They had lost their father, aunt, uncle and two nephews before they too began to show signs of Ebola after caring for their dying mother. With only a few family members left, three sisters aged 14, 16 and 21 arrived at the Ebola Treatment Center (ETC) in Kerrytown, Sierra Leone.
This scenario is common in the current Ebola epidemic, the largest in history. Multiple generations of families have been stripped away in a matter of weeks, simply because family members unknowingly exposed themselves to this highly contagious infection while trying to care for their ill relatives.
As a doctor, I am no stranger to health care crisis situations. I had spent 15 years in Haiti, working alongside the public sector and dealing, more recently, with both cholera epidemic and the aftermath of the earthquake that decimated the country. When Ebola began to spread throughout West Africa in the second half of 2014, I felt increasingly drawn to go and do something to help end the epidemic.
Now, the tide of the Ebola epidemic is finally turning. When I arrived in Sierra Leone, I quickly noticed a number of crisis response efforts seemed to be working.
Improving Emergency Response
In the last few weeks, the number of new Ebola infections finally appears to be decreasing throughout West Africa, according to the World Health Organization. Though the work of stemming the outbreak is far from over, it is encouraging to see progress -- progress that can only be credited to the tireless and heroic efforts of countless national and international health workers, community organizers, NGOs, government health ministries, and ordinary citizens.
One of the most exciting developments of the last six months is the establishment of the 117 emergency hotline. Akin to 911 in the US, this was not a resource that existed prior to the outbreak.
In the U.S., we hardly think about the infrastructure required to respond to a single 911 call. But for a country without this infrastructure, it has required a monumental effort to coordinate: building and staffing a call center capable of fielding hundreds of calls a day, organizing ambulance and burial teams ready for dispatch, and educating the public on how to use and trust the system.
This emergency call center was developed by SBTS Group, a Sierra Leonean tech firm, founded by Evelyn Lewis. In an effort to strengthen the call center processes, ThoughtWorks, the global technology consultancy that I work for, developed a heat map to show real-time information on the number, location, and density of reported Ebola cases in Sierra Leone.
Even after the Ebola crisis passes, this emergency response system will remain a critical element and foundation of the healthcare infrastructure of the country, and can likely be expanded in the coming months to years.
The three sisters, were quickly collected by an ambulance shortly after their brother's call to 117 and were promptly taken to a holding center to be tested for Ebola.
As the use of this system grows, an increasing number of patients have been able to experience the benefits of an improving emergency response system.
Technology has a critical role to play in both acute epidemics like the Ebola outbreak as well as the more chronic inequities in health outcomes that preferentially affect the poor. Though it may seem counterintuitive, healthcare software can be transformative in one of the poorest countries in Africa. Examples like 117 and the heat map provide a potent counter-narrative to naysayers and potential roadmaps for future interventions.
Looking to the Future
It has been an extraordinary privilege to be here in solidarity with the people of Sierra Leone working to stem the tide of Ebola. Seeing the devastation and consequences the disease has wrought is a stark reminder that getting to zero cases requires sustained global attention and the continued marshaling and contribution of resources.
Challenges will remain after this outbreak has been eradicated: resuscitating the public sector, reinforcing maternal and child health, primary care, vaccination, chronic disease. They cannot be underestimated. Addressing the gaping hole left by the hundreds of health care workers who lost their lives caring for others must also happen in tandem with these efforts.
I am inspired by the effort and dedication of the community that has saved countless lives. So many government officials, doctors, technologists, developers, and engineers -- from Sierra Leone and elsewhere -- have contributed to fighting this disease. They have given their time, knowledge and expertise -- and in some tragic cases, their lives.
Their efforts have had a real impact on the lives of those here in Sierra Leone. Two weeks ago the three sisters left the ETC free of Ebola, excited to return home and start rebuilding their lives and families.