I am back in Sierra Leone for a brief stint, at the request of WHO. As I was only currently available for three weeks , I was surprised to get a call on March 6^th to arrange my flights! I arrived on Thursday evening, after being in transit for 27 hrs. It was good to feel more at ease this time, which helped when I had to search for a room for the night. I knew that I would find a bed somewhere! I will be coordinating WHO’s technical activities for the next two weeks. Although there are many new faces, it was good to meet up again with colleagues from before. There are far more WHO staff here now and they are spread across the country. At the end of last year, we were scrambling to get expertise even in the hardest hit areas. Local, sustainable, disease-control, and infection prevention and control capacity is being developed as a start to (re)building a health system.

The outbreak is definitely slowing down. There are now only a limited number of Chiefdoms with transmission, with 58 cases last week. This is still a significant number, but the smallest weekly total since July 4, 2014 when the President declared Ebola as an emergency. Resistance to control measures continues for a number of reasons, including mistrust of government and a preference to be treated by traditional healers and to adhere to traditional burial practices.

The fishing community that I can see from my hotel window is very quiet just now. The normal transit of boats, morning and evening, has been interrupted by the disease. A fisherman, recently infected, returned to his village in the interior to consult a traditional healer. As a result, cases occurred there as well as in the fishing community across the bay. Although the quarantine period is now over, the fishers have yet to return. As a possible sign of a return to normality, the weekend runners were out in force again early this morning, right near the dock.

Banners announcing religious revival meetings now outnumber those promoting protection against Ebola, although there will be another door-to-door search in two weeks time for cases across the country. It will not be a “lock-down” but a “stay at home”. An exception will be made for going to Friday prayers and to church for Palm Sunday.

The desire for the country to resume “normal” life is compelling. Funders such as the UK and World Bank would also like to start cutting back. But, at the same time, communities and public health officials need to remain vigilant. I spent many hours on Saturday in a meeting discussing “right-sizing”. The tension between being positive that the end is in sight and the need to plan for the future and avoid complacency will remain until we are free of disease.

Images to remember:

A girl, about 4 years old, sitting outside a squatter’s shack enthusiastically brushing her teeth at 0730 on a Sunday morning.

A woman in stunning traditional dress with her child, getting off the back of a motorcycle taxi to enter a Mennonite Church, from which organ music could be heard.

A man getting a mango from high in a tree with a pole and sling with the customer waiting below.