The charity Médecins du Monde (Doctors of the World) says many people are dying in Sierra Leone not from ebola but because of the melt down of the country’s health care – partly because of ebola’s pressure on hospital systems.

Ebola has killed at least 3,900 people in Sierra Leone so far, but more are believed to have died from malaria, while deaths of mothers and babies in child birth are believed to have risen significantly. Attendance at clinics has dropped by more than 70 per cent.

British doctor James Elston says there is every reason to believe the situation is Sierra Leone-wide.

Many community health centres do not have a safe, clean water supply, Elston found. Of 14 primary care units inspected for his report, only one had piped water – and that was not functioning.

Five were using unsafe water from a stream or open well without disinfectant. Only half had water from a protected source such as a closed well. Only four had a functioning power source and only two of those had regular power. Seven had a working fridge – the rest could not store vaccines and sometimes had to obtain them from many miles away. None had a telephone – staff had to use their own mobile phones and credit for calls. None had good facilities for delivering women in labour.

Meanwhile, the World Health Organization has a plan to eradicate the ebola by identifying and isolating the dwindling number of new cases by the end of May.

In its new plan, the UN health agency stressed the importance of maintaining the massive efforts to rid the worst-affected nations – Guinea, Liberia and Sierra Leone – of the viral disease, cases of which have already fallen sharply. According to the latest numbers, around 26,300 people have so far been infected with the virus, and nearly 10,900 of them have died.

Now, WHO says case numbers have “plateaued… due to persistently high transmission in the western areas of both Guinea and Sierra Leone”.

Among the concerns are continued “ebola deaths in the community and numerous instances of unsafe burials” of highly contagious bodies, WHO said.

New cases are among people not known to have been in contact with previous cases, or who cannot be linked to known chains of transmission, it warned.