FREETOWN – Community fear and suspicion in Sierra Leone are obstructing officials' attempts to stop the spread of Ebola, health reports showed on Wednesday, after the West African nation reported its first cases of the deadly virus in months.
The discovery of a case last week, only made posthumously, was announced a day after the World Health Organization said transmission had ended in what had been the only country yet to be declared Ebola-free - Liberia.
Sierra Leone had been declared officially free of transmission two months earlier.
The new death was a setback for the region seeking to end a two-year epidemic that has killed more than 11,300 people, and it was followed by a second case on Wednesday, heightening fears of further transmission.
Internal health reports seen by Reuters showed that at least 50 people linked to Mariatu Jalloh, the 22-year-old student who died from Ebola on Jan. 12, and who were potentially exposed to virus have gone missing. At least a dozen of them are considered at high risk of infection.
Last week, just three contacts were reported missing.
One of the health reports noted: "Community very uncooperative and unwilling to direct us to the missing contacts".
They also referred to "great resistance" to a program to vaccinate locals who were potentially exposed to the virus in the Northern Province, a remote area near the Guinean border where Jalloh had traveled before falling ill.
The reports show that suspicion toward health officials, one of the aggravating factors in the disease's early spread nearly two years ago, is still dogging attempts to end the epidemic.
Some conceded, however, that such incredulity is understandable given the apparent failure of local officials to follow basic health protocols with the last case.
Sierra Leone was supposed to be in a 90-day period of "heightened surveillance" but Jalloh was examined by an official without protective clothing against the virus.
"I cannot believe Ebola is back in Sierra Leone!" said Zainab Thorlie, a resident of the capital Freetown, cursing under her breath. "I think the health workers at the hospital made a bad situation potentially terrible."
Health sources familiar with the reports who sought anonymity said that the number of total contacts has increased to over 200 people, from 109 quarantined last week.
One high risk contact sought by authorities is a sheikh believed to have fled the Northern Province by boat to Freetown, possibly with his wives who are also missing. He is Jalloh's stepfather.
Some fear the virus will reach the capital, where the disease spread rapidly in late 2014 as ambulances struggled to fetch the sick and the main graveyard burst its limits with the dead.
At the time, army officials from former colonial power Britain helped bring down case numbers by setting up a series of command centers and the National Emergency Response Centre (NERC) in a building once used to try civil war criminals.
But NERC is now shut and most international medical workers and soldiers have gone. On the walls of Freetown's twisting streets, painted anti-Ebola slogans designed to motivate locals to fight the disease are peeling off.
"I think the dissolution of NERC was untimely," said retired civil servant Foday Kallon.
A Western aid worker, speaking on condition of anonymity said money was part of the problem. "Government agencies are being asked to come up with a full (Ebola) response but there's very little funding for that sort of thing," he said.