In Freetown, poverty and population density fueled a deadly crisis. Between the makeshift shelters of Kroo Bay, a slum in the capital of Sierra Leone, people wash, cook, urinate, and repair roofs, radios, and engines. White banners reading "Ebola: No Touch Am" "Don't touch" in Krio, a creole language widely spoken in Sierra Leone droop from crumbling walls—a reminder of the invisible killer ravaging the country, which spreads through bodily contact.
It's an impossible command to follow in a place where families of six commonly share single rooms and two people cannot pass through an alley without brushing shoulders. The greater Freetown area had become the epicenter of the deadly disease. At the end of a road to the settlement, a woman lying in the shade of a cinderblock building told me she had seen four people—potential Ebola cases—removed from their shelters that day. Government agents were sending the sick to recently constructed "holding centers" to wait for the results of Ebola tests.
She said it sedately, and added that she was tired and hungry. We stared at the slums below and a sea clouded by Saharan dust. In the beginning of September, there were 79 cases in the western region, including the capital.
By the end of December, there were 2,, a fold increase. Officials were also worried then about a potential time bomb: A third of corpses recovered in homes had tested positive for the virus. Before those people died, they would have spent a week in the "wet" phase of the disease—sweating, vomiting, and bleeding—shedding virus-laden fluids that could have infected those around them. At that time, Sierra Leone, with assistance from foreign governments and nonprofit organizations, was still ramping up its response.
It appears now to be working, as the spread of the disease slows there and elsewhere in West Africa. A close examination of what made Freetown so vulnerable to the outbreak offers critical lessons for the future in fighting Ebola or another major calamity. Like many developing world cities, Freetown—population ,, the largest city in Sierra Leone—lacks the infrastructure to support its impoverished populace, making it prone to tragedy, whether through pestilence, violence, or natural disaster.
