Ebola's most vulnerable victims With local partners in Sierra Leone, Bread and Water for Africa UK has been actively monitoring and assisting affected communities. The Outbreak, Local Nurses, and a Way Forward? Around the world, an echo of frustration can be heard in response to the most recent Ebola outbreak. The Center for Disease Control (CDC) first announced the outbreak on March 25, 2014 and although the rate of expansion slowed in April, there has been an uptick in death tolls since June. There is outrage over the lack of progress made on experimental medicine for those already infected, as expressed by Jeremy Farrar of Welcome Trust, claiming “It’s ridiculous that we haven’t got these (experimental) products out of labs and animal trials and into human testing, and at least offered to people,”. Health organizations such as the Red Cross and Medicins Sans Frontiers(MSF, the French arm of Doctors Without Borders) are also in distress as their posts in the region have been threatened by both the risk of Ebola contraction and local resistance to care. Although the World Health Organization (WHO) has been effectively disseminating information about disease prevention and has called for 11 West African states, including Mali, Senegal, and Ivory Coast, to hold a crisis meeting on the subject, new cases in new areas continue to arise. Aid organisations aren’t giving up on West Africa, but their lives have been threatened by their posts on the front lines of the fight. And, in many cases, that fight is not just against Ebola but is also with the victims of the epidemic and the local, at-risk populations. Recently, the Red Cross was forced to suspend operations in a major southeast city in Guinea due to violent attacks on its staff. Medecins Sans Frontiers faced similar threats in April 2014 from locals who “accused [MSF] of bringing the disease into the country.” But there is good reason to argue that the virulence of this epidemic is due to cultural and foundational issues than complacency. One such example is the misunderstanding between foreign health workers in the region and their beneficiaries. Doctors Without Borders, MSF, the Red Cross and countless others have penetrated the region with staff and supplies in the name of altruism but the long standing air of mistrust has led several communities in West Africa to doubt the intentions of the aid community. While the impact and selflessness of these aid workers cannot be underestimated, Bread and Water for Africa UK has found it useful to empower existing local clinics – such as our partners at Faith Healing Development Organisation (FHDO) who run four clinics across Sierra Leone – proves beneficial in spreading the word on prevention strategies, and providing a “trusted” local voice on the dangers and reality of Ebola. The clean water provided for communities of thousands of people through FHDO’s water wells also assist in stymying the spread of Ebola at more communal and less sanitary water sources. However, local health professionals in West Africa are among the most vulnerable victims of the epidemic. They maintain close contact with the infected and are at constant risk of infection themselves. Bread and Water for Africa UK’s partner clinics in Sierra Leone are facing mounting risks of treating patients that have not yet been diagnosed with Ebola and more and more people are opting to retreat from public spaces or day jobs in unsanitary or crowded work-spaces – such as construction. The very small glimmer of good in this outbreak is that the medical community has a strong grasp of what Ebola is, how to quarantine individuals who have it, and are on a steady path to finding a vaccine. Containment is of utmost importance when addressing such outbreaks. While prevention is a common strategy and familiar to many regions of Africa that were recipients of international HIV/AIDS treatment and containment aid, because Ebola is entirely new to these West African countries, it is proving increasingly difficult for aid organisations to overcome local distrust and spread this information as quickly as they would like.