MONROVIA, Liberia (Christian Examiner) -- The rash of violent deaths of Americans has captured the attention of the world in recent days, but even without that, weariness with the subject of Ebola has pushed to the background what the World Health Organization has called an "international health emergency that requires a coordinated global approach."
While America has moved on to horrific news within its own borders, however, the Ebola virus like a trained assassin continues to advance nearly unrelentingly and in some places in West Africa virtually unchecked.
Aid groups based in the United States and elsewhere around the world continue to be involved, providing: medical care; clean water wells with spigots for hand-washing; medical, cleaning and food supplies; the construction of community care centers where Ebola victims can be treated; and education about the dangers of and safeguards for control of the disease. But the contagion still is raging, especially among the most poor, and even fear of death is not enough to change some behaviors that propagate the disease.
"The untold, or certainly under-told story, is that of West Africa's orphaned children who, despite their vast number, are being all but forgotten in this epidemic," wrote Chloe Brett in a first-person article published Dec. 6 in the Daily Mail British tabloid. "Ebola spreads in the poorest, worst-educated and most unhygienic areas, and it is in these communities that children are becoming orphaned."
National health workers see up close and personal how Ebola ravages families and communities.
"The traditional council spokesman in the area [200 miles northeast of coastal Monrovia, Liberia], when contacted by the Rivercess County Health Team, instructed the community that nobody should touch [a dead woman's] body, but the people didn't listen," according to a late-November article by a U.S. media team from NPR. "Before the response team from the county health team arrived to the community, they bathed and buried her. A few days later they all started to get sick and began dying, one after the other."
Each of the people who cared for the Ebola patient went on to care in usual ways for their own family and others in the community, and like dominoes the village began to fall.
"A total of 94 contacts were identified; 23 who were considered strong contacts were sent to the Ebola treatment unit in Monrovia," according to NPR. "Currently, 71 contacts are being monitored in the community. But some unidentified are still on the run, and they could infect other people. So there might be other deaths in the days to come."
Then there is the "ping-pong effect" where people from rural areas in Liberia go to urban areas to get treatment, and, urban residents feeling ill take the Ebola virus with them when they turn to the comfort of their families – and perhaps traditional healers – in remote communities. Thus transmission continues to go back and forth between rural areas and urban centers.
The Ebola virus, first identified in 1976, causes vomiting, diarrhea and bleeding. It is fatal in at least half the cases in this West African epidemic. People are infected through direct contact with the bodily fluids of a person who has the virus or who has died from Ebola.
NPR reporter Kelly McEvers wrote about her participation in a search for a woman who might have been exposed to Ebola. The woman they were looking for went into hiding, McEvers reported. The traditional healer they chanced upon went back to his village after an ambulance couldn't get to him before nightfall because of blocked roads.
"That's why it's so difficult to stop Ebola," McEvers wrote. "These places are very hard to reach. The roads are bad. There's no electricity, no phone coverage. And once you finally get to where you're going, you have no idea what you're going to find."
The first case of Ebola in the current outbreak was detected last December in Guinea, a 2-year-old boy, though it was not identified as Ebola until March. As of Nov. 30, the official number of cases is 2,283 in Guinea, with 1,327 deaths. WHO reports the number of new cases is increasing slightly with persistent transmission continuing in Conakry, Guinea's capital.
This third-world nation has a total of 245 beds in three emergency treatment centers, an increase of 85 beds from the week prior, but still fewer than the total of 490 beds needed. However, that need is lower than the 700 beds estimated in mid-November.
United Nations data shows a six-week decline in case counts in Liberia. This followed national days of prayer Aug. 6-8 and Oct. 29-31. As of Nov. 28, according to a Dec. 3 WHO situation report, 7,635 clinical cases of Ebola have been diagnosed in Liberia, with 3,145 deaths. But there were as few as 19 cases reported in the latest week with complete data, from a high of 346 new cases listed in the patient database for the first week in September.
But the declining numbers do not lessen the personal tragedy.
On Dec. 5, WHO announced the third member of a United Nations peacekeeping force had been diagnosed with Ebola; the first two died. No information was given as to the peacekeepers' nationalities.
As of Dec. 8, this nation northwest of and sharing the same Atlantic Coast with Liberia, 7,856 cases of Ebola have been reported by the poverty-stricken nation's Ministry of Health. Of those, 2,074 have died.
"Media reports say at least two doctors in Sierra Leone have died of Ebola in the past few days," reported InternationalSOS.com on Dec. 7. "This is a devastating loss in a country where medical personnel is [sic] in short supply and the Ebola remains intense.
"There are also reports that Red Cross burial teams have been attacked by community members in several areas. Dissatisfaction with Ebola response, fear and misunderstanding all play a role in the cultural challenge of implementing health interventions in local communities."
Data show Sierra Leone has overtaken neighboring Liberia as the nation with the most cases of Ebola.
Scrambling to gain traction on the virus, on Dec. 1, the Sierra Leone government began preventing people from entering or leaving the Tonkolili district, a northern province. The measure will remain in place until Dec. 15. During this period, the borders of the district will be closed and the authorities will conduct a door-to-door awareness-raising campaign within the area. No visitors will be allowed in the area; vehicles will be permitted to pass through but not stop.
Ebola could easily spread anywhere in the world, as people travel from place to place, said Tony Banbury, head of the UN Ebola response mission in West Africa to the BBC. "That is why it's so important to get down to zero case as quickly as possible."