The Ebola outbreak, which is stabilizing in Liberia and Guinea, is spreading fastest in Sierra Leone. In a recent 21-day period, Guinea had 306 new Ebola cases. Liberia had 278. Sierra Leone had 1,455, according to the World Health Organization.
Mawanda believes that clinging to dangerous practices is the reason why. So does Sierra Leone President Ernest Bai Koroma, who on Tuesday urged Sierra Leoneans to desist from washing of corpses, from secretly burying the dead at night instead of calling for Ebola burial teams and any from other practices that could accelerate infections.
"Naturally what happens is that as more and more people get infected, people learn lessons. Unfortunately, that takes a long time," Mawanda, a 38-year-old Ugandan physician, said in an interview with The Associated Press.
Unsafe burials are believed responsible for 70 percent of new infections in Sierra Leone, Chief Medical Officer Dr. Brima Kargbo told reporters Wednesday.
The bodies of people who have died from Ebola are particularly contagious and must be handled carefully, but throughout the region, many people continue to bury their dead using traditional methods, including washing and touching the body. Ebola is spread through contact with bodily fluids of an infected person or corpse.
Mawanda said sensitization campaigns have not been widely successful in West Africa largely because many locals seem unwilling to break with age-old customs such as communal dining. He saw people eating from the same plate even as Ebola was claiming victims in the capital.
The WHO says saliva may carry some risk but that "the science is inconclusive." According to the WHO, the most infectious bodily fluids for spreading Ebola are blood, feces and vomit.
"Tracing contacts and isolating them as early as possible is not happening in Sierra Leone," Mawanda said. "What that means is people are getting infected and they are infecting others and there is this great multiplication factor. It is all about capacity and Sierra Leone needs help to effectively do contact tracing."
