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Table 1 A comparison of the features of the two case studies

From: Ebola in the context of conflict affected states and health systems: case studies of Northern Uganda and Sierra Leone

  Uganda 2000-2001 Sierra Leone 2014-15
Cases 425 13059
Case fatality rate 53 % 30 %
Response features National Task Force established within 4 days of MoH notification Delay in notification of MoH
CDC establishes local field laboratory Slow implementation of control measures
Effective co-ordination of international support Sharp rise in cases 2 months after notification of MoH
Basic control measures still absent 7 months into outbreak
Human resource factors Significant difficulties but evidence of intrinsic motivation; supportive environment and positive role of international NGOs and experts. Insufficient numbers, inadequate and inappropriate training and poor motivation all documented
Media Effective use for public communication Antagonistic relationship between government and press; accusations of government incompetence and attempts at censorship
Limited scare mongering
Community level Some problems of stigma and distrust between community and health authorities but some community responses highly consistent with public health recommendations Significant problems of lack of co-operation and trust, and conflict between public health measures and traditional practices
Institutional development Rapid development in South of country in preceding 15 years provided basis for national institutional response Limited economic and political recovery post conflict probably contributed to failures
Importance of established faith based hospital
International response Fast, effective emergency response of agencies such as WHO and CDC Delayed response may have been premised on complacency and political concerns.