Sierra Leone, a West African state of 6 million, saw 11 000 cases and over 3000 deaths during last year's Ebola outbreak. A bitter civil war from 1991 to 2002, fuelled largely by fierce factions from neighbouring countries, led to 50 000 deaths and degradation of the country's infrastructure and social fabric. Sierra Leone's exports of diamonds and bauxite notwithstanding, the lack of a socially responsive polity and a largely agrarian population set the scene for the epidemic. Over 70% of its population live in extreme poverty.1
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