TIME ebola

5 Million Kids Aren’t in School Because of Ebola

Schools closed in Sierra Leone after Ebola outbreak
A classroom of a school stands abandoned on Aug. 25, 2014 in Kenema, Sierra Leone. Schools closed and villages quarantined after dozens of its congregation died with Ebola symptoms. Mohammed Elshamy—Anadolu Agency/Getty Images

Children from Guinea, Sierra Leone and Liberia are still out of school. Here's what's being done

Public schools in Guinea have been closed since March. Schools in Sierra Leone and Liberia never opened after the summer holiday. All told, the children’s rights and emergency relief group UNICEF estimates that 5 million children ages 3 to 17 are out of school due to Ebola.

“This Ebola crisis has been predominantly seen as a health crisis but its implications go way beyond health,” says Sayo Aoki, an education specialist for UNICEF working in the affected countries. “It’s time we start looking at it from other perspectives, and education is part of that.”

Some schools were closed out of fear the disease could spread in large gatherings while others had no access to water, making handwashing impossible. But the longer a child stays out of school, the less likely it is he or she will return—which is why UNICEF is working closely with the Ministry of Education and Ministry of Health to come up with protocols necessary to implement in order to let children back into the classrooms. The draft—which calls for measures like Ebola screenings, hygiene requirements and a plan in the event a suspected case—is currently being reviewed by experts at the Centers for Disease Control and Prevention in the U.S. and the World Health Organization.

MORE: TIME’s Person of the Year: Ebola Fighters

In the meantime, UNICEF and partner NGOs have trained out-of-work teachers to act as “social mobilizers,” going door to door to spread messages about how to identify Ebola and prevent its spread. UNICEF and partners are also using the radio programs to offer long-distance learning while kids are kept at home. “We are trying to make [the radio shows] simple and more interesting so children will get some learning,” says Aoki. “If they listen to it at a certain time of the day during the week, it gives them a routine they’ve lost from not going to school. It brings them a sense of normalcy, some sort of stability and hope.”

Stability has been largely destroyed for many children living in Ebola-affected countries. Many have seen family members, friends and neighbors get infected, and many have become orphans as well. Ebola has also changed social mores. “Nobody shakes hands in public,” says Aoki. “It has put a lot of stress on children. There’s no cuddling, no hugging, no kissing. The simple joys of life have been taken away.”

Even before Ebola, Guinea, Sierra Leone and Liberia were economically troubled countries still emerging from conflict and civil war. Guinea and Liberia were in the process of increasing their school attendance numbers—Guinea was at 58% and Liberia was at 34%—and experts worry that Ebola has set progress back. School closures, including private schools, are also a bad economic indicator. Jeff Trudeau, the director of The American International School of Monrovia (AISM) told TIME in August that he lost more than half his expected students for the 2014 school year, many of whom were children of foreign families who moved to the region for jobs in Liberia’s burgeoning business sector. That school’s earliest possible start date is January and for others, there appear to be “moving” deadlines for reopening. Guinea is aiming for January while Liberia and Sierra Leone are hoping for March.

But all the countries will have to patiently wait until their caseloads are under control, since a premature opening may only add fuel to the fire.

TIME World

Exclusive: 29 Instagrams That Defined the World in 2014

See some of the most powerful images shared on Instagram this year

As Instagram hit a milestone this month, with its number of monthly active users ballooning to 300 million, TIME, in association with the photo-sharing app, takes a look back at the key moments of 2014.

The selection of images, shared by some of Instagram’s most popular and respected photographers, offers an intimate view of some of the defining events of the year: From the toll of war in Gaza to the unrest in Ferguson, Mo., and from the border between Mexico and the U.S. all the way to Mongolia, Afghanistan and Sierra Leone.

“Real moments are captured and posted on Instagram every single day, from Nana Kofi Acquah’s image of a Tanzanian doctor timing a baby’s labored breathing using his mobile phone, to Brendan Hoffman’s haunting first reactions upon arriving at the crash site of Malaysia Airlines Flight 17 in eastern Ukraine,” says Pamela Chen, Instagram’s Editorial Director. “These are just a sampling of the powerful images shared by people around the world in 2014.”

Read next: The Top 10 Photos of 2014

TIME ebola

U.N.: Ebola Outbreak Will Take Several More Months to Contain

Liberia Ebola Missed Goals
Health workers wearing Ebola protective gear spray the shrouded body of a suspected Ebola victim with disinfectant at an Ebola treatment center at Tubmanburg, on the outskirts of Monrovia, Liberia, on Nov. 28, 2014 Abbas Dulleh—AP

The U.N. goal of containing 100% of Ebola cases by Jan. 1 will not be met

The U.N.’s special envoy on Ebola said Thursday that it would be several months before the outbreak in West Africa is under control.

Dr. David Nabarro said international governments as well as local communities had taken a “massive shift” in responding to the crisis over the past four month, the Associated Press reports.

However, he noted that more needed to be done to contain the spread of the disease in western Sierra Leone and northern Mali.

“It’s going to take, I’m afraid, several more months before we can truly declare that the outbreak is coming under control,” Nabarro said.

The World Health Organization aimed to have 100% of cases isolated by Jan. 1, but acknowledges that previous targets have not been met.

[AP]

TIME ebola

Ebola Rages on in Sierra Leone With Over 1,000 New Cases

The country has surpassed Liberia

In the last 21 days, Sierra Leone has reported 1,319 new cases of Ebola virus infections, the World Health Organization (WHO) reports.

The country has surpassed Liberia, which has experienced a decrease in cases over the last four weeks with 225 new cases in the last 21 days. Liberia has reported 7,719 cases of the disease so far, and Sierra Leone has reported 7,897. Sierra Leone is hardest hit in its capital, Freetown, WHO reports.

The total case load in West Africa is 17,908 cases and 6,373 deaths.

MORE: Ebola Fighters: The Ones Who Answered the Call

A total of 639 health-care workers have been infected with Ebola during the current outbreak, and 349 have died. That’s an unprecedented number for a health crisis.

“Our team met heroic doctors and nurses at their wits end, exhausted burial teams and lab techs, all doing the best they could but they simply ran out of resources and were overrun with gravely ill people,” said Dr. Olu Olushayo, the WHO National Coordinator of Ebola Epidemic Response in a statement sent to media. Olushayo went into Sierra Leone to assess the spike in cases.

TIME named Ebola Fighters the 2014 Persons of the Year. Read about the courageous men and women fighting the Ebola virus, here.

Read next: Why Ebola Fighters Are TIME’s Person of the Year 2014

TIME ebola

Sierra Leone Has Overtaken Liberia in Ebola

A burial team extracts the body of Isatu Sesay, 16, an Ebola victim, from her home in Kissi Town, Sierra Leone.
A burial team extracts the body of Isatu Sesay, 16, an Ebola victim, from her home in Kissi Town, Sierra Leone, Nov. 22, 2014. Daniel Berehulak—The New York Times/Redux

It now has more cases than anywhere in the world

Sierra Leone has the highest number of Ebola cases of any country, according to the most recent World Health Organization statistics.

Sierra Leone has seen 7,780 cases of Ebola, more than the 7,719 cases in Liberia, WHO figures published on Monday show. Some 17,800 people have fallen ill with virus in those two countries and in Guinea, 6,187 of whom have died.

In the WHO’s latest situation report, published last week, the group said its goal of safely burying 70 % of Ebola victims and isolating 70 % of Ebola patients had been met in “most districts” of the three hardest-hit West African countries. The WHO cited Liberia as a bright point in the global effort to contain the disease, reporting that case incidence was “stable or declining” in the struggling nation, where 3,177 people have died from the disease.

Yet the WHO said that transmission of the virus was still “intense” in Sierra Leone, which at the beginning of the month reported more than 500 new cases over a period of just days.

TIME infectious diseases

Malaria Deaths Have Almost Halved Since 2000 Says WHO Report

But eliminating the disease altogether remains an uphill task

Global deaths from malaria, as well as the number of overall malaria cases, have reduced dramatically in the last thirteen years, the World Health Organization said in a statement on Tuesday.

According to the World Malaria Report 2014, the mortality rate for the disease decreased by 47% worldwide since 2000, and the number of people infected by it went from 173 million the same year to 128 million in 2013.

“We have the right tools and our defenses are working,” said WHO Director-General Dr. Margaret Chan. “But we still need to get those tools to a lot more people if we are to make these gains sustainable.”

The report attributed the progress combating malaria to increased access to insecticide-treated mosquito nets and enhanced diagnostics and treatment, but admitted that there is still a lot of work to be done.

The increased susceptibility to the disease in Ebola-affected countries like Guinea, Liberia and Sierra Leone is an added cause for concern.

TIME ebola

Emory’s ‘Sickest’ Ebola Patient, Now in Recovery, Reveals Identity

He weighed 220 lb. pre-Ebola, but lost 30

A doctor who contracted Ebola while treating patients in Sierra Leone and was evacuated to the U.S. for care in September revealed his identity in a report published Sunday.

Ian Crozier, who had been working with the World Health Organization in Kenema, told the New York Times that he explicitly kept his identity a secret to protect his family. Crozier, 44, is now recovering in Phoenix and working through a physical-therapy program.

One specialist admitted in the report that Crozier was the “sickest” patient that Emory University Hospital in Atlanta has seen thus far. He weighed 220 lb. pre-Ebola, but lost 30. The viral load in his blood was 100 times that of the facility’s other patients; he spent 12 days on a ventilator and was on dialysis for 24 days.

Crozier went public, he said, to thank Emory and bring awareness to the epidemic. At least 17,145 cases of Ebola have been reported in the outbreak, including 6,070 deaths.

Read more at NYT

TIME ebola

Top U.S. Commander in Africa Is Optimistic on Liberia’s Battle With Ebola

David M. Rodriguez
United States Army General David M. Rodriguez serving as the Commander for United States Africa Command (AFRICOM) meets with Ali Laarayedh (Not seen), the Tunisian PM, on Nov. 21 in Tunisia. Anadolu Agency—Getty Images

“The trend lines are all moving in the right direction,” says Gen. David M. Rodriguez

The top American military commander for Africa on Wednesday gave a vote of confidence to the international effort to halt Ebola, saying that the U.S. mission against the virus might be able to scale back its operations in Liberia by next month.

Gen. David M. Rodriguez told reporters at the Pentagon that U.S. troops deployed in Liberia might be shifted to other hard-hit countries in the region, or even sent back home, if progress reports continue to encourage optimism. The latest status report from the World Health Organization (WHO), released on Wednesday, said that cases in Liberia are “stable or declining,” but was cautious in its assessments for Sierra Leone and Guinea.

“The majority of the big engineering and logistic things in Liberia will probably start to tail off at the end of the year or January,” Rodriguez said. “The trend lines are all moving in the right direction.”

Some 2,900 U.S. troops have been deployed to West Africa to help contain the Ebola virus, which has killed 6,070 people and infected 17,145. The WHO says that while its goals for the region – treating 70 percent of all infected people and safely burying 70 percent of all people killed by the virus – have been met in “most districts” of the three worst-hit countries, “serious shortfalls” persist in other parts of the region.

In its most recent update, the WHO said that transmission of the virus is “slightly increasing in Guinea” and “remains persistent and intense” in Sierra Leone, where 202 new cases have been reported in the capital, Freetown, since Nov. 30.

Meanwhile, Liberia reported just 43 new cases nationwide over a five-day period, down from 78 cases the previous week, the WHO says. The country still overall has the highest number of Ebola-related deaths out of the three countries, with more than 3,000 killed by the virus.

The U.S. mission began in September and is expected to include up to 4,000 U.S. troops and last at least a year.

TIME ebola

The First Attempt to Digitize Ebola Health Records

Ebola treatment in West Africa is going digital

Keeping detailed patient records during the Ebola outbreak can be a nightmare.

Currently, health care workers use very basic methods, ranging from scanning files to writing on white boards to calling results across rooms to simple memorization. But the International Rescue Committee (IRC), a crisis organization, is about to change that by bringing in electronic health records to its new Ebola treatment unit opening the week of Dec. 15 in Monrovia, Liberia.

“There’s a rule in medicine that if it’s not written down, you didn’t do it,” says Dr. Wilson Wang, a senior clinical advisor for IRC’s Ebola response. Wang says the new electronic health record system can be used for health care accountability and to record decisions made, as well as those decisions’ outcome. IRC’s new system can be accessed via waterproof Sony tablets that can be brought into high-risk zones. The devices will still destroyed when the unit is no longer needed, but the actual data will not be lost. The system was developed by IRC’s own technology team with the help of health software company Vecna.

Some of the patient data will be handed over to the Liberian Ministry of Health to aid in contact tracing, but IRC says other data that doesn’t identify patients will be shared publicly in some capacity. That data could consist of what specific Ebola treatments are being provided, how many patients are seen in the unit, what percentage of patients test positive or negative for the virus, how many people survived, and among those who didn’t, where did they go? In the future, this may aid in other outbreaks, and help scientists and researchers understand what went right and wrong in the current outbreak.

“We want to share [the system],” says Wang. “We plan to essentially give it away, but we want to demonstrate that it works.”

It will also enable physician support. Currently, doctors treating Ebola rely on their own experiences and what’s reported to be successful in the past to determine how to treat a person, but Wang says there’s not a single place doctors can go to get the most up to date data on what’s working in the current outbreak. The new system could make it easier for doctors to get directions on how much medication they should provide, for instance, or what to do when someone has a seizure. “When providers are under stress, and even when they’re not, they make mistakes. They’re human,” says Wang. It’s his hope that this technology could help doctors avoid some of those mistakes by giving them a resource to turn to.

IRC has been in West Africa for over two decades often helping hospitals with infrastructure. When the current outbreak is contained, IRC says it plans to find a way to use the system to help rebuild the currently devastated health system in Liberia—even if it’s just to aid in administrative tasks. “Hospitals need a system to manage this type of data and place orders [for resources and drugs],” says Wang. “[Right now] it’s sort of like coming up with a grocery list for a party when you don’t know what people are going to eat.”

In the meantime, IRC plans to roll out the system in its own unit in mid-December, and plans to continue to refine the platform as they go.

“We think this has the potential to really change not only how quality and safety is addressed in an Ebola situation, but it can also be adapted to any health care situation,” says Wang.

TIME

Photojournalism Daily: Dec. 1, 2014

Today’s daily Photojournalism Links collection highlights Daniel Berehulak’s continuing coverage of the Ebola outbreak in West Africa. Berehulak had spent the last several months in Liberia for the New York Times, but this latest work comes from neighboring Sierra Leone, where the disease is raging with more than 1,800 new cases in November alone. Last week, the United Nations warned that Ebola cases in Sierra Leone would “soon eclipse” Liberia, which has been the hardest-hit nation in the outbreak. These heartbreaking pictures capture the death of a 16-year old girl in Kissi Town, near the capital Freetown, and remind us that the battle against the virus is far from over.


Daniel Berehulak: As Ebola Rages in Sierra Leone, a Lonely Death (The New York Times)

Bryan Denton: Boomtown (World Press Photo) These pictures document the oil boom in Williston, North Dakota.

The Open Road: Photography and the American Road Trip review – a survey of photographers’ journeys (The Guardian) Sean O’Hagan writes on David Campany’s study of the great photographic odysseys across America.

Trent Parke (Vimeo) Insightful video interview with the Australian Magnum photographer.

Phil Moore (Verve Photo) The British, Nairobi-based photographer, writes about one of his pictures from the Democratic Republic of Congo.


Photojournalism Links is a compilation of the most interesting photojournalism found on the web, curated by Mikko Takkunen, Associate Photo Editor at TIME. Follow him on Twitter @photojournalism.


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