The Ebola outbreak in West Africa was unprecedented in its sheer scale. The outbreak occurred close to the confluence of the borders between Guinea, Sierra Leone and Liberia, where movement of people between countries is regular and often not controlled.
1.1 THE LARGEST EBOLA OUTBREAK IN HISTORY
On 21 March 2014, the Ebola outbreak in Guinea was laboratory confirmed and MSF quickly dispatched experienced teams from Geneva and Brussels to set up case management facilities and start outbreak control measures. An MSF team in Sierra Leone with Ebola experience was directed across the border into Guinea and began setting up isolation facilities in Guéckédou, near the epicentre of the outbreak, as well as implementing outbreak control measures in the affected area.
By late July 2014, the epidemic had spread to major cities in Guinea, Liberia and Sierra Leone. By the beginning of October 2015, the World Health Organization (WHO) had reported more than 28,000 cases and 11,000 deaths.
With the rapid increase in cases and the lack of other humanitarian actors, MSF was stretched to the limit. Because of the high risk associated with responding to Ebola, and because previous outbreaks had been quite small in comparison, very few humanitarian actors had the experience or capacity to respond. In August 2014, during the peak of the outbreak, MSF increased its on-ground capacity fivefold.
The international community, including WHO, was slow to respond and reluctant to accept the scale and severity of the Ebola outbreak. Affected governments did not want to spread panic among their populations, while fearing the economic impact of declaring an epidemic. For the MSF response, this contributed to very limited access to important data, as well as little opportunity to engage the population in controlling the disease with safe practices, awareness raising and setting up networks of alerts. Soon the epidemic had become the largest Ebola outbreak in history. Finally, by late 2014, the outbreak showed signs of slowing.