I was not expecting to write this blog as I had planned to be in Koinadugu and out of contact. Instead, I am working with UNICEF and the Ministry of Health to select sites for CCCs in the Western Area, which includes Freetown. We had not thought that this would be necessary, but treatment beds and other isolation beds are not coming on stream fast enough. Rapidly constructed CCCs may be the answer.

One proposed location was a soccer field about a kilometer from our hotel. Erecting temporary facilities in urban areas has many challenges, including safe waste disposal. While touring potential sites, we passed by communities beyond the main roads south of the city. In one village, a house was under quarantine guarded by an armed soldier. It is clear why Sierra Leone is considered to be one of the least developed countries in the world.

As I have mentioned previously, Ebola is affecting all aspects of life. The lack of schooling, schools and their social advantages are highlighted in this story. It is tragic, and I feel torn when we are looking at setting up another CCC in a school yard.

There are many endemic diseases here, not the least malaria and Lassa Fever. Whereas each year outbreaks of cholera are usual, this has not been the case this year. There is the suggestion that it may be related to everyone washing their hands so regularly.

I share a small office with three others and we have two desks. It is good that we get on and that we are not all there all of the time. One colleague is from the UK and another is from upper New York State. You can see from the linked stories why we have interesting conversations even beyond Ebola.

While the team thinks that we (the collective) will succeed in getting EVD under control, the task, in summary, is strengthening weak health care and public health systems and improving health governance, while fighting a devastating countrywide outbreak. I will not provide any epidemiologic analyses but only to say that despite an influx of public health experts and training of community investigation teams, estimates of numbers of cases and deaths are far from accurate, but the trends that you read about are probably meaningful.

It is Sunday, and I had my run to the beach today without being stopped by the police. We often hear Friday prayers and, on Sunday morning, many go to worship. It would not be easy to find a driver this morning, as most are in Church. For those who have travelled, you will know that vehicles in many developing countries are adorned with religious sayings. The other day, I saw a sign on a community bus that read, “Fear judgement day”, which I thought somewhat worrying on the front of a means of public transport! I sometimes have time to watch the fishing boats from the hotel, but today got to see the other side. A shopkeeper that I just bought something from led the way to the beach.

Quarantine note for this week: Our social mobilization expert was due to be at home in the Philippines for Christmas. Now, she has to spend three weeks in Geneva to avoid being sent to an island off the coast for 21 days of enforced isolation.

It was good to welcome a colleague from UBC – an infectious disease doc who worked in Guinea for MSF. At the same time, we said goodbye to a psychiatrist from Hungary and an infection control expert who was from Ottawa, but now lives in Kentucky. A good team!