Ganta, Liberia - Normally bustling with trucks carrying rubber, timber and other goods to and from Guinea, the streets of Ganta in Liberia's Ebola “hot zone” have fallen quiet since the bridge spanning the border was shut in August to try to halt the spread of the disease.
Now, fear of the deadly haemorrhagic fever - which has killed more than 3 800 people in three small West African states, 2 200 of them in Liberia - stalks the town, with many locals saying they are afraid to seek medical treatment.
“Even if you have a runny stomach or headache and you go to the hospital, you'll just be considered as an Ebola person,” said Musu Kardamie, head of a local women's association.
“We're dying on a daily basis in this country, especially in Ganta.”
When President Ellen Johnson Sirleaf visited the remote corner of the northerly Nimba county this week, she found that Ebola was not the only emergency affecting communities that have been quarantined over the disease.
Hunger is also biting, and when Johnson Sirleaf's presidential cortege distributed rice and money at several stops and then moved on, fights broke out among desperate young men over the bags of rice, worth about $40 each.
The president also brought money to pay the nurses of the United Methodist Hospital, who had not received any salaries in over a month, despite caring for more than 100 Ebola patients.
“I have come to say 'thank-you' for the service that you continue to render, not only to the people of Nimba but the people of Liberia,” Johnson Sirleaf said, before a stocky assistant distributed wads of cash from a rucksack to nurses in crisp white uniforms who danced and clapped in gratitude.
But the president's mission went beyond handouts.
When an elderly chieftain in the village of Belah approached for a traditional greeting carrying a gift of kola nuts on a plastic plate, the president refused it, saying: “I don't want to receive this because of Ebola. You must stay safe!”
At the village health checkpoint, she washed her hands in chlorine solution and had her temperature taken.
And in every village she visited, she asked community leaders if they were following the rules for fighting Ebola, a disease passed on by contact with the bodily fluids of victims, who can suffer fever, vomiting and diarrhoea.
That meant shunning traditional greetings that involve touching, and practices such as washing corpses by hand.
“It took us a while to say this,” she told Reuters.
“The only way you can prevent transmission is to break people's cultural habits.”
She admits that at first her government focused only on isolating victims, but since then it has launched a communications offensive.
In the capital Monrovia, named after 19th century US president James Monroe, containers of chlorinated water with taps sit outside every building. In churches, celebrants wear gloves as they distribute communion wafers.
Public information placards by the roadside exhort passers-by: “Don't Be The Next Victim. Stop Washing Dead Body. Stop Touching Sick Persons. Stop Travelling With The Ebola Virus. Report All Suspected Cases.”
But it is harder to get the message out to the countryside, not least with transport and the economy breaking down.
Work on a tarmac highway to connect Monrovia to Nimba county - some eight hours' drive away - was suspended by two Chinese contractors when Ebola struck. For long stretches, the route remains little more than a muddy track, though the government hopes work will resume within months.
Johnson Sirleaf said in an interview that there were early signs the outbreak in her country might be “in decline”.
In Nimba County, medical officer Collins Saa Bowah agreed: “We are beginning to see a decrease in the cases.”
But medical NGOs in the frontline of the battle against Ebola are much more cautious, wondering whether a fall in the number of registered cases may be the result of sick people in remote areas staying at home, or simply afraid to go for treatment.
“We don't have the means of getting to where the cases are. Sometimes it takes four or five days before we can get to the affected areas,” said Randall Boyer, a local youth officer.
The hospital in Ganta lies near the centre of the outbreak, which was detected six months ago just over the border in Guinea and spread to Liberia and Sierra Leone.
Liberia, founded by freed American slaves, has strong ties with the United States, and President Barack Obama is sending 3,000 military personnel to build treatment centres there and train staff.
But for now, there are still only six specialised Ebola Treatment Units (ETUs) for all of Liberia's 4 million people, and hospitals like Ganta's have been forced to step into the breach.
Director Victor Taryor said nurses were currently treating four confirmed Ebola cases and, with more aid arriving as the international community steps up its response, the hospital's eye and fistula departments were being converted into an ETU.
As night falls, Nimba County's commercial hub of Gbarnga empties. Schools there remain shut under an emergency government order, and after 7pm shops, restaurants and bars must also close. Ebola has crippled the local economy.
“The town is not moving like before,” said Christian Karr, whose hotel has been deserted since foreign NGOs pulled out of the region. “The government needs to do more.” - Reuters