Contributing+Factors-+Lassa+Fever

__General Systemic Factors Associated With Civic Unrest and War__

The systemic unrest present in Sierra Leone, both from the corruption from the diamond industry and from civil war, played a huge role in generating the contributing factors to the outbreak of Lassa Fever. Corruption and instability from the diamond industry **inhibited the**

**establishment of a stable, adequately-funded medical system**. The civil war in Sierra Leone that began in 1991 and lasted for 11 years played a large role in worsening the weaknesses in Sierra Leone's medical system. With all major powers in Sierra Leone preoccupied with winning the civil war, the response to the Lassa Fever outbreak was too late and too weak. Additionally, the atmosphere of fear and danger only made getting treatment more risky and difficult for infected individuals. By forcing threatened individuals to leave their homes and relocate to temporary camps, the civil war forced individuals to live in **conditions with poor sanitation and hygiene**. The war also **destabilized the already weak, underfunded medical infrastructure**. Many hospitals were forced to shut down and only small squads of dedicated doctors and nurses remained to travel amongst the civilians and treat infected individuals. **Health delivery systems** already struggled prior to the civil war due to the challenges of having few hospitals and the inaccessibility inherent in having Sierra Leone's rural population spread across the country. The threats presented by civil war only further limited the mobility of health delivery systems and further challenged the traveling squads of doctors and nurses. A **lack of widespread knowledge of Lassa Fever** prevention and treatment among the general public prior to the outbreak and the civil war **hindered the transfer of information**. While Sierra Leone eventually received support from the World Health Organization, it **needed more assistance** more quickly from both its neighboring countries and the international community to combat the start of the outbreak with quick, sustained response.

__Factors Specific to Lassa Fever__

Due to Lassa Fever being transmitted through the multimammate rat, the lack of sanitation in rural Sierra Leone proved a huge contributing factor to the outbreak. The cultural factor of using **multimammate rats as a food source** greatly contributed to exposure to the rats during the hunting and preparing processes. **Water supplies**, which were often open and exposed to contamination, were a huge threat to spreading disease due to often being communal supplies shared among entire communities. Additionally, the **lack of rat-proof containers** to contain food or water allowed rats easy contamination. Ultimately, the lack of awareness of Lassa Fever being transmitted through multimammate rats and how to protect food and water from rats proved the greatest Lassa Fever-specific contributing factor.