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PostPosted: Wed Aug 20, 2014 4:33 pm 
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Am I the only person who feels this is a huge mistake? You have a group of individuals who don't trust the government. What do you get when you try to enforce a quarantine? A huge group of individuals, some possibly infected, who will do anything to escape said quarantine.

These are poor individuals, it's not like they have alot of things holding them down. Give them reasons for leaving, fear, lack of food, inadequate health care and what are they doing to do? Everything within their power to escape and solders with guns might stop a few in the daylight but what about at night? What about bribes (if anyone can afford them)? What about the woman and her children who are begging to get out and the solder who relents and lets her pass.

These people need reasons to take their sick to a center, not more reasons to run.


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PostPosted: Wed Aug 20, 2014 7:00 pm 
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Wholly agree with you. But after reading today's live chat with those who are supposedly in the best positions to manage the crisis, and finding only circular talk, I have decided that the only thing I can do as an individual is either stay on the sidelines or go, in person, to the affected areas. Nothing else in between will do.


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PostPosted: Wed Aug 20, 2014 8:02 pm 
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WHO sees start of shortages due to Ebola-related restrictions
Filed Under: Ebola
Lisa Schnirring | Staff Writer | CIDRAP News | Aug 20, 2014

Service interruptions by shippers are starting to cause food and fuel shortages in Ebola-hit countries, the WHO said.
The World Health Organization (WHO) today aired concern about companies suspending services to countries affected by the Ebola outbreak, with some starting to feel shortages of food and other supplies, and said the pace of new illnesses and deaths continues to surge, especially in Liberia and Sierra Leone.

High-level communications between the WHO and affected countries, companies, and groups that conduct business in and with Africa are still underway, and some companies have suspended services to the affected countries, according to a WHO statement today. Last week the agency aired concerns about flight bans and said the actions could hamper the flow of needed supplies to the outbreak region.

Shortages could hamper response, relief efforts
Delivery suspensions by shipping companies are starting to cause shortages of food, fuel, and basic supplies in affected countries, the WHO said, adding that it is already working with the United Nations World Food Programme to shore up food and other supplies for the region. It called on companies to make their decisions based on sound science about Ebola virus transmission.

Some airlines, such as British Airways and Emirates Airlines, have suspended service to outbreak areas. In a related development, some Air France flights crews are refusing to board planes because of outbreak fears, Agence France-Presse (AFP) reported today. A spokesman for the airline told AFP that flights scheduled for the region have not been left shorthanded.

Besides one sick airline traveler whose illness was detected in Nigeria, no travel-linked Ebola virus disease (EVD) cases have been detected anywhere in the world. The WHO and its emergency committee have said the risk for travel-related spread is very low and have urged countries not to issue trade or travel bans.

Illnesses and deaths rise in three countries
In outbreak developments, the WHO said today that between Aug 17 and 18, 221 new EVD cases and 106 deaths were reported from the West African outbreak countries, lifting the overall total to 2,473 illnesses with 1,350 deaths.

Liberia, which carries the biggest burden of cases, reported 126 more EVD cases and 95 deaths, boosting its total to 972 infections, 576 of them fatal. Sierra Leone health officials reported 59 more illnesses and 9 more deaths, bringing its total to 907 EVD cases, 374 of them fatal.

Civil unrest in the Liberian capital, Monrovia, has been hampering disease control efforts and fueling fears of further spread, and today police used tear gas and live ammunition to scatter a crowd attempting to break out of a quarantined neighborhood, according to a Reuters report.

The conflict occurred in the city's West Point slum area, where on Aug 16 a crowd looted an Ebola holding area, scattering patients and clinic supplies, including soiled items, into the community. The country's health ministry said yesterday that all of the patients, who were being evaluated for possible exposure to the virus, had been found and were being monitored at one of the city's hospitals.

In Guinea, which has recently seen some hopeful signs in the battle to curb the virus, authorities reported 36 more illnesses and 2 more deaths, raising its total to 579 cases and 396 deaths. Nigeria, where cases were linked to a sick traveler, reported no new cases or deaths, keeping its tally at 15 cases and 4 deaths.

California, New Mexico isolate patients, await test results
In other developments, California health officials said today that a patient identified as low-risk for EVD infection is in an isolation unit at a Sacramento County hospital awaiting the results of EVD testing, which is underway at the US Centers for Disease Control and Prevention (CDC).

Kaiser Permanente said yesterday in a statement that it was working with county health officials regarding a patient admitted to Kaiser Permanente South Sacramento Medical Center who may have been exposed to the Ebola virus. Kaiser said it was taking the same precautions it uses for other patients with suspected infectious diseases, which include isolating the patient in a negative-pressure room, use of personal protective equipment (PPE) by trained staff, and coordination with infectious disease specialists.

Gil Chavez, MD, state epidemiologist at the California Department of Public Health (CDPH), said at a media telebriefing today that he couldn't share any patient details because of privacy rules, but federal, state, and local health officials have deemed the patient at low risk on the basis of a CDC assessment of travel history, exposure, and symptoms. He added that the patient is being tested out of an abundance of caution and that test results are expected back in about 3 days.

In another precaution, California health officials are already identifying the patient's close contacts. "We are being very proactive very early on. There have been no cases that have met the CDC definition of high risk," Chavez said. He said identification of a low-risk patient isn't surprising, because other diseases resemble the initial symptoms of EVD and patients travel to California from all over the world.

The CDC has urged states to increase their surveillance for possible cases, and so far hospitals in 27 states have alerted the agency about possible cases, CDC officials told ABC News today. Among the states reporting, 58 cases were ruled out in view of patient exposures and symptoms, but blood samples were sent to the CDC for 10 patients. So far 7 have tested negative and test results are pending for 3, according to the ABC News report.

On Aug 17 the New Mexico Department of Health (NMDH) said it was working with the CDC regarding tests to rule out an EVD infection in a 30-year-old woman who came down with a sore throat, headache, muscle aches, and fever after teaching in Sierra Leone. It said the University of Mexico Hospital has isolated the patient, and tests are being done out of an abundance of caution.

Since early August, when West Africa's EVD outbreak became much worse, with two American medical missionaries evacuated to the United States for treatment, the CDC has issued several guidance documents for health providers and has activated its emergency operations center (EOC) at its highest level to devote more resources to monitoring and responding to the outbreak.

CDC guidance tackles environmental issues
Yesterday the CDC posted interim guidance for EVD environmental control in hospitals. It said that though the role of the environment in transmission hasn't been pinned down, limited lab studies suggest the virus can remain viable on solid surfaces, with slowly declining concentrations, over several days. Though there is no evidence that the virus transmits through the environment or fomites, stronger precautions are warranted, given the apparently low infectious dose, the potential for high virus titers in the blood of sick patients, and the severity of the disease, the agency said.

The CDC's guidance covers PPE for environmental services staff, disinfectants that should be used, considerations about porous surface contamination, and laundry.

See also:

Aug 20 WHO update

Aug 20 AFP story

Aug 20 Reuters story

Aug 14 CIDRAP News story "WHO pushes back against Ebola-related flight bans"

Aug 19 CDPH press release

Aug 19 Kaiser Permanente statement

Aug 17 NMDH press release

Aug 20 ABC News report

Aug 19 CDC interim guidance on environmental infection control for Ebola virus

http://www.cidrap.umn.edu/news-perspect ... strictions

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PostPosted: Wed Aug 20, 2014 9:16 pm 
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Ebola outbreak: Liberian police shoot to disperse West Point protest as death toll hits 1,350
Updated 21 Aug 2014, 8:54amThu 21 Aug 2014, 8:54am

Police in Liberia have fired live rounds and tear gas to disperse a stone-throwing crowd trying to break an Ebola quarantine imposed on their neighbourhood, as the death toll from the epidemic in West Africa hits 1,350.

In the West Point neighbourhood of capital Monrovia at least four people were injured in clashes with security forces, witnesses said.

It was unclear whether anyone was wounded by gunfire, though a Reuters photographer saw a young boy with his leg largely severed just above the ankle.

"The soldiers are using live rounds," army spokesman Dessaline Allison said.

"The soldiers applied the rules of engagement. They did not fire on peaceful citizens."

The World Health Organisation (WHO) said countries hit by the outbreak of the deadly virus were beginning to suffer shortages of fuel, food and basic supplies after shipping companies and airlines suspended services to the region.

The epidemic of the hemorrhagic fever, which can kill up to 90 per cent of those it infects, is ravaging the three small West African states of Liberia, Sierra Leone and Guinea, and also has a toehold in Nigeria, Africa's biggest economy.

Ebola virus explained


What is Ebola, and how does this highly contagious and deadly disease spread?
Liberia, where the death toll is rising fastest, said its health ministry warehouse had run out of rubber boots and hand sanitiser bottles, essential for preventing the spread of the disease.

Since it was discovered in remote south-eastern Guinea in March, the overall death toll from the outbreak has reached 1,350 from a total of 2,473 cases.

Liberian authorities introduced a nationwide curfew on Tuesday and put the teeming West Point neighbourhood under quarantine to curb the spread of the disease.

Witnesses said clashes started after security forces blocked roads early on Wednesday with tables, chairs and barbed wire.

Security forces came in to escort the local commissioner out of the neighbourhood, they said.

Attempts to isolate the worst affected areas of the country and neighbouring Sierra Leone have raised fears of unrest in one of the world's poorest regions should communities start to run low on food and medical supplies.

"I don't have any food and we're scared," Alpha Barry said, a resident of West Point who said he came from Guinea and had four children under 13.

The World Food Programme has begun emergency food deliveries to quarantined zones where 1 million people may be at risk of shortages.

The WHO has appealed to companies and international organisations to continue providing supplies and services to countries at risk, saying there was a low risk of contagion.

http://www.abc.net.au/news/2014-08-21/p ... 50/5685576

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PostPosted: Wed Aug 20, 2014 9:29 pm 
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Clashes Erupt As Liberia Sets A Quarantine
By NORIMITSU ONISHIAUG. 20, 2014

MONROVIA, Liberia — Soldiers and police officers in riot gear blocked the roads. Even the waterfront was cordoned off, with the coast guard stopping residents from setting out in canoes. The entire neighborhood, a sprawling slum with tens of thousands of people, awoke Wednesday morning to find that it was under strict quarantine in the government’s halting fight against Ebola.

The reaction was swift, and violent. Angry young men hurled rocks and stormed barbed-wire barricades, trying to break out. Soldiers repelled the surging crowd with live rounds, driving back hundreds of young men.

One teenager in the crowd, Shakie Kamara, 15, lay on the ground near the barricade, his right leg apparently wounded by a bullet from the melee. “Help me,” he pleaded, barefoot and wearing a green Philadelphia Eagles T-shirt.

The clashes were a dangerous new chapter in West Africa’s five-month-old fight against the deadliest Ebola outbreak on record. The virus continues to spread, yet the total number of cases reported in the affected nations — Guinea, Liberia, Nigeria and Sierra Leone — is already higher than in all other Ebola outbreaks combined since 1976, when the disease was first identified, the Centers for Disease Control and Prevention said Wednesday.

So far, the outbreak has mostly been concentrated in rural areas, but the disease has also spread to major cities like the Guinean capital Conakry, and especially here in Monrovia, the Liberian capital. Fighting Ebola in an urban area — particularly in a neighborhood like this one, known as West Point, an extremely poor and often violent place that still bears deep scars from Liberia’s 14 years of civil war — presents challenges that the government and international aid organizations have only started grappling with.

The risks that Ebola will spread quickly, and the difficulties in containing it, are multiplied in a dense urban environment, especially one where the health system has largely collapsed and residents appear increasingly distrustful of the government’s approach to the crisis, experts say.

At least 1,350 people are estimated to have died in the current outbreak of Ebola, the first of its kind in West Africa. The deaths are rising most rapidly in Liberia, which now has the highest death toll, estimated to be at least 576.

“Being the first time to get this problem, they didn’t know what they were dealing with,” Dr. David Kaggwa, a Ugandan physician working for the World Health Organization here, said of the Liberian government. “They didn’t know how to respond to it. By the time they realized, it was way out of control.”

In a cholera ward at the John F. Kennedy Medical Center that he helped transform into an Ebola ward, Dr. Kaggwa said that his own nation’s long history with Ebola was limited to rural outbreaks.

“This is our first experience in a capital city, and all the indications are that it spreads faster in a city because people are living closer together,” he said.

Beyond the threat of Ebola itself, experts warn that there has been a broader collapse of the public health system here, resulting in a range of life-threatening illnesses and conditions that are being left untreated. Many hospitals closed after health workers died, and the facilities that remain open have become overwhelmed.

“The emergency within the emergency is the collapse of the health care system,” said Dr. Joanne Liu, the president of Doctors Without Borders, who recently surveyed Liberia and other affected nations. “People don’t have access to basic health care,” she said, including malaria treatment for children, medical care for pregnant women and other common but essential needs.

Dr. Liu said that her team had come across six instances of pregnant women who had been wandering around Monrovia for hours, looking for a facility that could help deliver their babies. “They couldn’t find one,” she said. By the time her team had attended to the women, she added, the babies had died.

“All the health care facilities are basically closed in Monrovia,” she added. “There may be some marginal activities, but basically there’s nothing really working right now.”

Sheldon Yett, the director in Liberia for Unicef, said the group has deployed volunteers to West Point and other poor areas to educate residents about Ebola. “The fact that it is really firmly entrenched now in the capital city makes it a real game changer for us,” he said.

Even before the government imposed a blanket quarantine on West Point — a strategy governments in the region are using in a desperate bid to contain the outbreak — the neighborhood was seething.

Last week, Health Ministry officials quietly turned a primary school in West Point into a holding center for Ebola patients without informing the residents. Over the weekend, hundreds of residents invaded the center, enraged that outsiders were also being transferred there. Their community, they believed, was becoming a dumping ground for Ebola patients. Residents stormed through, running off with a generator and supplies like mattresses, some soaked with the blood of patients who were believed to have Ebola.

“I can tell you they were uncountable,” said Isaac Toe, 25, a hygienist who was working at the center at the time of the invasion. “The entire West Point community broke in — men, women, children, boys and girls.”

Christiana Williams, 52, who lives behind the center, said that locals were bewildered when they learned that the neighborhood school had been turned overnight into an Ebola holding center. Through the weekend, she said she heard cries from inside the center.


Unrest in a slum in Monrovia, Liberia, is a case study for the panic and challenges doctors and patients face in poor, densely populated urban areas. Video Credit By Natalia V. Osipova on Publish Date August 20, 2014. Image CreditJohn Moore/Getty Images
“ ‘We’re not eating,’ ” Ms. Williams recalled hearing. “ ‘They’re just spraying us.’ ‘We’re getting weak.’ ”About 17 patients who were thought to have Ebola left the center for a couple of days before they were brought to the John F. Kennedy Medical Center here, raising concerns that the disease would continue to spread.

“There’s enough blame to go around,” said Lewis Brown, the information minister, acknowledging that the residents were caught by surprise.

Health officials had no choice but to transfer patients from outside West Point to the holding center because it was the only one of its kind in the city, Mr. Brown said, adding that the government is planning to open similar centers elsewhere.

On Tuesday, hours before the quarantine was declared, community leaders said that despite improvements since the end of the war in 2003 — the creation of public toilets, the paving of the main road — West Point remained a crucible for Liberia’s postwar problems. Crime keeps rising, and so has the use of crack cocaine, called coco or Italian White.

Sprawling across a peninsula just north of the city center, much of West Point is made up of shanties separated by alleys wide enough for only one person. After the war, its population swelled as rural Liberians gravitated here looking for work. Anywhere from 60,000 to 120,000 people are believed to live in West Point.

A deep distrust of the government has fueled rumors that the authorities have made up the Ebola crisis to squeeze money out of international donors.

“We have a lot of Doubting Thomases,” Philip Bropleh, 45, an electrician and community leader, said of people, including politicians, who have said that the government has invented the crisis. “Because of all these things, it allowed Ebola to run into Monrovia.”

On Tuesday night, after most people had gone to sleep, President Ellen Johnson Sirleaf announced the imposition of the quarantine in West Point as well as a nationwide curfew. Early Wednesday morning, crowds tried to break through the barricade near an electrical station.

During a lull, many residents complained that they could not leave West Point for work.

“There is nowhere to go for our daily bread,” said Davidette Wilson, 27, who sells goods at a large market just outside West Point.

Making matters worse, the quarantine immediately led to a surge in prices of goods sold inside West Point, residents said. A cup of rice, usually the equivalent of 30 cents, was now going for 90 cents, they said.

Peter Tarr, 22, one of the many former child soldiers in West Point, eked out a living by begging in the city’s wealthier areas. “Where can I go to beg now?” said Mr. Tarr, who lost his right arm in the war.

By midmorning, a crowd began gathering again in front of the entrance near the electrical station.

“You fight Ebola with arm?” David Anan, 34, shouted at the heavily armed soldiers.

Minutes later, hundreds of stone-hurling young men tried to storm through the barricade once again.

In all, residents tried to break through the barricade three times on Wednesday, Col. Prince Johnson, the army’s brigade commander, said Wednesday evening by phone. His soldiers had fired in the air, he said, but he would not comment on whether they had also fired into the crowd, including at the teenage boy. Heavy rains starting around noon helped quell West Point’s fury.

“Things have quieted down,” he said.

Clair MacDougall contributed reporting from Monrovia, and Sheri Fink from New York.

http://www.nytimes.com/2014/08/21/world ... ntine.html

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PostPosted: Thu Aug 21, 2014 4:24 pm 
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alforddm wrote:
Am I the only person who feels this is a huge mistake? You have a group of individuals who don't trust the government. What do you get when you try to enforce a quarantine? A huge group of individuals, some possibly infected, who will do anything to escape said quarantine.

These are poor individuals, it's not like they have alot of things holding them down. Give them reasons for leaving, fear, lack of food, inadequate health care and what are they doing to do? Everything within their power to escape and solders with guns might stop a few in the daylight but what about at night? What about bribes (if anyone can afford them)? What about the woman and her children who are begging to get out and the solder who relents and lets her pass.

These people need reasons to take their sick to a center, not more reasons to run.

Agree.

Enforced quarantines had limited success in the past:

The Washington Post
Quote:
The nightmare of containing Ebola in Liberia’s worst slum

By Terrence McCoy August 21 at 5:36 AM

[Liberia]
By early Wednesday morning, the soldiers had already arrived, roadblocks had risen and boats bobbed off the coast. People sleeping on thin mats on concrete inside metal shanties awoke to discover knocked-over tables and broken chairs lining the exits out of their neighborhood. Photos show emptied streets, closed shops and soldiers prowling with big guns. The residents of West Point, a peninsular slum hammered by Ebola, were trapped. No one in — no one out. It was a quarantine.

Residents rushed onto the streets of what is said to be “the worst slum in Liberia.” When they learned they couldn’t leave — not even for food — young men tried to climb over the barricades. Soldiers let loose with their guns, and one young man was apparently shot in the legs, the New York Times reported. The crowd was further enraged, local media said, when it learned the commissioner of West Point would be rescued — and none of her constituents. “So y’all taking her and leaving us here,” Front Page Africa quoted one resident saying. “She must not come back here in West Point again.”

Thursday opened with tear gas and live rounds fired upon residents, the BBC reported. Four people were injured.

It was a dark beginning to the West Point quarantine as Ebola flits from one dwelling to another. On Wednesday, Liberian President Ellen Johnson Sirleaf said “it has thus become necessary,” according to the Liberian Observer. West Point would be under a 9 p.m. to 6 a.m. curfew, she said, and “quarantined under full security watch. … No movements in and out of those areas. All entertainment centers are to be closed.”

Map
Ebola has killed at least 1,350 people across four affected countries. President Sirleaf blames Liberia’s 576 and the subsequent quarantine on “continued denials, cultural burying practices, disregard for the advice of health workers and disrespect for … warnings.”

There’s a lengthy history of combating disease with mandatory quarantines. The tactic was often used in fighting the Black Death. Once, in 1665, a village of 350 inhabitants quarantined itself to prevent the plague from spreading; only 90 residents survived. More recently, an entire city in China was quarantined after one man died of plague.

But there is little contemporary precedent for the quarantine of West Point, a warren of shacks little removed from the rest of the city. It’s only a 25-minute walk from the upscale neighborhood of Mamba Point, home to the United States embassy. Its eastern beaches, strewn with human feces, are only a short boat ride from the mainland.
Video: “How the Ebola Virus Works”

Experts concede any attempt at containing a massive Ebola outbreak in an urban capital has rarely been tried. “This is our first experience in a capital city, and all the indications are that it spreads faster in a city because people are living closer together,” David Kaggwa, a Ugandan doctor with the World Health Organization, told the New York Times.

What about the moral implications of trapping tens of thousands of people? “It might work,” Martin S. Cetron, a quarantine expert, told the Times. “But it has a lot of potential to go poorly if it’s not done with an ethical approach. Just letting the disease burn out and considering that the price of controlling it — we don’t live in that era anymore.”

Perhaps the closest approximation to the West Point quarantine is one imposed in 1995 in Kikwit, Zaire. Now belonging to Congo, the metropolis of 400,000 residents was without running water or electricity when Ebola struck, killing 97 percent of its victims.

According to expert Laurie Garrett, who won a Pulitzer Prize for her coverage of Ebola, dictator Mobutu Sese Seko’s response to the outbreak was both swift and brutal. He completely isolated the city, which sat 250 miles away from the capital of Kinshasa down an “abominable stretch of poorly paved roadway,” Garrett wrote that year in Vanity Fair.

By May 11 of that year, roadblocks had materialized, and everything shut down. Trade halted. People went hungry. It was “brutally successful,” Garrett wrote recently. “The desperately poor people were fully isolated to war with Ebola on their own.”

But within a week, as epidemiologists walked the streets looking for the infected, residents escaped despite the quarantine. “It was impossible to prevent people from leaving the city where the disease was concentrated,” an Associated Press article said on May 18, 1995.
“Those who are in quarantine are not under arrest and since they are not under arrest they can sometimes escape and do what they want,” Mobutu said.

Those who didn’t make it out went hungry. “They have to find another solution or we will have dire economic circumstances,” the city’s mayor told Garrett in 1995. “If the quarantine continues much longer the world may have its solution, but we will starve. … Here in Kikwit, we know the link between hunger and disease.”

West Point knows that link as well. The cost of food in the slum has skyrocketed, the New York Times reported. Before, a cup of rice cost around 30 cents — but now, it’s about 90 cents. This, in a country where most live on less than $1.25 per day, according to USAID.

“We live here,” one resident told Front Page Africa. But “since this morning our children have not eaten yet. Is it because of Ebola [the president] must kill us? We are tired with this thing. It is worse now.”

But as another day of quarantine dawns in West Point, it may only get worse still.


Terrence McCoy is a foreign affairs writer at the Washington Post. He served in the U.S. Peace Corps in Cambodia
and studied international politics at Columbia University. Follow him on Twitter here.


http://www.washingtonpost.com/news/morn ... orst-slum/


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PostPosted: Thu Aug 21, 2014 8:32 pm 
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The nightmare of containing Ebola in Liberia’s worst slum
By Terrence McCoy August 21 at 5:36 AM

By early Wednesday morning, the soldiers had already arrived, roadblocks had risen and boats bobbed off the coast. People sleeping on thin mats on concrete inside metal shanties awoke to discover knocked-over tables and broken chairs lining the exits out of their neighborhood. Photos show emptied streets, closed shops and soldiers prowling with big guns. The residents of West Point, a peninsular slum hammered by Ebola, were trapped. No one in — no one out. It was a quarantine.

Residents rushed onto the streets of what is said to be “the worst slum in Liberia.” When they learned they couldn’t leave — not even for food — young men tried to climb over the barricades. Soldiers let loose with their guns, and one young man was apparently shot in the legs, the New York Times reported. The crowd was further enraged, local media said, when it learned the commissioner of West Point would be rescued — and none of her constituents. “So y’all taking her and leaving us here,” Front Page Africa quoted one resident saying. “She must not come back here in West Point again.”

Thursday opened with tear gas and live rounds fired upon residents, the BBC reported. Four people were injured.

It was a dark beginning to the West Point quarantine as Ebola flits from one dwelling to another. On Wednesday, Liberian President Ellen Johnson Sirleaf said “it has thus become necessary,” according to the Liberian Observer. West Point would be under a 9 p.m. to 6 a.m. curfew, she said, and “quarantined under full security watch. … No movements in and out of those areas. All entertainment centers are to be closed.”

Ebola has killed at least 1,350 people across four affected countries. President Sirleaf blames Liberia’s 576 and the subsequent quarantine on “continued denials, cultural burying practices, disregard for the advice of health workers and disrespect for … warnings.”

There’s a lengthy history of combating disease with mandatory quarantines. The tactic was often used in fighting the Black Death. Once, in 1665, a village of 350 inhabitants quarantined itself to prevent the plague from spreading; only 90 residents survived. More recently, an entire city in China was quarantined after one man died of plague.

But there is little contemporary precedent for the quarantine of West Point, a warren of shacks little removed from the rest of the city. It’s only a 25-minute walk from the upscale neighborhood of Mamba Point, home to the United States embassy. Its eastern beaches, strewn with human feces, are only a short boat ride from the mainland.


Experts concede any attempt at containing a massive Ebola outbreak in an urban capital has rarely been tried. “This is our first experience in a capital city, and all the indications are that it spreads faster in a city because people are living closer together,” David Kaggwa, a Ugandan doctor with the World Health Organization, told the New York Times.

What about the moral implications of trapping tens of thousands of people? “It might work,” Martin S. Cetron, a quarantine expert, told the Times. “But it has a lot of potential to go poorly if it’s not done with an ethical approach. Just letting the disease burn out and considering that the price of controlling it — we don’t live in that era anymore.”


Perhaps the closest approximation to the West Point quarantine is one imposed in 1995 in Kikwit, Zaire. Now belonging to Congo, the metropolis of 400,000 residents was without running water or electricity when Ebola struck, killing 97 percent of its victims.

According to expert Laurie Garrett, who won a Pulitzer Prize for her coverage of Ebola, dictator Mobutu Sese Seko’s response to the outbreak was both swift and brutal. He completely isolated the city, which sat 250 miles away from the capital of Kinshasa down an “abominable stretch of poorly paved roadway,” Garrett wrote that year in Vanity Fair.

By May 11 of that year, roadblocks had materialized, and everything shut down. Trade halted. People went hungry. It was “brutally successful,” Garrett wrote recently. “The desperately poor people were fully isolated to war with Ebola on their own.”

But within a week, as epidemiologists walked the streets looking for the infected, residents escaped despite the quarantine. “It was impossible to prevent people from leaving the city where the disease was concentrated,” an Associated Press article said on May 18, 1995.

“Those who are in quarantine are not under arrest and since they are not under arrest they can sometimes escape and do what they want,” Mobutu said.

Those who didn’t make it out went hungry. “They have to find another solution or we will have dire economic circumstances,” the city’s mayor told Garrett in 1995. “If the quarantine continues much longer the world may have its solution, but we will starve. … Here in Kikwit, we know the link between hunger and disease.”


West Point knows that link as well. The cost of food in the slum has skyrocketed, the New York Times reported. Before, a cup of rice cost around 30 cents — but now, it’s about 90 cents. This, in a country where most live on less than $1.25 per day, according to USAID.

“We live here,” one resident told Front Page Africa. But “since this morning our children have not eaten yet. Is it because of Ebola [the president] must kill us? We are tired with this thing. It is worse now.”

But as another day of quarantine dawns in West Point, it may only get worse still.

Terrence McCoy is a foreign affairs writer at the Washington Post. He served in the U.S. Peace Corps in Cambodia and studied international politics at Columbia University. Follow him on Twitter here.

http://www.washingtonpost.com/news/morn ... orst-slum/

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PostPosted: Thu Aug 21, 2014 8:34 pm 
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Ebola crisis: Food, water scarce in quarantined Liberia area
Price of water skyrocketing in West Point area of Monrovia

The Associated Press Posted: Aug 21, 2014 7:22 PM ET Last Updated: Aug 21, 2014 7:22 PM ET

Government officials handed out bags of rice and sachets of drinking water Thursday to residents of an impoverished slum in Liberia's capital where tens of thousands of people have been barricaded in an effort to stop the spread of Ebola.

International aid workers warned that more help was needed as the country battles not only the virulent disease but also hunger as travel restrictions have blocked food from getting to parts of the seaside capital.

In the tense township of West Point, hundreds of residents lined up to receive government provisions a day after authorities put up barbed wire barricades and enforced a blockade of the area that kept market traders from entering or leaving.

Prices were skyrocketing inside the community on a peninsula, with the price of water quadrupling in a matter of days in the slums where there is no clean running water amid steamy temperatures.

The family of a government official living in the West Point neighbourhood of Liberia's capital, Monrovia, are hurried out by members of the Ebola Task Force on Aug. 20, 2014. The military on Wednesday began enforcing a quarantine on West Point, a congested slum of about 75,000, fearing a spread of the epidemic.
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"At the moment West Point is stuck at a standstill and is in an anarchy situation," said Moses Browne, who works for aid group Plan International in Liberia.

"We need food, we need water," he said, appealing for international support. "We're not just fighting Ebola here, we are fighting hunger too."

On Wednesday, residents of West Point clashed with police and soldiers hours after the neighbourhood was sealed off, furious that they were being blamed and cut off from markets and jobs. The situation calmed down on Thursday, though fears remain about how much food and water will be brought into the kilometre-long peninsula.

By afternoon, hundreds of anxious residents lined up at the food distribution point to await their rations. The World Food Program said it would also begin distributing food in the area in the coming days.

Liberia is being hit especially hard by the dreaded virus that has killed 1,350 people in West Africa, accounting for 576 of the deaths.

Several counties and districts in Sierra Leone and Liberia have been cordoned off, and there are concerns this is slowing the supply of food and other goods to these areas. The World Food Program is preparing to feed one million people affected by such travel restrictions.

Senegal closes border to Guinea

Senegal announced late Thursday that it was closing its border with Guinea because of the outbreak, according to a government statement carried by APS, the national press agency.


In the United States, two aid workers who were infected in Liberia have recovered and were discharged from a hospital. Both Dr. Kent Brantly and Nancy Writebol had received ZMapp, an experimental and unproven treatment for Ebola.

Three health workers are currently receiving the same treatment in Liberia — the first and so far only Africans to get the drug. They were showing "very positive signs of recovery," Liberia's information ministry said earlier this week.

A Spaniard who had contracted Ebola and also received the treatment died. The drug supply is now exhausted, the U.S. manufacturer has said.

Ebola is transmitted by direct contact with the bodily fluids of someone who is sick and showing symptoms. To stop its spread, experts say, the sick should be isolated and not have any contact with the healthy. Overcrowded treatment centres, reluctance on the part of sick people to seek medical care, and burial practices that involve touching the dead have helped fuel the disease's spread.

A number of airlines have suspended flights to the affected countries, despite the World Health Organization's advice that Ebola is unlikely to spread through air travel. Guinea's president, Alpha Conde, met airline representatives and foreign diplomats on Wednesday to reassure them that Guinea is screening passengers leaving the country for fever and other symptoms, in line with WHO recommendations.

http://www.cbc.ca/news/health/ebola-cri ... -1.2743464

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PostPosted: Fri Aug 22, 2014 6:35 pm 
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A Food Crisis Follows Africa's Ebola Crisis
by DAN CHARLES
August 22, 2014 5:09 PM ET
AUDIO
http://www.npr.org/player/v2/mediaPlaye ... =342494285
Image
A street market remains empty in Monrovia's West Point slum as part of quarantine measures to contain the spread of Ebola in Liberia.

In the shadows of West Africa's Ebola outbreak, food shortages are starting to develop.

This time of year is traditionally the lean season in West Africa, when last year's harvest of rice or groundnuts is mostly exhausted. Until recently, people were quite hopeful about the approaching harvest this year.

"The rainfall situation was very good," says Shukri Ahmed, a senior economist with the UN's Food and Agriculture Organization in Rome. "We were actually developing an optimistic forecast for crop production this year."

But then came Ebola.

The first food source that disappeared from markets was "bush meat"; meat from forest animals. Some of those animals, like fruit bats, can actually carry Ebola, so governments have banned it.

Other foods have become scarce as a side effect of efforts to keep the virus from spreading.

David Mwesigwa, the FAO's acting representative in Sierra Leone, says that when governments stopped people from moving from country to country, or even from one town to another, it stopped traders from delivering food to the markets. "The primary impact has been on the mobility of most of the traders," he says.
Image
The Liberian government delivered bags of rice, beans and cooking oil to residents of the West Point slum in Monrovia. The community has been quarantined due to the Ebola outbreak in the area.
John Moore/Getty Images

In quarantined areas, some food markets have been shut down completely.

Sierra Leone, and to an even greater extent, Liberia, also import a lot of rice. Those imports are down, too. Ships are reluctant to dock in places affected by the epidemic.

As a result, there's less food for sale, and prices are rising. According to Mwesigwa, people in many parts of Sierra Leone are paying 40 or 50 percent more for rice and other foods. The prices of meat and fish have doubled in some places. The situation in Liberia, he says, is similar, but probably even a bit worse.

While this is already cutting the ability of people to afford adequate food, things may get even worse over the coming year. This year's harvest is also in danger because communal work arrangements have broken down.

"The Ebola came in at a time when farmers were ready to go to the field to work together, in groups," Mwesigwa says.

But people now have been advised to avoid such activities. Coming together in groups could spread the disease. So essential work like weeding the rice is not happening.

Gon Myers, the World Food Program's representative in Sierra Leone says when you take all these factors together "we think there will be a food crisis after the Ebola crisis."

Myers and Mwesigwa say that their organizations will need to start responding even while the Ebola outbreak continues.

Some food aid will be required to nourish people who've been cut off from their normal supplies of food.

But the FAO's Mwesigwa says he wants to keep food aid to a minimum. Sierra Leone, in particular, has the potential to grow a lot of food itself, and it's made great progress toward self-sufficiency since the country's civil war ended a decade ago.

Mwesigwa says international agencies can help the region's farmers get back on their feet. They can provide seeds when those are in short supply, and livestock so that people can produce more of their own meat.

That effort to rebuild food supplies, he says, probably will last at least one or two years.

See more of NPR's ebola coverage on the global health blog Goats and Soda.

http://www.npr.org/blogs/thesalt/2014/0 ... ola-crisis

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PostPosted: Fri Aug 22, 2014 6:42 pm 
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