leone |journal=Emerging Infectious Diseases |date=August 2018 |volume=24 |issue=8 |pages=1412–1421 |doi=10.3201/eid2408.171367 |pmid=30014839 |pmc=6056101 |issn=1080-6040}}
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==External links==
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Latest revision as of 04:58, 17 November 2024

Ebola virus epidemic in Sierra Leone
Map of Sierra Leone
Cropped satellite view of S. Leone
DiseaseEbola virus
Confirmed cases14,061 (as of 25 October 2015)
Deaths3,955

An Ebola virus epidemic in Sierra Leone occurred in 2014, along with the neighbouring countries of Guinea and Liberia. At the time it was discovered, it was thought that Ebola virus was not endemic to Sierra Leone or to the West African region and that the epidemic represented the first time the virus was discovered there. However, US researchers pointed to lab samples used for Lassa fever testing to suggest that Ebola had been in Sierra Leone as early as 2006.

History of Ebola in Sierra Leone

Articles related to the
Western African
Ebola virus epidemic
Overview
Nations with widespread cases
Other affected nations
Other outbreaks

In 2014, it was discovered that samples of suspected Lassa fever showed evidence of the Zaire strain of Ebola virus in Sierra Leone as early as 2006. Prior to the current Zaire strain outbreak in 2014, Ebola had not really been seen in Sierra Leone, or even in West Africa among humans. It is suspected that fruit bats are natural carriers of disease, native to this region of Africa including Sierra Leone and also a popular food source for both humans and wildlife. The Gola forests in south-east Sierra Leone are a noted source of bushmeat.

Fruit bats gather on a tree in West Africa.

Bats are known to be carriers of at least 90 different viruses that can make transition to a human host. However, the virus has different symptoms in humans. It takes one to ten viruses to infect a human but there can be millions in a drop of blood from someone very sick from the disease. Transmission is believed to be by contact with the blood and body fluids of those infected with the virus, as well as by handling raw bushmeat such as bats and monkeys, which are important sources of protein in West Africa. Infectious body fluids include blood, sweat, semen, breast milk, saliva, tears, feces, urine, vaginal secretions, vomit, and diarrhea.

Even after a successful recovery from an Ebola infection, semen may contain the virus for at least two months. Breast milk may contain the virus for two weeks after recovery, and transmission of the disease to a consumer of the breast milk may be possible. By October 2014, it was suspected that handling a piece of contaminated paper may be enough to contract the disease. Contamination on paper makes it harder to keep records in Ebola clinics, as data about patients written on paper that gets written down in a "hot" zone is hard to pass to a "safe" zone, because if there is any contamination it may bring Ebola into that area.

One aspect of Sierra Leone that is alleged to have aided the disease, is the strong desire of many to have very involved funeral practices. For example, for the Kissi people who inhabit part of Sierra Leone, it is important to bury the bodies of the dead near them. Funeral practices include rubbing the corpses down with oil, dressing them in fine clothes, then having those at the funeral hug and kiss the dead body. This may aid the transmission of Ebola, because those that die from Ebola disease are thought to have high concentrations of the virus in their body, even after they have died.

For the 2001 outbreak of Sudan virus in Uganda, attending a funeral of an Ebola victim was rated by the Centers for Disease Control and Prevention (CDC) as one of the top three risk factors for contracting Ebola, along with contact with a family member with Ebola or providing medical care to someone with a case of Ebola virus disease. The main start of the outbreak in Sierra Leone was linked to a single funeral in which the World Health Organization (WHO) estimates as many as 365 died from Ebola disease after getting the disease at the funeral.

Bushmeat has also been implicated in spreading Ebola disease, either by handling the raw meat or through droppings from the animals. It is the raw blood and meat that is thought to be more dangerous, so it is those that hunt and butcher the raw meat that are more at risk as opposed to cooked meat sold at market. Health care workers in Sierra Leone have been warned not to go to markets.

2014: Outbreak started

Main article: West African Ebola virus epidemic

In late March 2014, there were suspected but not confirmed cases in Sierra Leone. The government announced on 31 March 2014, that there were no cases in Sierra Leone. Cases initially started appearing soon after the arrival of US researchers into the area. "After Ebola was first confirmed by laboratory tests in mid-March 2014, persistent rumours in the region linked the outbreak to a US-run research laboratory in Kenema, Sierra Leone (Wilkinson, 2017)."

Spring 2014: Early cases

The reported weekly cases of Ebola in Sierra Leone as listed on Misplaced Pages's 2014 Ebola Virus in West Africa timeline of reported cases and deaths; some values are interpolated.

Two U.S. doctors who "followed all CDC and WHO protocols to the letter" contracted Ebola, and it is not clear how they got infected.

By 27 May 2014, it was reported 5 people died from the Ebola virus and there were 16 new cases of the disease. Between 27 May 2014, and 30 May the number of confirmed, probable, or suspected cases of Ebola went from 16 to 50. By 9 June, the number of cases had risen to 42 known and 113 being tested, with a total of 16 known to have died from the disease by that time.

The disease spread rapidly in Kenema, and the local government hospital was overwhelmed. At that hospital, 12 nurses died despite having the world's only Lassa fever isolation ward, according to the U.N. Many health are workers were infected at the state hospital, including beloved physician and hemorrhagic fever expert, Dr. Sheik Humarr Khan, and chief nurse Mbalu Fonnie. Khan and his colleagues had bravely provided care to patients with this devastating illness.

Summer 2014: Continued growth, Dr. Khan dies

At this hospital in Kenema, samples were tested for Ebola. (Shown in June 2014)

On 12 June, the country declared a state of emergency in the Kailahun District, where it announced the closure of schools, cinemas, and nightlife places; the district borders both Guinea and Liberia, and all vehicles would be subject to screening at checkpoints. The government declared on 11 June, that its country's borders would be closed to Guinea and Liberia; but many local people cross the borders on unofficial routes which were difficult for authorities to control. Seasonal rains that fall between June and August interfered with the fight against Ebola, and in some cases caused flooding in Sierra Leone.

By 11 July 2014, the first case was reported in the capital of Sierra Leone, Freetown, however the person had traveled to the capital from another area of the country. By this time there were over 300 confirmed cases and 99 were confirmed to have died from Ebola. There was another case before the end of the month.

On 29 July, well-known physician Sheik Umar Khan, Sierra Leone's only expert on hemorrhagic fever, died after contracting Ebola at his clinic in Kenema. Khan had long worked with Lassa fever, a disease that kills over 5,000 a year in Africa. He had expanded his clinic to accept Ebola patients. Sierra Leone's president, Ernest Bai Koroma, celebrated Khan as a "national hero". On 30 July, Sierra Leone declared a state of emergency and deployed troops to quarantine hot spots.

In August, awareness campaigns in Freetown, Sierra Leone's capital, were delivered over the radio and through loudspeakers. Also in August, Sierra Leone passed a law that subjected anyone hiding someone believed to be infected to two years in jail. At the time the law was enacted, a top parliamentarian was critical of failures by neighboring countries to stop the outbreak. Also in early August Sierra Leone cancelled league football (soccer) matches.

September 2014: Exponential growth, quarantines

A view of a part of an isolation ward in Freetown
Woman in household quarantine

Within 2 days of 12 September 2014, there were 20 lab-confirmed cases discovered in Freetown, Sierra Leone. One issue was that residents were leaving dead bodies in the street. By 6 September 2014, there were 60 cases of Ebola in Freetown, out of about 1100 nationwide at this time. However, not everyone was bringing cases to doctors, and they were not always being treated. One doctor said the Freetown health system was not functioning, and during this time, respected Freetown Doctor Olivette Buck fell ill and died from Ebola by 14 September 2014. The population of Freetown in 2011 was 941,000.

By 18 September 2014, teams of people that buried the dead were struggling to keep up, as 20–30 bodies needed to be buried each day. The teams drove on motor-bikes to collect samples from corpses to see if they died from Ebola. Freetown, Sierra Leone had one laboratory that could do Ebola testing.

WHO estimated on 21 September, that Sierra Leone's capacity to treat Ebola cases fell short by the equivalent of 532 beds. Experts pushed for a greater response at this time noting that it could destroy Sierra Leone and Liberia. At that time it was estimated that if it spread through both Liberia and Sierra Leone up to 5 million could be killed; the population of Liberia is about 4.3 million and Sierra Leone is about 6.1 million.

In an attempt to control the disease, Sierra Leone imposed a three-day lockdown on its population from 19 to 21 September. During this period 28,500 trained community workers and volunteers went door-to-door providing information on how to prevent infection, as well as setting up community Ebola surveillance teams. The campaign was called the Ouse to Ouse Tock in Krio language. There was concern the 72-hour lock-down could backfire.

Quarantine travel pass, Sierra Leone

On 22 September, Stephen Gaojia said that the three-day lock down had obtained its objective and would not be extended. Eighty percent of targeted households were reached in the operation. A total of around 150 new cases were uncovered, but the exact figures would only be known on the following Thursday as the health ministry was still awaiting reports from remote locations. One incident during the lock-down was when a burial team was attacked.

On 24 September, President Ernest Bai Koroma added three more districts under "isolation", in an effort to contain the spread. The districts included Port Loko, Bombali, and Moyamba. In the capital, Freetown, all homes with identified cases would be quarantined. This brought the total areas under isolation to 5, including the outbreak "hot spots" Kenema and Kailahun which were already in isolation. Only deliveries and essential services would be allowed in and out. A sharp rise in cases in these areas was also noted by WHO.

As of late September, about 2 million people were in areas of restricted travel, which included Kailahun, Kenema, Bombali, Tonkolili, and Port Loko Districts. The number of cases seemed to be doubling every 20 days, which led to the estimate that by January 2015 the number of cases in Liberia and Sierra Leone could grow to 1.4 million.

On 25 September, there were 1940 cases and 587 deaths officially, however, many acknowledged under-reporting and there was an increasing number of cases in Freetown (the capital of Sierra Leone).

WHO estimated on 21 September, that Sierra Leone's capacity to treat Ebola cases fell short by the equivalent of 532 beds. There were reports that political interference and administrative incompetence had hindered the flow of medical supplies into the country.

October 2014: Responders overwhelmed

A road from Kenema to Kailahun District

By 2 October 2014, an estimated 5 people per hour were being infected with the Ebola virus in Sierra Leone. By this time it was estimated the number of infected had been doubling every 20 days. On 4 October, Sierra Leone recorded 121 fatalities, the largest number in a single day. On 8 October, Sierra Leone burial crews went on strike. On 12 October, it was reported that the UK would begin providing military support to Sierra Leone in addition to a major UK civilian operation in support of the Government of Sierra Leone.

In October, it was noted hospitals were running out of supplies in Sierra Leone. There were reports that political interference and administrative incompetence hindered the flow of medical supplies into the country. In the week prior to 2 October there were 765 new cases, and Ebola was spreading rapidly. At the start of October, there were nearly 2200 laboratory confirmed cases of Ebola and over 600 had died from it. The epidemic also had claimed the life of 4 doctors and at least 60 nurses by the end of September 2014. Sierra Leone limited its reported deaths to laboratory confirmed cases in facilities, so the actual number of losses was known to be higher.

Sierra Leone was considering making reduced care clinics, to stop those sick with Ebola from getting their families sick with the disease and to provide something in between home-care and the full-care clinics. These "isolation centers" would provide an alternative to the overwhelmed clinics. The problem the country was facing was 726 new Ebola cases but less than 330 beds available.

More than 160 additional medical personnel from Cuba arrived in early October, building on about 60 that had been there since September. At that time there were about 327 beds for patients in Sierra Leone. Canada announced it was sending a 2nd mobile lab and more staff to Sierra Leone on 4 October 2014.

There were reports of drunken grave-diggers making graves for Ebola patients too shallow, and as a result wildlife came and dug up and ate at the corpses. In addition, in some cases bodies were not buried for days, because no one came to collect them. One problem was that it was hard to care for local health care workers, and there was not enough money to evacuate them. Meanwhile, other diseases like malaria, pneumonia, and diarrhea were not being treated properly because the health system was trying to deal with Ebola patients. On 7 October 2014, Canada sent a C-130 loaded with 128,000 face shields to Freetown.

In early October 2014, a burial team leader said there were piles of corpses south of Freetown. On 9 October, the International Charter on Space and Major Disasters was activated on Sierra Leone's behalf, the first time that its charitably repurposed satellite imaging assets had been deployed in an epidemiological role. On 14 October 2014, 800 Sierra Leone peacekeepers due to relieve a contingent deployed in Somalia, were placed under quarantine when one of the soldiers tested positive for Ebola.

The last district in Sierra Leone untouched by the Ebola virus declared Ebola cases. According to Abdul Sesay, a local health official, 15 suspected deaths with 2 confirmed cases of the deadly disease were reported on 16 October, in the village of Fakonya. The village is 60 miles from the town of Kabala in the center of the mountainous region of the Koinadugu district. This was the last district free from the virus in Sierra Leone. All of the districts in this country had then confirmed cases of Ebola.

The Royal Navy's Argus

In late October 2014, the United Kingdom sent one of their hospital ships, the Royal Navy's Argus, to help Sierra Leone. By late October Sierra Leone was experiencing more than twenty deaths a day from Ebola. In October 2014, officials reported that very few pregnant women were surviving Ebola disease. In previous outbreaks pregnant women were noted to have a higher rate of death with Ebola.

Officials struggled to maintain order in one town after a medical team trying to take a blood sample from a corpse were blocked by an angry machete-wielding mob. They allegedly believed the person had died from high-blood pressure and did not want the body being tested for Ebola. When security forces tried to defend the medical team, a riot ensued leaving two dead. The town was placed on a 24-hour curfew and authorities tried to calm the situation down. Despite this several buildings were attacked.

On 30 October, the ship Argus arrived in Sierra Leone. It carried 32 off-road vehicles to support Ebola treatment units. The ship also carried three transport helicopters to support operations against the epidemic. By the end of October 2014 there were over 5200 laboratory confirmed cases of Ebola virus disease in Sierra Leone.

Ebola outbreak in West Africa – outbreak distribution map as of 29 October 2014

On 31 October 2014, an ambulance driver in Bo District died of Ebola. His ambulance picked up Ebola patients (or suspected Ebola cases) and took them to treatment centers.

November 2014: Continuing struggle

On 1 November, the United Kingdom announced plans to build three more Ebola laboratories in Sierra Leone. The labs helped to determine if a patient had been infected by the Ebola virus. At that time, it took as much as five days to test a sample because of the volume of samples that needed to be tested.

On 2 November, a person with Ebola employed by the United Nations was evacuated from Sierra Leone to France for treatment. On 4 November, it was reported that thousands violated quarantine in search for food, in the town of Kenema. On 6 November, it was reported that the situation was "getting worse" due to "intense transmission" in Freetown as a contributing factor; the capital city reported 115 cases in the previous week alone. Food shortages and aggressive quarantines were reported to be making the situation worse, according to the Disaster Emergency Committee. Sierra Leone established call centers in Port Loko and Kambia, according to MSSL Communications as reported on 21 November; this was in addition to the June hotline originally established.

On 12 November, more than 400 health workers went on strike over salary issues at one of the few Ebola treatment centers in the country. On 18 November, the supply ship Karel Doorman of the Royal Netherlands Navy (Koninklijke Marine) arrived in Freetown, with supplies. Its Captain-Commander, Peter van den Berg, took steps to reduce the chance of the crew contracting Ebola virus disease.

The Neini Chiefdom in Koinadugu District was subject to isolation after Ebola cases. On 19 November, it was reported that the Ebola virus was spreading intensely; "much of this was driven by intense transmission in the country's west and north", the WHO said.

Ebola treatment centre built by the UK in Kerry Town in 2014

A British-built Ebola Treatment Centre which started in Kerry Town during November, generated some controversy because of its initially limited capacity. However, this was because they were following guidelines of how to safely open an Ebola treatment unit. This was the first of six planned treatment centres which, when completed, would be staffed by a number of NGOs.

In mid-November the WHO reported that while all cases and deaths continued to be under-reported, "there is some evidence that case incidence is no longer increasing nationally in Guinea and Liberia, but steep increases persist in Sierra Leone". On 19 November, it was reported that the Ebola virus was spreading intensely; "much of this was driven by intense transmission in the country's west and north", the WHO said. The first Cuban doctor to be infected with the virus was flown to Geneva. On 26 November, it was reported that due to Sierra Leone's increased Ebola transmission, the country would surpass Liberia in the total cases count. On 27 November, Canada announced it would deploy military health staff to the infected region. On 29 November, the President of Sierra Leone canceled a planned three-day shutdown in Freetown to curb the virus.

December 2014

A situation map of Sierra Leone and surrounding nations showing the districts with reported cases of Ebola, as of 17 December 2014

On 2 December, it was reported that the Tonkolili district had begun a two-week lockdown, "which was agreed in a key stakeholders meeting of cabinet ministers, parliamentarians and paramount chiefs of the district as part of efforts to stem the spread of the disease", according to a ministry spokesman. The move meant that a total of six districts, containing more than half of the population, were locked down.

Sierra Leone indicated, in a report on 5 December, that about 100 cases of the virus were now being reported daily. On the same day, it was further reported that families caught taking part in burial washing rituals, which can spread the virus, would be taken to jail. On 6 December, a report indicated that the Canadian Armed Forces would send a medical team to the country of Sierra Leone to help combat the Ebola virus epidemic.

On 8 December, the doctors in Sierra Leone went on strike, demanding better treatment for health care workers, according to Health Ministry spokesman Jonathan Abass Kamara.

On 9 December, Sierra Leone authorities placed the Eastern Kono District in a two-week lock-down following the alarming rate of infection and deaths there. The lock down lasted until 23 December. This followed the grim discovery of bodies piling up in the district. The WHO reported fear of a major breakout in the area. The district with 350,000 inhabitants buried 87 bodies in 11 days, with 25 patients dying in 5 days before the WHO arrived.

On 12 December, Sierra Leone banned all public festivities for Christmas or New Year, because of the outbreak. On 13 December, it was reported that the first Australian facility had been opened; "operations will be gradually scaled up to full capacity at 100 beds under strict guidelines to ensure infection control procedures are working effectively and trained staff ... are in place", one source indicated.

Médecins Sans Frontières/Doctors Without Borders, in partnership with the Ministry of Health, carried out during December the largest-ever distribution of antimalarials in Sierra Leone. Teams distributed 1.5 million antimalarial treatments in Freetown and surrounding districts with the aim of protecting people from malaria during the disease's peak season. A spokesman said "In the context of Ebola, malaria is a major concern, because people who are sick with malaria have the same symptoms as people sick with Ebola. As a result, most people turn up at Ebola treatment centres thinking that they have Ebola, when actually they have malaria. It's a huge load on the system, as well as being a huge stress on patients and their families."

Between 14 and 17 December Sierra Leone reported 403 new cases with a total of 8,759 cases on the latter date. On 25 December, Sierra Leone put the north area of the country on lockdown. By the end of December Sierra Leone again reported a surge in numbers, with 9,446 cases reported.

On 29 December 2014, Pauline Cafferkey, a British aid worker who had just returned to Glasgow from working at the treatment centre in Kerry Town, was diagnosed with Ebola at Glasgow's Gartnavel General Hospital.

2015: Outbreak continues

January 2015

On 4 January, the lockdown was extended for two weeks. On this day the country reported 9780 cases with 2943 deaths. Among healthcare workers there were 296 cases with 221 fatalities reported.

On 8 January, MSF admitted its first patients to a Treatment Centre (ETC) in Kissy, an Ebola hotspot on the outskirts of Freetown. Once the ETC is fully operational it will include specialist facilities for pregnant women. By 9 January, the case load in the country exceeded 10,000, with 10,074 cases and 3,029 deaths reported. On 9 January, it was reported that South Korea would send a medical team to Goderich.

On 10 January, Sierra Leone declared its first Ebola-free district. The Pujehun district in the south east of the country reported no new cases for 42 days.

February 2015

A worker at Kerry Town clinic was evacuated to the United Kingdom on 2 February 2015, after a needlestick injury. On 5 February, it was reported that there was a rise in weekly cases for the first time this year. The U.N. indicated that the sharp drop in cases had "flattened out" raising concern about the virus.

March 2015

Port Loko District Ebola Response Centre staff remove contaminated items in April 2015.

On 5 March, a report indicated cases in Sierra Leone continued to rise. The government of Sierra Leone declared a three-day country-wide lock-down including 2.5 million people on 18 March. The U.N. indicates the outbreak will be over by August of this year.

The 3-day lock-down of over 6 million inhabitants revealed a 191% increase in possible Ebola cases. In Freetown alone 173 patients meeting the criteria for Ebola were discovered according to Obi Sesay from the National Ebola Response Center.

Spring 2015

As of 12 May, Sierra Leone had gone 8 days without an Ebola case, and was down to two confirmed cases of Ebola. The WHO weekly update for 29 July reported a total of only three new cases, the lowest total in more than a year. On 17 August, the country had its first week with no new cases, and one week later the last patients were released.

August/September 2015

A new death was reported on 1 September after a patient from Sella Kafta village in Kambia District was tested positive for the disease after her death. On 5 September, another case of Ebola was identified in the village among the approximately 1000 people currently under quarantine. A woman tested positive for the virus. The "Guinea ring vaccine" has been administered by a WHO team in the village since Friday 5 September. On 8 September the head of the National Ebola Response Center confirmed new cases of Ebola. This brought the total from the village to four cases, with all of them being under the "high risk" contact cases with the death of the new index case in the village. In total four cases were then confirmed including the dead woman.

On 14 September, the National Ebola Response Center confirmed the death of a 16-year-old in a village in the Bombali district. Swabs taken from the body tested positive for the disease. The village was placed under quarantine. She had no history of traveling outside the village, and it is suspected that she contracted the disease from the semen of an Ebola survivor who was discharged in March 2015. Seven of her immediate contacts were taken to an Ebola treatment center, with a further three patients she had contact with at a health clinic. A new study to be published in the New England Journal of Medicine indicates the possibility that the virus may lurk in the semen of survivors for up to six months. Nearly half of 200 patients tested had traces of the virus in their semen six months after surviving the disease. On 7 November, the World Health Organization declared Sierra Leone Ebola-free.

January 2016

Sierra Leone entered a 90-day period of enhanced surveillance which was scheduled to conclude on 5 February 2016, but due to a new case in mid-January it did not. On 14 January, it was reported there had been a fatality linked to the Ebola virus. The case occurred in the Tonkolili district. Prior to this case WHO had advised, "we anticipate more flare-ups and must be prepared for them ... massive effort is underway to ensure robust prevention, surveillance and response capacity across all three countries by the end of March." On 16 January, it was reported that the woman who died of the virus may have exposed several individuals; the government announced that 100 people had been quarantined. On the same day, WHO released a statement, indicating that originally the 90-day enhanced surveillance period was to end on 5 February. Investigations indicate the female case was a student at Lunsar in Port Loko district, who had gone to Kambia district on 28 December until returning symptomatic. Bombali district was visited by the individual, for consultation with an herbalist, later going to a government hospital in Magburaka. WHO indicates there are 109 contacts, 28 of which are high risk, furthermore, there are three missing contacts.The source or route of transmission which caused the fatality is still unknown. A second new case was confirmed on 20 January; the patient had contact with the previous fatality. On 17 March, the WHO declared the country Ebola-free.

Healthcare capacity

Long-term political factors contributed to the Ebola crisis including the acute dependency on external health assistance, patron-client politics, corruption and a weak state capacity. Prior to the Ebola epidemic Sierra Leone had about 136 doctors and 1,017 nurses/midwives for a population of about 6 million people. On 26 August, the WHO (World Health Organisation) shut down one of two laboratories after a health worker became infected. The laboratory was situated in the Kailahun district, one of the worst-affected areas. It was thought by some that this move would disrupt efforts to increase the global response to the outbreak of the disease in the district.

"It's a temporary measure to take care of the welfare of our remaining workers", WHO spokesperson Christy Feig announced. He did not specify how long the closure would last, but said they would return after an assessment of the situation by the WHO. The medical worker, one of the first WHO staff infected by the Ebola Virus, was treated at a hospital in Kenema and then evacuated to Germany. By 4 October 2014, it was announced he has recovered and left Germany.

As the Ebola epidemic grew it damaged the health care infrastructure, leading to increased deaths from other health issues including malaria, diarrhoea, and pneumonia because they were not being treated. The WHO estimated on 21 September that Sierra Leone's capacity to treat Ebola cases fell short by the equivalent of 532 beds.

Death of health workers

St John of God Hospital Sierra Leone, also known as Mabesseneh Hospital, near Lunsar. This is one of the hospitals operated in part by the Spanish aid organization Brothers Hospitallers of St. John of God, which lost multiple health workers to Ebola including two evacuated to Spain.

On 27 August 2014, Dr. Sahr Rogers died from Ebola after contracting it working in Kenema. Sierra Leone lost three of its top doctors by the end of August to Ebola.

A fourth doctor, Dr. Olivette Buck, became ill with Ebola in September and died later that month. Dr. Olivette Buck was a Sierra Leone doctor who worked in Freetown, who tested positive for Ebola on 9 September 2014, and died on 14 September 2014. Her staff believes she was exposed in August. She eventually went to Lumley Hospital on 1 September 2014, with a fever, thinking it was malaria. After a few more days of illness she was admitted to Connaught Hospital.

By 23 September 2014, out of 91 health workers known to have been infected with Ebola in Sierra Leone, approximately 61 had died.

On 19 October, the WHO reported 129 cases with 95 deaths of healthcare workers (125 / 91 confirmed). On 2 November 2014, a fifth doctor, Dr. Godfrey George, a medical superintendent of Kambia Government Hospital died as a result of Ebola infection. On 17 November 2014, a sixth doctor, Dr Martin Salia, died as a result of Ebola infection, after being transported by medevac to Nebraska Medical Center in the United States.

On 18 November 2014, a seventh doctor, Dr Michael Kargbo, died in Sierra Leone. He worked at the Magburaka Government Hospital.

Dr. Aiah Solomon Konoyeima was reported to have Ebola in late November 2014, which would make him the eighth physician to contract Ebola. He was reported to have died from the disease on 7 December 2014, becoming what was reported as the tenth doctor to die from Ebola.

On 26 November 2014, a ninth doctor, Dr. Songo Mbriwa, was reported to be sick with Ebola disease. He was working at an Ebola treatment centre in Freetown. He was one of the doctors that cared for the late Dr Martin Salia, who experienced a false-negative Ebola test, but did indeed have it and may have exposed others.

On Friday 5 December, a senior health official announced the death of two of the country's doctors in one day. This brings the total number of doctors who have died from the disease in Sierra Leone to ten. Dr Dauda Koroma and Dr Thomas Rogers are the latest deaths among healthcare workers. The two doctors were not in the front line of the Ebola battle and did not work in an Ebola treatment hospital.

On 18 December, Dr. Victor Willoughby died from the disease after being tested positive for the disease on Saturday 6 December. The doctor died hours before he was to receive ZMAb, an experimental treatment from Canada, according to Dr. Brima Kargbo the country's chief medical officer. Dr. Victor Willoughby is the 11th doctor, and a top physician, to succumb to the disease.

Evacuations

Since the beginning of the outbreak in Sierra Leone in late May 2014, several people have been evacuated. An increasing lack of hospital beds, medical equipment, and health care personnel made treatment difficult.On 24 August William Pooley, a British nurse, was evacuated from Sierra Leone. He was released on 3 September 2014. In October 2014, he announced he would return to Sierra Leone.

On 21 September 2014, Spain evacuated a Catholic priest who had contracted Ebola while working in Sierra Leone with Hospital Order of San Juan de Dios. He died on 25 September in Madrid. On 6 October 2014, a nurse who treated the priest tested positive for Ebola. By 20 October 2014, the nurse seemed to have recovered after many days battling the disease in the hospital, with tests coming back negative.

A doctor from Senegal contracted Ebola while working in Sierra Leone for the WHO, and was evacuated to Germany at the end of August 2014. By 4 October 2014, it was announced he has recovered and returned to Senegal.

In late September, a doctor working for an International Aid organization in Sierra Leone, was evacuated to Switzerland after potentially being exposed. He later tested negative for the disease.

In late September 2014, an American doctor working in Sierra Leone was evacuated to Maryland, USA, after being exposed to Ebola. "Just because someone is exposed to the deadly virus, it doesn't necessarily mean they are infected", said Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases at the NIH. He was evacuated after a needle sticking accident and even developed a fever, but he was determined not to have Ebola and was released the first week in October 2014. After being discharged he remained at home under medical observation, checking his temperature twice a day for 21 days.

In early October, a Ugandan doctor who contracted Ebola while working in Sierra Leone was evacuated for treatment to Frankfurt, Germany. The doctor was working at Lakaa Hospital and flown out from Lungi Airport.

On 6 October 2014, a female Norwegian MSF worker tested positive for Ebola virus and was subsequently evacuated to Norway. Norwegian authorities reported that they had been granted a dose of the experimental biopharmaceutical drug ZMAb, a variant of ZMapp. ZMapp has previously been used on 3 Liberian health workers, of which 2 survived. It was also used on 4 evacuated westerners, of which 3 survived. A U.N. employee was evacuated to France in early November 2014 after contracting Ebola.

On 12 November 2014, Dr Martin Salia, a permanent resident of the United States, tested positive for Ebola while working as a specialist surgeon at the Connaught Hospital in Freetown. He is the sixth Sierra Leone doctor to have contracted Ebola virus disease. Initially he preferred to be treated at the Hastings Holding Centre by Sierra Leonean medical personnel, however on 15 November 2014, he was evacuated to the Nebraska Medical Center where his condition was reported as "still extremely critical" on 16 November. On 16 November the hospital released a statement that he "passed away as a result of the advanced symptoms of the disease".

On 18 November a Cuban doctor, Felix Baez, tested positive for Ebola and was due to be sent to Geneva for treatment. He later recovered. Baez was one of 165 Cuban doctors and nurses in Sierra Leone helping treat Ebola patients. There were a further 53 Cubans in Liberia and 38 in Guinea, making this the largest single country medical team mobilized during the outbreak.

Confounding factors

Freetown, Sierra Leone

Sierra Leonean government intransigence

On 5 October, The New York Times reported that a shipping container full of protective gowns, gloves, stretchers, mattresses and other medical supplies had been allowed to sit unopened on the docks in Freetown, Sierra Leone, since 9 August. The $140,000 worth of equipment included 100 bags and boxes of hospital linens, 100 cases of protective suits, 80 cases of face masks and other items, and were donated by individuals and institutions in the United States.

The shipment was organised by Mr Chernoh Alpha Bah, a Sierra Leonean opposition politician, who comes from Sierra Leonean President Ernest Bai Koroma's hometown, Makeni. The New York Times reported that political tensions may have contributed to the government delay in clearing the shipping container, to prevent the political opposition from trumpeting the donations.

Government officials stated that the shipping container could not be cleared through customs, as proper procedures had not been followed. The Sierra Leonean government refused to pay the shipping fee of $6,500. The New York Times noted that the government had already received well over $40 million in cash from international donors to fight Ebola. The New York Times noted that in the 2 months that the shipping container remained on the docks in Freetown, health workers in Sierra Leone endured severe shortages of protective supplies, with some nurses having to wear street clothes.

David Tam-Baryoh, a radio journalist, was held for 11 days when he and a talk show guest, an opposition party spokesperson, criticised how President Ernest Bai Koroma handled the Ebola outbreak in a live broadcast on 1 November 2014. The weekly show Monologue was taken off-air mid-show from the independently run Citizen FM. He was arrested on 3 November and sent to the Pademba Road jail, after an executive order was signed by the president. On 14 November Sierra Leone's Deputy Information Minister Theo Nicol gave a statement that Baryoh had "been put on a ten thousand dollar bail by the Criminal Investigation Department after a statement has been taken from him".

Amid concerns for his health, Tam-Baryoh apparently signed a confession to ensure his release from the prison, engineered by a committee made up of his lawyer, 2 journalists and a peace studies lecturer of the University of Sierra Leone. Rightsway International, an independent human rights group, has condemned President Koroma for allegedly dictating to the committee about obtaining the confession. A statement later released by the group read:

Rightsway is disappointed that Tam Baryoh's forced confession has been published widely by pro-government media outlets and social networks. The publication of forced confessions is often used to discredit dissident news and information providers. This is a media propaganda tool used by dictatorial regimes, to avoid being exposed, investigated and punished for the grave violations of human rights.

Local conspiracy theories

  • "The Ebola outbreak was sparked by a bewitched aircraft that crashed in a remote part of Sierra Leone, casting a spell over three West African countries – but a heavily alcoholic drink called bitter Kola can cure the virus."
  • "Some members of the community thought it was a bad spirit, a devil or poisoning."
  • At the beginning of the outbreak, many did not believe that the disease existed. "I thought it was a lie (invented) to collect money because at that moment I hadn't seen people affected in my community."

Community violence

On 21 October, there was Ebola related violence and rioting in the eastern town of Koidu, with police imposing a curfew. Local youth fired at police with shotguns after a former youth leader refused health authorities permission to take her relative for an Ebola test. Several buildings were attacked and youth gangs roamed the streets shouting "No more Ebola!"

A local leader reported seeing two bodies with gunshot wounds in the aftermath. Police denied that anyone had been killed. Doctors reported two dead. The local district medical officer said he had been forced to abandon the local hospital because of the rioting.

Effects

Travel restrictions

Health screening room in Sierra Leonean airport

There are various restrictions and quarantines within Sierra Leone, and a state of emergency was declared on 31 July 2014. Countries at higher risk for Ebola in Africa include Benin, Burkina Faso, Côte d'Ivoire, Guinea-Bissau, Mali, and Senegal.

  • In April 2014, The Gambia banned air travel from several West African countries including Sierra Leone.
  • By 11 June 2014, Sierra Leone closed its border with Liberia and Guinea.
  • In July airlines of Nigeria and Togo cancelled flights to Freetown.
  • On 1 August 2014, Ghana banned air travel from several Ebola impacted countries including Sierra Leone.
  • On 8 August 2014, Zambia banned travelers from Sierra Leone and Ebola-affected countries and also banned Zambians from going to those places.
  • On 10 August 2014, Mauritania blocked entry of citizens of Sierra Leone.
  • On 11 August 2014, Ivory Coast blocked travel from Sierra Leone, Liberia, and Guinea. The restriction was lifted on 26 September 2014.
  • On 12 August 2014, Botswana banned travel of all non-Botswanans from Sierra Leone, Guinea, Liberia, and Nigeria; they also added the D.R. Congo later that month.
  • On 18 August 2014, Cameroon banned travelers from several countries including Sierra Leone.
  • On 21 August 2014, South Africa banned travelers from Sierra Leone, Liberia, and Guinea, but its own citizens were allowed to return from these places.
  • On 22 August 2014, a Kenyan airline put temporary restrictions Sierra Leone, saying the Ebola outbreak was underestimated.
  • On 22 August 2014, Senegal blocked air travel to Sierra Leone, Liberia, and Guinea.
  • On 22 August 2014, Rwanda banned travelers who had been to Sierra Leone, Guinea, and Liberia in the previous 22 days.
  • On 11 September 2014, Namibia banned travelers from 'Ebola affected countries'.
  • In September 2014, bans on the Sierra Leone hosting federation football (soccer) games continued.
  • In October 2014, Trinidad and Tobago banned travelers from the Ebola-stricken West African countries, including Sierra Leone.
  • In October 2014, Jamaica, Colombia, Guyana and Saint Lucia banned travelers from Sierra Leone and other affected West African countries.
  • In mid October 2014, Saint Vincent and the Grenadines banned Sierra Leone nationals and those from some other West African nations.
  • In late October 2014, Panama banned anyone coming from, or had been in Sierra Leone, Liberia, or Guinea in the previous 21 days.
  • On 18 October 2014, Belize banned travelers from Sierra Leone, and also banned those that had been there or Guinea or Liberia in the previous 21 days.
  • Suriname banned travelers who had been to Sierra Leone, Guinea, or Liberia in the previous 21 days unless they have a health certificate.
  • By 21 October 2014, the Dominican Republic banned foreigners who had been to Sierra Leone or other Ebola-affected nations in the previous 30 days.
  • On 11 November 2014, The Gambia opened its borders again to travelers from Sierra Leone, Liberia, Nigeria and Guinea.

Additional effects

Hand-washing station at Lungi Airport

The outbreak was noted for increasing hand washing stations, and reducing the prevalence of physical greetings such as hand-shakes between members of society.

In June 2014 all schools were closed because of the spread of Ebola.

In August 2014 the S.L. Health Minister was removed from that office. (see Cabinet of Sierra Leone) In October 2014 the Defense Minister was placed in charge of the anti-Ebola efforts. The president at this time was Ernest Bai Koroma.

On 13 October, the UN's International Fund for Agricultural Development stated up to 40% of farms had been abandoned in the worst Ebola-hit areas of Sierra Leone.

In October 2014 Sierra Leone launched a school by radio program, that will be transmitted on 41 of the local radio stations as well as on the only local TV station. (See Cultural effects of the Ebola crisis)

September through October is the malaria season, which may complicate efforts to treat Ebola. For example, one Freetown doctor did not immediately quarantine herself because she thought she had malaria not Ebola. The doctor was eventually diagnosed with Ebola and died in September 2014.

Local works derived from the Ebola crisis

Main article: Cultural effects of the Ebola crisis
  • A Sierra Leone DJ, Amara Bangura, shares knowledge about Ebola in his weekly show which is transmitted on 35 stations in Sierra Leone. He takes selected questions from the text messages sent in and gets answers from health experts and government officials.
  • "White Ebola", a political song by Mr. Monrovia, AG Da Profit and Daddy Cool, centered on the general mistrust of foreigners.
  • "Ebola in Town", a dance tune by a group of West African rappers, D-12, Shadow and Kuzzy Of 2 Kings warns people of the dangers of the Ebola virus and explaining how to react, became popular in Guinea and Liberia during the first quarter of 2014. A dance was developed in which no body contact was required, a rare occurrence in African dance. Some health care workers from the IFRC had concerns that the Ebola In Town song's warning "don't touch your friend" may worsen the stigma.
  • In August 2014, George Weah and Ghanaian musician Sidney produced a song to raise awareness about Ebola. All proceeds from the track been donated to the Liberian Health Ministry.
  • There are a number of Ebola-themed jokes circulating in West Africa to spread awareness.

See also

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