I’m a humanitarian officer for Save the Children working on the Ebola outbreak in Sierra Leone - AMA!

While you are looking after the children who unfortunately have or may have the disease, what methods do you use to keep their spirits up and make them less scared?

That's a really good question. We're in the process of helping set up a treatment centre near Freetown - when that opens it will be the start of Save the Children treating people here. The treatment centre is an incredibly hazardous environment. One slip up or mistake can cost lives so we have to work within very strict and careful parameters. But of course the suits and the protocols and everything that goes with them, not to mention the disease itself, will be very frightening for children, so we need to find ways to comfort them. We are working at the moment to see how best to do that in the treatment centre - plans are developing every day and i have just asked our protection experts what the latest is. I'll post on here when i know more.

First all, thank you for the work you're doing. I have a crazy amount of respect for you and your colleagues! My question: The UN warns that we have 60 days to beat this and the disease is currently "beating" us. Is that your impression being right there in the midst of it?

To some extent being in the middle of it you have to trust the impressions of organisations like the UN and the WHO - I can only see a very small piece of the jigsaw. But the district I write this from, which includes the capital Freetown, recently became the district with the most cases in Sierra Leone, overtaking the epicentre of the outbreak. The cases are going up every day here and if Ebola takes hold in this densely populated city of 1 million+ people then it could be catastrophic and incredibly difficult to stop. So in that respect yes this very much feels like a tipping point and so long as the cases keep going up - more than 100 in the last 2 days in Sierra Leone - it's beating us.

What is being done to help the now orphaned children that are being shunned by their family members in many cases? Is your organization able to help with these issues?

This is a really key issue. You're right that some children have been shunned and stigmatised by their communities and families, and of course it's that the time when they are most vulnerable. We support an interim care centre in Kailahun, which is the epicentre of the outbreak in Sierra Leone. It's a place where children who have been made orphans, or whose parents have Ebola, can stay in a caring environment. But crucially, that mustn't be the end of their journey. We then work with their families and communities to dispell some of the fear and myths that surround Ebola, so that the children can return to a loving, protective environment. We have encountered families who were really afraid for these children to return, and worked with them sensitively until they welcome them back.

I hear about what needs to be done on the news all the time. In reality, what could be most effective or is most needed? I feel useless sat here and not doing anything.

The needs are huge in many different ways, but ultimately and fundamentally, the transmission rate needs to come down. We need to do whatever we can to achieve that. So one key way is to ensure people with suspected Ebola have somewhere to go where they can get the best possible care. This is good for them as while there is no proven cure it does help to treat the symptoms well, giving people the best possible chance to fight off the virus themselves. But it also means that they come out of their communities, reducing the risk of them infecting people around them. Right now, across the region, we need more beds. Lots more. Save the Children is helping the UK government set up a new treatment centre near Freetown which will do just that: provide more specialist capacity for Ebola patients.

The other key thing is information that must ultimately lead to behaviour change. For example, it's crucial people have confidence in the Ebola treatment centres, but the sad fact is that many people will die there. So you can see why people may not immediately want to send their loved ones there, in the care of strangers in white suits, when they know many people still don't come back alive. So we have to work really hard to build trust with communities. We also have to reduce the behaviour that can lead to transmission. The traditional burial techniques which involve washing and coming into contact with the deceased have been well publicised. People need to stop dong what is considered a sign of respect. Regular hand washing and avoiding bodily contact with people you don't know well are a must. Reaching the number of people we need to and ultimately helping them change the way they act is a huge challenge but absolutely crucial. We're training community health workers who go out into communities to do that.

So then we come to what people can do. Not to get all fundraising-y but Save the Children is working incredibly hard to scale up all of the things I'm talking about on here - but we need help. Donating to our response really will help us save the lives of children here. If anyone is interested in helping us please do, and you can here: http://save.tc/HnmT. Thank you.

What should we expect to see in the next couple of months if a breakout occurs in the US?

I can't speak from experience of the US health system, I find it very hard to picture what any outbreak would look like there. I think the only way to ensure that the outbreak doesn't spread further, or continue to provide a even a low level threat to people in countries like the US, is to focus resources here in West Africa now and get it under control here.

Do you see any signs that the number of transmissions will be slowing down in the near future?

Reliable data is hard to come by and there is no doubt under reporting is going on, either because remote communities can't be reached or because people are afraid to seek treatment. It does seem that where the outbreak started in Sierra Leone cases are going down, which is a sign the spread of Ebola can be controlled. However in other parts of the country - like Freetown where I am - cases continue to rise and rise. I'd say here in Sierra Leone there's evidence its possible to slow infection rates, but we haven't achieved it yet and the time really is now to ensure we do. We'll continue to need much more international support and expertise to bring the epidemic under control.

Do you think any of the millions of $ being donated will make it to you guys? I always hear about donations in African countries getting eaten up as graft and such.

I do, yes. I can't comment on other contexts but it is of course always something that you need to be vigilant about. Here I can see huge work on the ground. We're helping the UK govt set up a new Ebola Treatment Centre near Freetown. It's a massive undertaking and an incredibly tangible demonstration of where the money is going. It was a building site a few weeks ago and it's now nearly finished. It will provide 80 more Ebola treatment beds for the public in Sierra Leone and Save the Children will take over the running when it opens at the end of the month.

80 beds? If there are over 100 new cases in the last two days, that seems like it's not going to do much, right?

There is no doubt whatsoever that we need more beds than these. There are, I believe, currently 327 Ebola treatment centre beds across the country. The 80 for the public - and we'll also be taking over 20 specifically for health workers a little later - will make a huge difference to many children and families but it is only part of the solution. We urgently need more international support. And not just financial, but clinical and logistical expertise too.

Have you or any of your colleagues had any close calls while you've been in Sierra Leone?

Myself, not really, thankfully. The closest I have come is visiting a health centre the day after they had their first suspected case of Ebola there. I'd be lying if I said I didn't have a nervous shiver when they told me. When people are ill clearly the first place many go is to their local health clinic. The staff there recognised the signs and symptoms, and moved the boy into an area where he could be isolated while they called the specialist team to come and pick him up. That's what the local health clinics need to do - ensure that any suspected cases don't risk infecting anyone else at the centre and try to make sure they're comfortable while an ambulance can come to take them to a facility that is set up to look after them. You can see a vlog I did from the health centre here: https://www.youtube.com/watch?v=1Qu13ljUlMA&list=UU7RCGWVd4j_WxIGalDkVi0w

Usma, in our Education team, came much closer. He is from Sierra Leone and sadly his mother-in-law passed away. It wasn't suspected to be Ebola, but after her funeral two people who attended became ill with Ebola and died. It seems clear his mother-in-law had been misdiagnosed. His wife had been to the funeral and so was at risk herself, as were the rest of the family she had returned to. Ebola has a 2 - 21 day incubation time which means it can take up to 3 weeks for the symptoms to show. The whole family put themselves in quarantine up until 21 days had passed. I can only imagine what that must be like - waiting and hoping that you don't become ill. Thankfully they made it through the 21 days and are out of danger now.

Why is there so much disinformation abound with ebola? I can understand why in the developing world such as Sierra Leone, but am baffled by it's prevalence in the US. Is there anything we can do to educate the masses?

I think it's caused by fear - and no-one is immune to that wherever you are. The death rate is so high and the symptoms, like bleeding, are so horrible that people are inevitably and understandably frightened.

The WHO website is packed with reliable information on Ebola, their FAQs are a good place to start: http://www.who.int/csr/disease/ebola/faq-ebola/en/ so I can recommend people take a look at that.

What I'd like people to understand and act on is that right now the key to defeating Ebola is here in West Africa.

Is there anything we can do to help your efforts?

By supporting Save the Children here: http://save.tc/HnmT.

Donations will go towards things like nourishing food for children affected by Ebola, or the daily allowances required for a community health worker helping to stop the spread of the disease.

Thank you.

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Done.

What's the mood of the people, so you know what's changed community wise?

I would say people are carrying on their lives with a mixture of caution and determination. I have been here for about a month and hadn't been to Sierra Leone before so I can't compare first hand. But people tell me it is quieter, more subdued, certainly in the evenings. Public gatherings are banned so people can't really go out together at night. Schools are shut so we're extremely concerned about the impact this will have on children's education. Ebola is on everyone's minds and all over the radio. And underlying it all is a level of fear. I don't think anyone is completely without that.

From reports one can gather that there is a strongheld belief in some groups that Ebola is made-up. Have you encountered such persons? How much of the efforts.to contain and slow down Ebola are directed toward education?

It is definitely true that many people believed that to begin with. So far I haven't personally met anyone who believes that now. I say this tentatively, but it seems like the message that Ebola is real is getting through in Sierra Leone. Too many people have died. Too many communities have been affected. And there has been a lot of community education work - we call it 'community sensitisation'. So to answer your question, yes education is key and a big part of what we're doing here. But then turning the acceptance that Ebola is real into real changes in people's behaviour is a huge challenge. People may believe in the disease, but will they follow the kinds of steps I have discussed in this AMA to tackle it? Or do they still believe a traditional healer can help? These are questions and issues we must continue to address.

Thanks for being there for them.. I've read some posts that the mainstream medias cover up some stories about the outbreak in Europe.. In your opinion, is this kind of thing important, to keep the world at ease using news with hopes, rather than telling the truth no matter how cruel it is?

I haven't seen those posts or heard that, I must admit. But my inclination would always be towards giving as truthful a picture of what's going on as possible. If people want hope, we have it. We are not in a 'no hope' situation. We still have a chance to turn this around but we can only do that with international support. I would think the best way to achieve that is by sharing the best information we have so people can develop a genuine understanding of what's happening.

How can I help?

You can support Save the Children's emergency response here: http://save.tc/HnmT. Donations will go towards things like nourishing food for children affected by Ebola, or the daily allowances required for a community health worker helping to stop the spread of the disease. Thank you.