Via MSF's Ebola page, extensive updates on the situation, plus statements on Senegal and Nigeria, and on. the separate outbreak in DR Congo. Click through and scroll down to find the reports. Here is the Liberia update:
The MSF team is trying to understand the situation in local communities, as well as working with other actors to evaluate the possibility of offering safe burials in addition to cremations. The perception of Ebola case management centers (CMC) in Monrovia is poor—community understanding of what happens inside them is shrouded in mystery and fear. There is a widespread aversion to the government-enforced cremation practice, which is not culturally well-accepted.
The number of admitted is still stable, at around 140 patients as of October 20. The center has a 250-bed capacity and the teams continue to work hard to ensure that more patients are admitted. Many people are reaching the center by their own means, which suggests that the ambulance and referral systems are not working properly. Additionally, taxis have largely stopped accepting patients for fear of contamination. Other issues such as the mandatory cremation policy and a lack of outreach activities have been identified as reasons for the decrease in patients in the facility.
The household protection kit distribution campaign continues: so far, over 32,000 have been handed out in Monrovia. This is an attempt to slow transmission at the household level, but it was not devised to substitute for care provided in case management centers.
There are also efforts to reach communities and inform them about the case management centers—over the past ten days, MSF has held seven focus group discussions with different communities in Monrovia.
The number of admissions in Foya has been low for the past few weeks, with an average of around seven to ten patients in the CMC at any one time. The majority of patients are coming from Gbegbedu (Quardu Bondi) or Voinjama city and Boi (Zorzor). In the last 21 days, there has not been a confirmed case coming from Foya or Kailahun districts.
MSF activities in Voinjama and Quardu Bondi are increasing accordingly. Health promotion teams are active in the villages of Barkedu and Gbegbedu in Quardu Bondi district near the Guinean border. MSF continues to support the referral system for patients from these districts to the Foya CMC.
MSF will soon open a transit unit to accommodate patients identified late in the day. They will spend the night at the unit and be transferred the next morning to the centre in Foya. Triage stations in the outpatient department (OPD) and General Hospital of Voinjama are also being established.
As local health centers are starting to reopen, MSF is making donations of protective equipment and providing training to the staff working in these centers for the safe use of this equipment. The decline in admissions has also allowed MSF to reorganize its outreach activities.
In Foya MSF has expanded preventive health promotion activities to villages where outbreaks have not yet occurred and is training local associations to deliver MSF health promotion messages to more remote areas that MSF has not yet reached. In Voinjama the health promotion team is educating trainers in other NGOs and organizations to ensure best practices are passed on.
The lower number of cases, particularly in the west of the county, is leading to a concerning perception among the community that Ebola may soon be over. MSF is remaining vigilant, however, and is reinforcing health promotion messages.