Sierra Leone combats MPO outbreak: "We see cases of total denial by patients, who refer to it as chickenpox."
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In this image, George Kamara, MSF community health officer, examines a patient at the mpox treatment center in Calaba Town, a neighborhood of the capital. https://imagenes.elpais.com/resizer/v2/KEAHKD5VEFC43I4YYYD45PXAVM.jpg?auth=25f7b69afe1fbd1e5844112b0a3a49e37eaecfc90cf7517f72da7d2388ec1f4c&width=828 640w, https://imagenes.elpais.com/resizer/v2/KEAHKD5VEFC43I4YYYD45PXAVM.jpg?auth=25f7b69afe1fbd1e5844112b0a3a49e37eaecfc90cf7517f72da7d2388ec1f4c&width=980 1000w, https://imagenes.elpais.com/resizer/v2/KEAHKD5VEFC43I4YYYD45PXAVM.jpg?auth=25f7b69afe1fbd1e5844112b0a3a49e37eaecfc90cf7517f72da7d2388ec1f4c&width=1960 1960w" width="414" sizes="(min-width:1199px) 1155px,(min-width:1001px) calc(100vw - 44px),(min-width:768px) 767px, 100vw" src="https://imagenes.elpais.com/resizer/v2/KEAHKD5VEFC43I4YYYD45PXAVM.jpg?auth=25f7b69afe1fbd1e5844112b0a3a49e37eaecfc90cf7517f72da7d2388ec1f4c&width=414">Sierra Leone is experiencing a new outbreak of mpox, a disease that was declared a public health emergency by the local Ministry of Health in January of this year. All 16 districts in the country have reported cases, and those in the western region, including the capital Freetown, have been identified as outbreak hotspots. "Mpox is not new to Sierra Leone. This is the fourth time we have reported cases. The current outbreak is primarily affecting the Rural West Area district and the capital, which are densely populated areas with more than one million inhabitants," explains Agnes Dama, Médecins Sans Frontières (MSF) lead representative for the mpox response in Sierra Leone and responsible for coordinating the organization's medical activities related to the outbreak in the country. According to the National Public Health Agency (NPHA), as of July 10, 4,599 confirmed cases and 33 deaths had been recorded in the country.
In this image, George Kamara, MSF's community health officer, examines a patient at the MPOX treatment center in Calaba Town, a neighborhood in the capital.Noor Ahmad Saleem (MSF)“In Sierra Leone, the decline continues in both suspected and confirmed cases, which is quite encouraging. However, the fact that the test positivity rate remains at around 85% highlights the need to accelerate the interventions that have been implemented in terms of active surveillance,” Yap Boum, deputy incident manager at the Africa Centers for Disease Control and Prevention (CDC), highlighted in an online press conference last Thursday. In the photo, Isata Conteh of the Ministry of Health selects medications for a patient at the pharmacy of the MSF-supported MPOX treatment center in Calaba Town, on June 19, 2025.Noor Ahmad Saleem (MSF)To address the outbreak, the Sierra Leone Ministry of Health has intensified its vaccination campaign across the country, prioritizing frontline health workers and vulnerable and at-risk populations. It has also introduced social distancing measures and launched public awareness campaigns about this viral disease, whose most common symptoms are skin rashes and mucosal lesions that can last two to four weeks, accompanied by fever, headaches, muscle pain, lack of energy, and swollen lymph nodes. In the most severe cases, it can be fatal. In this photo, Marie Josephine Kamara, a vaccinator with the Ministry of Health, prepares to administer the first dose of the MPOX vaccine to staff working at the treatment center in Calaba Town, Freetown, Sierra Leone, on June 9, 2025.Mary Dumbuya (MSF)Since January 2024, there have been 45,822 confirmed cases of mpox and 156,833 suspected cases, as well as 213 confirmed and 1,840 suspected deaths in 26 African countries, with the Democratic Republic of the Congo, Sierra Leone, Burundi, and Uganda being the most affected, according to data released last Thursday by the Africa Centers for Disease Control and Prevention (CDC). Yap Boum, CDC deputy incident manager, emphasized in the online press conference that the goal is "by August, mpox will be under control in countries that have never seen what we call an epidemic, and in other places in the region where it has." "We understand that we may not reach zero cases of mpox in countries, but we want to get them to a level where they can easily control it using the different measures [vaccination, surveillance, and case management] that we have learned," Boum added. In this image, Musu Kamara, a nurse with the Ministry of Health, receives the first dose of the MPOX vaccine at the MSF-supported treatment center in Calaba Town on June 9.Mary Dumbuya (MSF)Médecins Sans Frontières (MSF) has supported the government response by rehabilitating the isolation ward at Connaught Hospital and Kenema Public Hospital, training Ministry of Health staff in infection prevention and control measures, donating supplies to reinforce these measures, and providing training on how to produce chlorine locally. In June, Médecins Sans Frontières (MSF) launched a 50-bed treatment center for severe and moderate cases of MPO in Calaba Town, a neighborhood of Freetown. Pictured here is a view of the Calaba center on June 19.Mary Dumbuya (MSF)Two health workers examine Wilson [not her real name], a one-month-old baby admitted to the MPOX treatment center in Calaba Town, Freetown, Sierra Leone, in mid-June. His mother, Fatima [not her real name], explains that her son was only two weeks old when she noticed lesions on his skin. "Then his fever spiked, so I took him to my community health center. They told me it was just a rash and gave me a paste to spread on his skin." Days later, Fatima returned with her baby to the health center to update his vaccination record, and a nurse noticed the lesions had spread to his foot, so they decided to test him for MPOX. The next day, the woman received a call informing her that her son had tested positive and that they needed to vaccinate the rest of the family and their neighbors. "I was happy when the health workers came to my house dressed in street clothes, so many people in my community don't know my baby has MPOX. Only my closest neighbors, who were also vaccinated, know. I was worried they would be afraid of my son and me," she says.Noor Ahmad Saleem (MSF)According to MSF, stigma and lack of awareness are some of the factors that prevent affected people from seeking healthcare. This is confirmed by Dama, MSF's medical representative for the response to the mpox outbreak in Sierra Leone. "Initially, mild cases of mpox were managed through self-isolation, and severe cases were admitted to a health center. However, due to stigma, lack of information, and fear, many people do not seek treatment centers. We see cases of total denial on the part of patients, who refer to mpox as chickenpox and treat it with alcohol, local clay, and traditional herbs," she explains.Noor Ahmad Saleem (MSF)"Some patients arrive at the center with no hope of getting better, as they have seen a lot of misinformation about MPOX," Dama emphasizes. The MSF official explains that they also struggle to accept their disease and inform their close circles due to the stigma they may face in their communities and traditional beliefs about the treatment. "With the psychosocial support we provide, we are seeing greater acceptance; patients are gradually understanding their diagnosis and regaining confidence that they can be cured." In this photo, taken on June 19, a nurse dressed in personal protective equipment (PPE) holds a patient's medical record in the women's ward of the MPOX treatment center in Calaba Town, Freetown.Noor Ahmad Saleem (MSF) Michael [not his real name], one of the patients treated at this center, explains that the first symptoms he felt were bumps, itching, and pain in his genitals. Then his face began to itch, and he couldn't sleep at night. After trying treatments with antibiotics, injections, salt, lemon, and alcohol, he decided to take a photo and send it to a friend of his who is a nurse, without telling her it was him. "I was too embarrassed," he explains. She recommended he get tested for MPOX, and when the result was positive, Michael wasn't surprised. "They wanted to send an ambulance to pick me up and take me to the center, but I refused because all my neighbors would know I have the disease," he recalls. "I haven't told any of my friends or family that I have MPOX. They wouldn't understand, and they'd be afraid to be around me," he explains. “I was also afraid of this disease. At the hospital where I was tested, I heard some MPOX patients crying, and I thought that if my results came out positive, I would cry too… and so it happened.” George Kamara, an MSF worker, examines a patient on June 19, 2025, at the MSF treatment center in Calaba Town, Freetown. https://imagenes.elpais.com/resizer/v2/JF6IUAPSHRDVRODCUBH7VZZ7LI.jpg?auth=df70232357b9dd966a852be824d424049aa131f5771a7410aeeee9fddc26f88e&width=828 640w, https://imagenes.elpais.com/resizer/v2/JF6IUAPSHRDVRODCUBH7VZZ7LI.jpg?auth=df70232357b9dd966a852be824d424049aa131f5771a7410aeeee9fddc26f88e&width=980 1000w, https://imagenes.elpais.com/resizer/v2/JF6IUAPSHRDVRODCUBH7VZZ7LI.jpg?auth=df70232357b9dd966a852be824d424049aa131f5771a7410aeeee9fddc26f88e&width=1960 1960w" width="414" sizes="(min-width:1199px) 1155px,(min-width:1001px) calc(100vw - 44px),(min-width:768px) 767px, 100vw" src="https://imagenes.elpais.com/resizer/v2/JF6IUAPSHRDVRODCUBH7VZZ7LI.jpg?auth=df70232357b9dd966a852be824d424049aa131f5771a7410aeeee9fddc26f88e&width=414">
Michael [not his real name], one of the patients treated at this center, explains that the first symptoms he felt were bumps, itching, and pain in his genitals. Then his face began to itch, and he couldn't sleep at night. After trying treatments with antibiotics, injections, salt, lemon, and alcohol, he decided to take a photo and send it to a friend of his who is a nurse, without telling her it was him. "I was too embarrassed," he explains. She recommended he get tested for MPOX, and when the result was positive, Michael wasn't surprised. "They wanted to send an ambulance to pick me up and take me to the center, but I refused because all my neighbors would know I have the disease," he recalls. "I haven't told any of my friends or family that I have MPOX. They wouldn't understand, and they'd be afraid to be around me," he explains. “I was also afraid of this disease. At the hospital where I was tested, I heard some MPOX patients crying, and I thought if my results came back positive, I would cry too… and that's what happened.” George Kamara, an MSF worker, examines a patient on June 19, 2025, at the MSF treatment center in Calaba Town, Freetown.Noor Ahmad Saleem (MSF)
