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Dangerous practices spread Ebola in Sierra Leone

KAMPALA, Uganda — Dr. Michael Mawanda saw some disturbing behavior when he was in Sierra Leone helping fight the Ebola epidemic, including relatives removing patients from the hospital where he worked.

Those relatives couldn’t bear to be separated from their loved ones, but their actions made it nearly impossible for health workers to track new Ebola infections and risked spreading the virus further, said Mawanda, who, despite taking precautions, came down with Ebola himself and barely survived.

The Ebola outbreak is stabilizing in Liberia and Guinea, but quickly spreading in Sierra Leone. In a recent 21-day period, Guinea had 306 new Ebola cases and Liberia 278. Sierra Leone had 1,455, according to the World Health Organization.


Mawanda believes that clinging to dangerous practices explains Sierra Leone’s numbers. So does President Ernest Bai Koroma, who on Tuesday urged citizens of Sierra Leone to desist from the washing of corpses, from secretly burying the dead at night instead of calling for Ebola burial teams, and any other practices that could accelerate infections.

‘‘Naturally what happens is that as more and more people get infected, people learn lessons. Unfortunately, that takes a long time,’’ Mawanda, a 38-year-old Ugandan physician, said in an interview.

Unsafe burials are believed responsible for 70 percent of new infections in Sierra Leone, Chief Medical Officer Dr. Brima Kargbo told reporters Wednesday. The bodies of people who have died from Ebola are particularly contagious and must be handled carefully, but many people continue to bury their dead using traditional methods, including washing and touching the body. Ebola is spread through contact with bodily fluids of an infected person or corpse.

Mawanda said sensitization campaigns have not been widely successful in West Africa, largely because many seem unwilling to break with age-old customs such as communal dining. He saw people eating from the same plate, even as Ebola was claiming victims in the capital. The WHO says saliva may carry some risk, but that ‘‘the science is inconclusive.’’


Mawanda had worked in Sierra Leone since 2011.

After he tested positive for Ebola in September, he felt ‘‘helpless and hopeless’’ and believed he faced certain death. By the time he was put on a charter flight to Frankfurt for medical care, his organs were shutting down. He spent seven weeks in intensive care before being declared cured.

Last month he returned to Uganda and does not plan to immediately return to Sierra Leone.