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| Is Sierra Leone ready for the next epidemic? | Is Sierra Leone ready for the next epidemic? |
| (1 day later) | |
| It is not a question of if, but when. There will be another outbreak of some deadly disease in Sierra Leone at some point. | It is not a question of if, but when. There will be another outbreak of some deadly disease in Sierra Leone at some point. |
| Every country in the world is at risk. Viruses do not care about borders. | Every country in the world is at risk. Viruses do not care about borders. |
| Ebola was able to spiral out of control in such spectacular fashion here because Sierra Leone's health system was extremely weak. | Ebola was able to spiral out of control in such spectacular fashion here because Sierra Leone's health system was extremely weak. |
| When the virus came knocking, there was not a single laboratory in the country which could diagnose it. | When the virus came knocking, there was not a single laboratory in the country which could diagnose it. |
| There also were not enough doctors and nurses, not enough hospitals and not enough trust in the health system for people to turn up at clinics when they got sick. | There also were not enough doctors and nurses, not enough hospitals and not enough trust in the health system for people to turn up at clinics when they got sick. |
| But exactly two years since the World Health Organization (WHO) declared the Ebola outbreak a global health emergency, parts of the health system are probably in the best shape they have ever been in. | But exactly two years since the World Health Organization (WHO) declared the Ebola outbreak a global health emergency, parts of the health system are probably in the best shape they have ever been in. |
| However, there are still "major shortcomings", according to the WHO. | However, there are still "major shortcomings", according to the WHO. |
| 'Silent epidemic' | 'Silent epidemic' |
| "We are definitely more prepared [for a new outbreak] than we were when the Ebola outbreak started here in May 2014," said Dr Brima Kargbo, Sierra Leone's chief medical officer. | "We are definitely more prepared [for a new outbreak] than we were when the Ebola outbreak started here in May 2014," said Dr Brima Kargbo, Sierra Leone's chief medical officer. |
| "We have rapid response teams ready, and can isolate people quickly if we need to." | "We have rapid response teams ready, and can isolate people quickly if we need to." |
| The head of the WHO in Sierra Leone, Dr Anders Nordstrom, said that despite improvements in some areas, there was still much to do. | The head of the WHO in Sierra Leone, Dr Anders Nordstrom, said that despite improvements in some areas, there was still much to do. |
| "During the outbreak patients and staff were not coming to hospitals. | "During the outbreak patients and staff were not coming to hospitals. |
| "That has gone back to normal… but there are still major shortcomings in the health system. | "That has gone back to normal… but there are still major shortcomings in the health system. |
| "We have a big lack of trained healthcare workers. The quality of service is not good enough. Sierra Leone has the highest maternal mortality rate in the world. | "We have a big lack of trained healthcare workers. The quality of service is not good enough. Sierra Leone has the highest maternal mortality rate in the world. |
| "Around 30,000 women and children are dying every year in Sierra Leone for preventable reasons - it is a silent epidemic here." | "Around 30,000 women and children are dying every year in Sierra Leone for preventable reasons - it is a silent epidemic here." |
| Deadliest outbreak | |
| Timeline: How we lost control of the Ebola virus | |
| The UK pledged £427m ($560m) towards responding to the Ebola outbreak, and strengthening the country's health systems. | The UK pledged £427m ($560m) towards responding to the Ebola outbreak, and strengthening the country's health systems. |
| The jewel in the crown to that response was the 100-bed Kerrytown Ebola treatment centre. | The jewel in the crown to that response was the 100-bed Kerrytown Ebola treatment centre. |
| I visited the site a number of times during the outbreak. At its height it was a buzzing lifeline for a country that was overwhelmed. | I visited the site a number of times during the outbreak. At its height it was a buzzing lifeline for a country that was overwhelmed. |
| Some 1,500 British troops deployed there to help build and staff parts of the site. | Some 1,500 British troops deployed there to help build and staff parts of the site. |
| Save the Children took up the daunting task of running the main treatment areas. | Save the Children took up the daunting task of running the main treatment areas. |
| Their medics saved more than 150 lives. | Their medics saved more than 150 lives. |
| When I visited this time, it was derelict and decaying. A few stray dogs and a family of goats had taken up residence in what used to be functioning wards. | When I visited this time, it was derelict and decaying. A few stray dogs and a family of goats had taken up residence in what used to be functioning wards. |
| I went there with Kerrytown's first survivor, 18-year-old Daniel Turay, and his sister Cecilia. They lost 27 members of their family to Ebola. | I went there with Kerrytown's first survivor, 18-year-old Daniel Turay, and his sister Cecilia. They lost 27 members of their family to Ebola. |
| Daniel said he had both heart-breaking and heart-warming memories of the site. | Daniel said he had both heart-breaking and heart-warming memories of the site. |
| "When I was in the red zone it was horrible seeing people dying… but seeing the work the doctors were doing - even though they were risking their lives, they didn't relent. | "When I was in the red zone it was horrible seeing people dying… but seeing the work the doctors were doing - even though they were risking their lives, they didn't relent. |
| "They went on to make sure that we survived. I told them that because of what you've done, I want to be like you, I want to be a doctor." | "They went on to make sure that we survived. I told them that because of what you've done, I want to be like you, I want to be a doctor." |
| 'Total mess' | 'Total mess' |
| As Daniel wandered through the empty tents and overgrown grounds, he was clearly very frustrated. | As Daniel wandered through the empty tents and overgrown grounds, he was clearly very frustrated. |
| "The government said they wanted to establish a hospital here… but what I see really discourages me. | "The government said they wanted to establish a hospital here… but what I see really discourages me. |
| "It's something that hasn't been made a reality. It's a total mess to see it like this. | "It's something that hasn't been made a reality. It's a total mess to see it like this. |
| "There aren't many hospitals here. It could have been a benefit to the whole district." | "There aren't many hospitals here. It could have been a benefit to the whole district." |
| The Ministry of Health has said it plans to make a maternity unit on the site by the end of the year. We did not see any building work taking place. | The Ministry of Health has said it plans to make a maternity unit on the site by the end of the year. We did not see any building work taking place. |
| The solar panels for precious lighting, the drainage system and some of the structures were all still standing. These are rare commodities in a country desperate for more health facilities. | The solar panels for precious lighting, the drainage system and some of the structures were all still standing. These are rare commodities in a country desperate for more health facilities. |
| "There's a very small community in that area," said Dr Brima Kargbo. | "There's a very small community in that area," said Dr Brima Kargbo. |
| "We are building a new hospital in the nearby area of Waterloo instead." | "We are building a new hospital in the nearby area of Waterloo instead." |
| In the city's main Connaught hospital, which was overwhelmed with Ebola patients during the outbreak, a brand new shiny ambulance rolls into the refurbished accident and emergency department. | In the city's main Connaught hospital, which was overwhelmed with Ebola patients during the outbreak, a brand new shiny ambulance rolls into the refurbished accident and emergency department. |
| Thanks largely to British investment, the ward can offer free care to patients for the first 24 hours. | Thanks largely to British investment, the ward can offer free care to patients for the first 24 hours. |
| There is also a new isolation and infectious disease unit, both developed by London King's College Hospital's Sierra Leone Partnership. | There is also a new isolation and infectious disease unit, both developed by London King's College Hospital's Sierra Leone Partnership. |
| Consultant surgeon Dr Samuel Sesay oversees the new Accident and Emergency department and said: "Things have improved by more than 80%. | Consultant surgeon Dr Samuel Sesay oversees the new Accident and Emergency department and said: "Things have improved by more than 80%. |
| "When I look at A&E now compared to what it was like before, they are worlds apart. We are saving many more lives." | "When I look at A&E now compared to what it was like before, they are worlds apart. We are saving many more lives." |
| Training challenge | Training challenge |
| We headed up to the diagnostics laboratory, which is about to get a big refurbishment by the ministry of health and Public Health England. | We headed up to the diagnostics laboratory, which is about to get a big refurbishment by the ministry of health and Public Health England. |
| The UK agency has already set up two labs in other parts of the country. | The UK agency has already set up two labs in other parts of the country. |
| "The final objective is to avoid another massive epidemic, which obviously went well outside Sierra Leone," said Dr Autilia Newton, PHE head of mission in Sierra Leone. | "The final objective is to avoid another massive epidemic, which obviously went well outside Sierra Leone," said Dr Autilia Newton, PHE head of mission in Sierra Leone. |
| "The biggest challenge is to train staff to ensure the system is sustainable by the Sierra Leone government once Public Health England is gone." | "The biggest challenge is to train staff to ensure the system is sustainable by the Sierra Leone government once Public Health England is gone." |
| But the biggest challenge, and the biggest hope when it comes to saving lives in Sierra Leone, lies with people like Daniel Turay. | But the biggest challenge, and the biggest hope when it comes to saving lives in Sierra Leone, lies with people like Daniel Turay. |
| I met him again as he left his physics class for the day. He is studying hard to get the grades he needs to go to university to study medicine. | I met him again as he left his physics class for the day. He is studying hard to get the grades he needs to go to university to study medicine. |
| "Life saving is one of the most honourable jobs you can do," he told me. | "Life saving is one of the most honourable jobs you can do," he told me. |
| In a country with only 200 trained doctors, Daniel's ambition - and his success - are crucial. | In a country with only 200 trained doctors, Daniel's ambition - and his success - are crucial. |
| Follow @tulipmazumdar on Twitter | Follow @tulipmazumdar on Twitter |