By Daniel Flynn and Bate Felix
DAKAR (Reuters) - The number of Ebola cases is surging in Sierra Leone due to a lack of treatment centers, the United Nations said, while scarcity of food may also be forcing some people to leave quarantined areas, risking further spread of the virus.
The warning by the U.N. Mission for Ebola Emergency Response (UNMEER) came as Sierra Leone's Deputy Minister of Health said Ebola had so badly damaged confidence in the West African country's health system that many people were dying from other diseases as the sick refused to come to clinics for treatment.
Some 4,818 people have died of Ebola, mostly in Sierra Leone, Liberia and neighboring Guinea, the World Health Organization (WHO) said on Wednesday.
But while the situation is improving in Liberia and stable in Guinea, two-thirds of the new cases recorded in the past three weeks have been in Sierra Leone.
UNMEER said at present Sierra Leone had just four Ebola Treatment Centers (ETCs) with a total capacity of 288 beds and these were treating 196 cases of the disease as of Sunday.
However, the U.N. mission said it suspects 50 percent of cases of the Ebola virus disease (EVD) were not being reported in Sierra Leone.
To control the outbreak, UNMEER estimated a total of 1,864 beds were needed by December but the 10 new treatment centers currently planned had a total capacity of just 1,133 beds.
"Lack of available beds in ETCs is forcing families to care for patients at home, where caregivers are unable to adequately protect themselves from EVD exposure, thereby increasing transmission risk," it said in a report released late on Wednesday.
UNMEER also reported a growing incidence of families leaving their quarantined homes due to a lack of food and non-food items, but did not provide further details.
It said the World Food Program (WFP) had distributed rations to 80 percent of quarantined household and communities in the hard-hit area of Waterloo, in the outskirts of Freetown.
ISOLATED FOOD SHORTAGES
However, WFP Executive Director Ertharin Cousin, who has just completed a three-day visit to Sierra Leone, said there was no information to suggest this was a widespread phenomenon.
"There were isolated incidents where we did not receive a notice before the area was quarantined and so we did not provide the food," she said. "We are working to scale up as quickly as possible to ensure that no family need go in search for food."
Cousin said the U.N. agency had already reached its target of providing food to 1.3 million people in the region and would be scaling this up to reach more people in the weeks ahead.
Sierra Leone's Deputy Health Minister Madina Radman said the country's failure to clearly separate its Ebola treatment centers from its regular health facilities had destroyed confidence in hospitals and clinics.
"We are struggling to regain confidence in our health facilities because of this mistake," she said at a WHO conference in Benin. "About 50 percent of the deaths in the country are not Ebola but, because people fear to come to some of our healthcare facilities, they die needlessly in the community due to other treatable diseases."
According to the WHO, only 22 percent of the planned 4,707 beds needed in Ebola treatment units are in operation, U.N. spokesman Stephane Dujarric said on Thursday.
"The establishment of more beds is in part held back by challenges in finding sufficient numbers of foreign medical teams to operate the centers," Dujarric told reporters.
Dujarric said Sierra Leone had five foreign medical teams operating Ebola treatment centers but needed at least a further 10. Guinea had two foreign medical teams operating Ebola treatment centers but needed at least five more. Liberia has three foreign teams and needed 13 more.
U.S. Ambassador to the United Nations Samantha Power, who visited Guinea, Sierra Leona and Liberia last week, warned that restrictions on aid workers returning home from West Africa could deter thousands from volunteering.
Several U.S. states, including New York where the U.N. has its headquarters, have imposed a mandatory quarantine on healthcare workers returning from the region.
(Additional reporting by Tom Miles in Geneva; Editing by Gareth Jones)