The last case in Sierra Leone was an eight-month-old child, who was hospitalised nearly two weeks ago and died four days later.
Twenty-nine people who had contact with the child were moved from the densely packed slum of Magazine Wharf in the capital, Freetown, to a voluntary quarantine facility. None have so far shown signs of illness.
We will wait to see if any of those high-risk people develop [Ebola] but if not, and even if they do, we have them safely out of the community. Our hope is that that is the last bit of this outbreak,” said Marshall Elliott, director of the UK government’s interagency taskforce, which is running the response with the Sierra Leone government and army.
In Magazine Wharf – a stepped hill of concrete, wood and corrugated iron shacks leading down from Freetown’s biggest market to the sea – men, women, children and dozens of pigs wander the concrete steps. Some of the families washing children in plastic bowls in a front room or just sitting in the sun have returned from a 21-day period of quarantine having lost one or more of their relatives. But all of those who left temporarily have been able to tell their neighbours that they were not imprisoned, maltreated or starved.
“Everyone is very frightened of going there at first,” said Chris Lane, a World HealthOrganisation epidemiologist who spends a lot of time with the Magazine Wharf community, working to establish trust. Lane fixes holes in the corrugated iron roof of a quarantined family’s empty home to keep out the rain, visits those who have returned and talks to community leaders.
“When I was taking away someone last week, sending them up to PTS [the Police Training School, now used as a quarantine centre], this woman was extremely distraught. She was very unhappy, very scared of going there, and it was only when someone who was released the day before knocked on the window and he chatted away to her, that the tears stopped and she calmed down. I think she realised what we’re saying is actually true, but coming from one of her own, it’s absolute. If someone you know from around the corner says it’s great, you get food, a roof over your head, you’ve got a radio and your friends can come and visit any time they like - it suddenly makes it a different picture.”
Down on the seafront, Banjo Bai Koroma, the harbourmaster, stares out to sea, watching the Chinese fishing boats with little to do. There are still restrictions to prevent passenger boats landing and picking people up from Magazine Wharf. He gestures to a pile of painted wood, the wreckage of his own boat, destroyed by vandals. “Because of the quarantine, my boat got wrecked,” he says. “It was when I was quarantined.” It is another small part of the massive rebuilding exercise that is now needed in Sierra Leone.
Ebola was brought into the wharf by boat from the north of Sierra Leone, which earlier this year seemed to am intractable reservoir of the disease. But a big operation launched in June appears to have been a success.
There have been no cases in Kambia or Port Loko for well over a month, “which is really, really good”, said Elliott of Operation Northern Push. “It’s very hard for any of us who have worked on this for a long time to ever feel totally confident and relaxed because we have had surprises in the past. We remain vigilant.”
The west African epidemic was the largest ever outbreak of Ebola. The disease – first identified in 1976 – had only affected a few hundred people at any one time before. There have been almost 28,000 cases across west Africa since December 2013 and about 11,300 deaths. But Liberia has had no cases since the week ending 12 July, so that three in Guinea were the only infections in the whole of west Africa last week.
At its peak late last year, there were 450 cases a week just in Sierra Leone, which meant the responders could do little more than collect bodies and urge families to report to the authorities anybody who was sick or dead.
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