Sunday, February 1, 2015

As Ebola Ebbs in Africa, Focus Turns From Death to Life

                      Liberia — Life is edging back to normal after the deadliest Ebola outbreak in history.

At the height of the epidemic, Liberians met horrific deaths inside the blue-painted walls of the Nathaniel V. Massaquoi Elementary School, as classrooms became Ebola holding centers and the education of a nation’s children, shuttered in their homes for safety, was abruptly suspended.


Now, parents are streaming into the schoolyard once again, not to visit their stricken loved ones, but with their restless children in tow, to register for the start of classes in a delayed and shortened academic year.

Eager to learn and to play with her friends again, Florence Page, 11, bounded ahead, brimming with pent-up energy, as her mother, Mabel Togba, paused to look warily into the school building through its padlocked metal screen doors.

“They still haven’t told us that Liberia is free of Ebola, so I’m still afraid,” said Ms. Togba, 42. “But it’s better than to leave my children at home doing nothing.”
       New Ebola cases in Liberia, where streets were littered with the dead just a few months ago, now number in the single digits, according to the World Health Organization. In neighboring Sierra Leone and Guinea, the other two nations in the Ebola hot zone, new cases have fallen sharply in the last month, dropping to fewer than 100 in a week at the end of January — a level not seen in the region since June.

With a virus as deadly as Ebola, officials warn that the epidemic will not be over until cases reach zero in all three countries. But after nearly 9,000 deaths from the disease, the W.H.O. announced last week that it was focusing on a goal that had seemed out of reach for much of last year: ending the Ebola epidemic, no longer simply slowing its spread.

Here in Monrovia, the capital, ambulances and body collection vehicles that once barreled through the streets are a rare sight. Soccer matches are now played throughout the city on weekend mornings. Buckets filled with chlorine water are gone from most entrances, or sit empty. People can be seen shaking hands once again, squeezing into taxis and touching during conversations, as the fear of the virus ebbs and Liberians slip back into their daily, tactile rhythm.

“We used to be afraid to touch our friends, but the fear is small, small now,” Patrick Chea, 19, said outside Mary Brownell Junior High School, where students horsed around as they cleaned up the schoolyard. Mr. Chea playfully placed his hand on the head of Sonnie Kollie, a 16-year-old girl — who promptly punched him on the shoulder.

Experts are trying to understand how the disease, which has defied the ominous predictions of the world’s top infectious disease researchers, appears to be extinguishing itself with surprising swiftness. In September, the United States Centers for Disease Control and Prevention had projected that, by Jan. 20, the outbreak could reach 1.4 million cases in Liberia and Sierra Leone alone, but by that date only 21,797 were recorded in all three countries.
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While many have emphasized the enormous assistance hauled into the region by the United States and international organizations, there is strong evidence, especially here in Monrovia, that the biggest change came from the precautions taken by residents themselves.

“Fundamentally, this is about the extent to which societies change their behaviors, how they change them, and the speed at which they change them,” said Dr. David Nabarro, the United Nations special envoy on Ebola, who made frequent trips to the hot zone at the height of the epidemic. “I believe for various reasons people in Liberia changed quickly and dramatically. I believe Sierra Leoneans changed quickly in some areas and less quickly in some areas.”

When Ebola struck the densely crowded neighborhoods of Monrovia over the summer, the first time a capital city had faced Ebola’s full onslaught, the impact was devastating. Hundreds of new cases appeared around the country every week, hospitals collapsed or overflowed with patients, and sick people lay along the road, sometimes dying before help could reach them.

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