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Ebola virus: Emergency appeal launched for victims by British Red Cross

The British Red Cross has launched an emergency appeal to help people in West Africa affected by the deadly Ebola virus outbreak.

The public have been urged to dig deep into their pockets and contribute funds to help those in Guinea, Sierra Leone and Liberia, where more than 720 people have died after becoming infected.

A number of British Red Cross workers have been sent to West Africa to help support the relief effort, a spokesman said.

Teams on the ground are working with affected communities to educate people on how to prevent infection and to tackle stigma associated with the virus.

They are also helping to dispose safely of the bodies of those who have died and are helping to track down people who may have become infected.

"This outbreak shows no signs of abating, but we are doing everything we can to prevent new infections and help raise awareness about the disease," said Mandeep Mudhar, British Red Cross West Africa disaster response officer.

"The Red Cross's unique position in providing community health and hygiene promotion work is essential in avoiding further spread of the Ebola virus across the region. Money raised from this appeal will be invaluable in contributing to this fight."

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Ebola victims' bodies to be cremated to stop spread of virus at funerals

The Liberian government has said the bodies of all Ebola victims must be cremated as fears rose that the disease could be spread by burials in residential areas.

The order came after a tense stand-off erupted over the weekend when health workers tried to bury more than 20 Ebola victims on the outskirts of Monrovia.

Authorities said military police officers were called in to help restore order so that the burials could take place.

Many contracted the disease by touching the bodies of victims as is tradition at funerals.

At least 17 bodies have been abandoned on Monrovia's streets in recent days, health officials said.

Meanwhile, plastic buckets are selling at a record pace to people who fill them with chlorine to disinfect their hands.

"This situation has gotten worse. We need our concerted effort, this country needs everybody right now," information minister Lewis Brown said.

Never before has the disease with a fatality rate of at least 60% become so entrenched in urban population centres in Africa.

The situation is particularly dire in Liberia, where at least 156 people have succumbed to the disease, according to Doctors Without Borders.

Ebola is spread through contact with bodily fluids such as blood, sweat and vomit. Contact with the bodies of victims is particularly dangerous as evidenced by the fact that many victims contracted the disease when touching bodies at traditional funerals.

The mandate to cremate victims comes amid rising community opposition to burials for fear of contamination.

British doctor at centre of epidemic: 'Convincing our families we'll be okay can be hard'

A British doctor who was working in Sierra Leone before the deadly Ebola outbreak struck has described how his team have found themselves at the centre of the response to the epidemic.

Dr Oliver Johnson, along with a team of British medics, was working to build and strengthen the health system in the country's capital Freetown when the crisis took hold earlier this year.

When disaster struck, the team decided they wanted to stay and "do everything they could" to help, he said.

Ebola has no vaccine and there is no cure.

The outbreak has centred on Sierra Leone, Liberia and Guinea. There has also been particular concern after densely populated Nigeria reported what is thought to be its first death from the disease.

Dr Johnson, 28, is working in Freetown as part of the King's Health Partners scheme. The initiative is a partnership between Guy's and St Thomas', King's College Hospital and South London and Maudsley Trusts as well as King's College London. The team have been based at Connaught Hospital in Freetown for the last 18 months.

They were initially working to help strengthen the health system of the country through improving training, health policy, research and hospital management, among other things, before the first cases of the deadly virus started to emerge in neighbouring Guinea and Liberia

Dr Johnson said that it was hoped that the country had "dodged a bullet" - but Sierra Leone confirmed its first ever case of Ebola on May 25.

"Even as the outbreak spread to Liberia there had been some hope that it might pass us by," he said.

"We've now been hit hard though. Initially the disease was relatively well contained in the east but we've now seen cases in eleven districts. Hopefully these are isolated cases, but it's still a bit early to tell for sure."

Before the outbreak swept the country Dr Johnson, from London, had worked with African colleagues to help prepare for the worst - advising how to identify cases, set up isolation units, how to protect staff and providing refresher training for local health workers.

When cases started to emerge, the team had to ask themselves whether or not they should stay in the country to help with the response - their initial mission was to help strengthen the health system, not to provide a humanitarian response to an epidemic.

The team is made up of two consultants, two junior doctors, two nurses, a pharmacist and a hospital manager are all staff and volunteers. They chose to stay and help local health workers.

Dr Johnson said: "From the moment we heard about the first Ebola cases, all of our instincts on the team here and back in London were to do everything we could to help our colleagues overcome this new challenge.

"We have very close relationships with our colleagues at Connaught and the Ministry of Health and always try to respond to their requests for support. It was also clear that this new threat was something that they hadn't faced before and would require technical advice, extra manpower and trusted friends.

"We're not a humanitarian non-governmental organisation however, so of course we then had to go through the process of articulating this and agreeing it as a group - there was never opposition though and we've always had consensus."

Health workers have been identified as among those most at risk of contracting the virus. But Dr Johnson said that once the team got used to the overwhelming heat of the protective suits and the protocols to prevent infection, they became more "relaxed".

He said: "We're all aware that there is a risk and that we have to be extremely careful. However, we also know that if we wear the protective equipment properly and follow the protocols then we'll be okay. That doesn't leave room for error however - such as an accidental scratch of the face or forgotten hand wash.

"As we get used to it, we all begin to relax - the risk then is making sure that you don't cut corners or get too confident. Our families are often very concerned, and convincing them that we'll be okay can be hard.

"I definitely hesitated when I was first confronted with a probable case of Ebola (it takes a few days to get lab confirmation). Your instinct as a doctor is to rush in and help, but you know you can't touch a patient until you're fully protected. I first wore the protective suits during a bit of an emergency, so didn't have much time to reflect on it. The heat of the suits is quickly overwhelming, as your goggles steam up and you feel the sweat dripping underneath. And the smell of chlorine is intense.

"What shocking is how healthy the patients look before they die and how quickly they decline. A number of the Ebola patients I've seen look quite fit and healthy and can be walking around until shortly before their deaths."

He also described the difficulties of working out in the country - which is recovering from years of brutal civil war - because many thought the illness was a government conspiracy. Deep fear among patients and their families saw some trying to escape hospital, he said.

Dr Johnson said: "Ebola is a new disease in Sierra Leone and when the first cases emerged, many people thought it might be a government conspiracy to undermine certain tribal groups, steal organs or get money from international donors. This links to widely held scepticism about Western medicine and traditional beliefs and practices.

"Relatives don't get to see what happens to patients when they are isolated, so some expressed fears that they were being taken away to be killed by doctors - they don't get to see the good facilities and great care that patients receive that I see every day.

"That meant that some patients resisted being isolated and would try to run away or be carried off by family members. This is a constant challenge even now, and presents real ethical dilemmas about whether we can or should restrain patients and logistical ones about how it's even possible to safely restrain an infectious patient without putting yourself at risk."

Further reading:

Ebola virus outbreak: Sierra Leone and Liberia announce Army enforced quarantine zones and house-to-house searches to round up suspected victims 

Ebola virus warning for the UK: Health officials issue warning to doctors as outbreak fears grow 

Chief Ebola doctor in Sierra Leone Sheik Umar Khan contracts deadly disease 

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