Prayers and precautions in West Africa amid Ebola threat

CONAKRY, Guinea -- One preacher advocated fasting and prayer to spare people from a virus that usually leads to a horrible death. Some people pray that the Ebola outbreaks, which are hitting three countries in West Africa, stay away from their home areas. Others seem unruffled and say it will blow over.

But more than a month after Guinea President Alpha Conde told reporters the Ebola outbreak that originated in his country was under control, the death toll continues to climb in his country as well as in Sierra Leone and Liberia.

At least 231 people have died since the outbreak of the fearsome disease, which causes bleeding internally and externally and for which there is no known cure. Guinea has recorded just over 200 deaths, along with about a dozen each in Sierra Leone and Liberia.

The head of a nongovernmental health organization in Sierra Leone said on local radio Tuesday that the death toll is double the number officially reported in that country. Charles Mambu, chairman of Health for All Coalition, also called on the government to declare a public health emergency. Asked to comment, Amara Jambai, the director for disease control and prevention in the Ministry of Health, said "the spread of the disease is serious. Ebola is with us and we must come together as a nation to fight it."

Experts say the outbreak may have begun as far back as January in southeast Guinea. Ebola typically begins in remote places and it can take several infections before the disease is identified, making a precise start date virtually impossible to pin down. It's one of the worst outbreaks since the disease was first recorded in 1976 in simultaneous outbreaks in Sudan and Congo, said Dr. Armand Sprecher of Doctors Without Borders. It may wind up being the worst outbreak ever.

The West Africa Ebola situation is especially challenging because of the number of "satellite outbreaks" that have cropped up, said Sprecher, who has worked on the emergency responses in Guinea as well as in Uganda in 2000 and in Congo in 2007. There have been at least six satellite outbreaks elsewhere in Guinea -- including the sprawling seaside capital of Conakry -- and in Sierra Leone and Liberia, Sprecher said.

In each outbreak, health workers must identify patients, trace and monitor everyone they've been in contact with and teach people how to avoid the disease.

"Family members and traditional leaders are strongly advised to work with health teams to avoid dead bodies and their body fluids and prevent spreading of Ebola and deaths of member of communities. The public is also urged to wash their hands with soap and water or use sanitizer, ashes, avoid eating bush meat [monkeys, fruit bats], and to chlorinate their water before drinking," Bernice Dahn, Deputy Minister for Health Services in Liberia, said in a Saturday news release.

One preacher in Sierra Leone called for divine intervention.

"Even though the virus is said to have originated from birds and other animals, I believe the virus could be contained through God's miracle," said pastor Balogun Macauley, chairman of the Coalition of Religious Youths in Sierra Leone, which has called for a 21-day period of fasting and prayer.

Jambai, the Sierra Leone health official, said the country has "not reached that level as yet to declare unilaterally the disease a Public Health Emergency.

"We have to get the approval of WHO and other development partners," he added, referring to the World Health Organization.

Some people take the threat seriously in Sierra Leone and heed advice put out on radio and TV stations and in newspapers by the Ministry of Health and Sanitation. There is fear that Ebola might get to Freetown, the capital. Some note nervously that while the outbreak has been restricted to eastern Kailahun District next to the border with Liberia, that is the same district where on March 23, 1992 war spread to Sierra Leone from Liberia. That war wound up engulfing Sierra Leone for more than ten years.

Fear of the first outbreak of Ebola in West Africa has even bred violence.

Doctors Without Borders was forced to suspend activities at one treatment center in Guinea after it came under attack by protesters in April. The mob accused Doctors Without Borders health workers of bringing Ebola to Guinea, where there had never previously been any cases.

Doctors Without Borders cycles health workers out after three or four weeks because of concerns about fatigue, Sprecher said.

"Given that there are only so many people experienced with Ebola in the world, you get stretched thin," he said, noting that some have undertaken multiple tours.

The number of Ebola cases in the three countries has risen above 400, according to the World Health Organization. The most devastating outbreak on record came in Uganda's Gulu district 14 years ago, with 425 cases and 224 deaths.

"By the time this thing is done it will probably be one of the longer outbreaks, if not the longest," Sprecher said.

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Roy-Macaulay reported from Freetown, Sierra Leone. Jonathan Paye-Layleh in Monrovia, Liberia contributed to this report.