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Ebola finds new hotspots outside Liberian capital

JENEWONDE, Liberia — A schoolteacher brought his sick daughter from Liberia's capital to this small town of 300 people. Soon he and his entire family were dead and buried in the forest nearby, along with an increasing number of residents.

The community of Jenewonde has become a new hotspot for the Ebola outbreak in Liberia. With cases on the decline in the capital, officials must now turn their attention to hard-to-reach places where the disease is flaring.

Jenewonde, in Grand Cape Mount County near the border with Sierra Leone, has reportedly lost about 10 percent of its population to Ebola since late September. Markets and farms nearby have been abandoned.

Momo Sheriff, who lost his son to Ebola, said there is no health care in the community. No clinics could be seen along the road into town.

"If the government does not take action, everybody will die in this town," Sheriff told an Associated Press journalist. "We are burying two dead bodies today. We don't know who it will be tomorrow. Every day we have to cry."

Juma Mansaray lost her mother and grandmother on the same day. She said the community has been ostracized from neighboring ones.

"Everywhere we go, the people will drive us away," she said. "We can't even go to the local market to buy pepper or food because people think we are cursed."

Ebola is also hitting the town of Gorzohn in Rivercess County, which lies on Liberia's central coast, said Assistant Health Minister Tolbert Nyenswah, who heads Liberia's Ebola response.

The international response must adapt to this new phase, Doctors Without Borders warned. As Jenewonde saw, just one case can ignite a chain of transmission that leads to a dozen more infections, said Fasil Tezera, head of operations for the charity in Liberia.

Liberia has suffered the greatest death toll in the Ebola epidemic, with 2,766 deaths blamed on the first-ever Ebola outbreak in West Africa. The World Health Organization says that after months of aggressive efforts to isolate the sick and remove bodies of victims safely, Ebola appears to be declining in some parts of Liberia, including the capital where only about 50 of the 250 beds are filled at a Doctors Without Borders clinic.

"In the cities, I think we have sufficient resources," Tezera said. "We cannot bring everybody to big ETU's," or Ebola treatment units.

The outbreak now also needs a series of "rapid response teams" that can bring care to remote villages, rather than trying to get sick people out, the group says. Such teams would include medics, disinfection specialists and psychologists or social workers and could stamp out a budding outbreak in a village before it has a chance to spread. And they could work much faster than a treatment center can be built.

Tezera said that such mobile teams were frequently deployed in previous Ebola outbreaks, which typically hit remote areas of central or eastern Africa. The teams could travel by truck, boat or helicopter, if those assets are provided.

"If you handle it at the small village level, then you can contain it," he said.

Experts warn that the disease could flare again in Monrovia or other places where it seems to have subsided. As long as Ebola is circulating in this highly mobile region, no area is safe, said Tezera, and cases continue to rise in Guinea and Sierra Leone. There were 40 new Ebola cases in and around the Sierra Leonean capital of Freetown in the preceding 24 hours, authorities there said late Sunday.

A key component to stopping transmission everywhere is gaining the trust and cooperation of villagers, Tezera added. That has been a problem in Jenewonde.

Abdullai Kamara, a burial team leader for Grand Cape Mount County, said the people of Jenewonde have been stubborn and in constant denial, which he cites as the reason the disease is still spreading.

Ebola is contracted through direct contact with the bodily fluids of the sick and the dead. For weeks, residents of Jenewonde have been chasing away safe-burial teams and hiding the sick from outside health workers, he said.

"Our people played deaf ear to what was happening," Kamara said. "They denied the truth."

James Jallah Paul says people in the town are terrified to help the sick. On this recent day, a man in a protective suit sprayed a house with a virus-killing solution where a woman died from Ebola. Health workers carried a body into the forest for burial. Paul said more help is needed.

"If the government does not come to our rescue, we will finish (die) here," he said. "This place will be an empty space."

Associated Press writers Jonathan Paye-Layleh in Monrovia, Liberia; Clarence Roy-Macaulay in Freetown, Sierra Leone; and Sarah DiLorenzo in Dakar, Senegal, contributed to this report.


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