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The University of Liverpool Podcast Dr Calum Semple is a senior lecturer in Child Heath and Consultant Respiratory Paediatrician at the University of Liverpool. In 2014, he was tasked by the World Health Organization to assess the research capacity of Sierra Leone’s Ebola treatment sites. However, after arriving in the country in January 2015, he soon took a more ‘hands-on’ approach to providing clinical care.

Calum appeared on the University of Liverpool Podcast to discuss the Western intervention in the Ebola crisis – and the surprising impact it had on the disease’s eventual containment.

5 little-known facts about Sierra Leone’s Ebola outbreak – and the West’s response

  1. Initially, only 50 doctors were actively serving a population of six million
    Soon after arriving in the country, Calum was involved in a briefing meeting with Sierra Leonean investigators.

    Halfway through, the chair received a folded piece of paper telling him one of his colleagues, a respected physician, had just died from Ebola. Like all deaths in the Ebola outbreak, it was heart-breaking for those concerned. But this death had a wider implication for the country.

    “Sierra Leone is a country the same size as Scotland – with roughly the same population – and yet they only had 100 doctors,” says Calum. “Half of those were very senior and involved in administration, leaving really only 50 or fewer doctors providing direct clinical care.”
  2. Soon after the international response, the Ebola crisis subsided
    As the scale of the crisis became clear, the Western response accelerated.

    Health professionals arrived from around the world. Sophisticated techniques like plasma production were introduced at blood transfusion centres, effectively creating “passive immunisation” among plasma recipients. And clinical trials were established at breakneck speeds.

    “The simple conclusion,” says Calum, “would be that this massive intervention had a huge impact.”
  3. But did a more old-fashioned solution do the real work?
    On his first day in Sierra Leone, Calum was driven past several people lying ill in the street. “There were some quite shocking scenes,” he recalls.

    The public health posters on the walls of many of the streets also caught his attention – and he believes these were crucial in curbing the spread of the disease.

    Calum says: “The easy answer is to say ‘yes, things got better when the West came in’. But that’s a naïve view. From my understanding, what made a big difference was the local public health message around safe burial… and how to care for people that had signs of Ebola.”
  4. Cultural and behavioural shifts were key
    In West Africa, there was a practice of having close contact with corpses. This contact included dipping fingers into the water used to wash the body down, and even putting the fluid onto the faces of the living. Sometimes, this could be done by several hundred people who had known the dead person.

    In Calum’s view, it was a practice that “led to huge amplification of the Ebola infection within the local communities”.

    “The public health message and the change in human behaviour was probably more important in breaking the cycles of transmission. So, the non-contact and safe burial was terribly important.”
  5. A legacy of the West’s reaction remains in Sierra Leone today

    While Calum believes the public health messages were the most significant contributors to the containment of Ebola, he is convinced the West’s efforts had a lasting impact.

    We have a “legacy of research”, he says. “We […] have a cadre of staff in Freetown who can do quite sophisticated research techniques and run quite sophisticated biochemical analysis, and that’s something they didn’t have before”. “We’ve had over 500 survivors come to Freetown for Post-Ebola Syndrome medical care.”

    He refers to the team catering to survivors’ eye issues, neurological and muscular problems and that, he concludes, “is a great legacy”.

About this podcast

The University of Liverpool Podcast aims to bring listeners closer to some of the academic experts, authors and innovative thinkers from the University who, through their in-depth analyses, research and discoveries, are affecting positive change in the world today. Each episode features one or more of our academic experts discussing research in their specialist field. Subscribe to the University of Liverpool Podcast via iTunes, Tunein and Google Play Music (US and Canada only).

Interested in learning more about the University of Liverpool’s online health programmes? Find out more about our APHEA-accredited online Master of Public Health (MPH), online MPH – International Public Health, online MPH – Management of Health Systems.

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