The government of the West African nation of Sierra Leone has announced a controversial plan: for three days later this month—Friday, September 19, through Sunday, September 21—it is going to enforce a nationwide quarantine. Sierra Leone’s six million citizens will be confined to their homes for 72 hours, while some 7,000 teams of healthcare workers will go door-to-door in an effort to identify people who are suffering from Ebola hemorrhagic fever. Police and military will be used to support the extraordinary strategy to contain the spreading epidemic. It is not entirely clear from early reports whether the government plans to transport ill patients who are discovered to healthcare facilities—in some cases, presumably, against their will—but that seems to be a reasonable inference.
In describing the rationale for the action, government officials are using language that seems more appropriate to a military campaign against a foreign enemy than a public health action on behalf of the nation’s citizens. “It’s clear that we have pockets of resistance” to calls for Ebola-stricken people to seek healthcare, one government spokesperson says. “People are still harboring loved ones at home.”
Aside from civil liberties issues that this raises, it should be noted that health organizations have generally questioned the efficacy of this kind of strategy in the past, no matter how pressing the threat to public health. Such actions add an element of punishment to public health policy and create or worsen an adversarial relationship between health officials and the public. In this case, some observers think, it may only increase public distrust of healthcare workers, which has been a stumbling block to effective control of the Ebola epidemic from the start. The humanitarian group Doctors Without Borders notes that Sierra Leone does not have enough beds in treatment centers to accommodate the Ebola victims who are discovered, anyway.
International experts generally favor aggressive education campaigns instead of coercive measures. That said, the government’s decision underscores the increasing degree of concern and pressure that Sierra Leone’s leaders are feeling over the rapidly worsening crisis. Reportedly, Ebola has claimed more than 2,000 lives in West Africa. Learn more from a CNN report.
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