Ebola-hit nations revive age-old cordon
FREETOWN, SIERRA LEONE
THE Ebola outbreak in West Africa is so out of control that governments there have revived a disease-fighting tactic not used in nearly a century: the "cordon sanitaire", in which a line is drawn around the infected area and no one is allowed out.
Cordons, common in the mediaeval era of the Black Death, have not been seen since the border between Poland and the then Soviet Union was closed in 1918 to stop typhus from spreading west.
In the most extreme cases centuries ago, everyone within the boundaries was left to die or survive, until the outbreak ended.
Plans for the new cordon were announced on Aug 1 at an emergency meeting in Conakry, Guinea, of the Mano River Union, a regional association of Guinea, Sierra Leone and Liberia, the three countries hardest hit by Ebola.
The plan was to isolate a triangular area where the three countries meet, separated only by porous borders, and where 70 per cent of the cases known at that time had been found.
Troops began closing internal roads in Liberia and Sierra Leone last week. The epidemic began in southern Guinea in December, but new cases there have slowed to a trickle.
In the other two countries, the number of new cases is still rising rapidly. As of yesterday, the region had seen 1,975 cases and 1,069 deaths, according to the World Health Organisation (WHO).
Officials at the health organisation and the United States Centers for Disease Control and Prevention - which have experts advising the countries - say the tactic could help contain the outbreak, but want to see it used humanely.
"It might work," said Martin Cetron, the disease centre's chief quarantine expert. "But it has a lot of potential to go poorly if it's not done with an ethical approach. Just letting the disease burn out and considering that the price of controlling it - we don't live in that era any more."
Experts said that any cordon must let food, water and medical care reach those inside, and that the trust of inhabitants must be won through communication with their leaders.
In Sierra Leone, large sections of the Kailahun and Kenema districts, an area the size of Jamaica, have been cut off by military roadblocks.
Within the cordoned area for Sierra Leone and Liberia, alarmed residents have told reporters that they fear starvation because food prices are rising. Many farmers have died, and traders who cannot travel cannot earn money.
WHO spokesman Gregory Hartl said the agency will make sure food and supplies get in.