Wednesday, February 21, 2018

Fear, superstition fuel Ebola outbreak

JOHANNESBURG — Even the word was chilling: Ebola. The virus stole into the girl's house in her small eastern Guinea town, invisible as death, and swiftly killed her grandmother and great-aunt. There were dark rumors that Ebola was witchcraft.

Soon her mother and aunt fell sick too. Health workers with Doctors Without Borders came and talked to the family for a long time. Then they donned yellow heavy plastic suits, white plastic aprons, masks and bibs and took 12-year-old Rose, her mother and aunt in an ambulance.

And everybody knew that when they took you away, you never came back.

This is a time of terror in many West African communities as they face the world's worst outbreak of one of the deadliest known diseases, easily spread through bodily fluids and difficult and dangerous to treat. Rose's story, recounted by her nurse, exemplifies the fear — and sometimes bravery — that comes with the outbreak.

In the Doctors Without Borders isolation ward, things got worse for Rose's family. Her mother, feeling depressed and hopeless, gave up, waiting for death. Her aunt was also sure she was going to die.

"No, you're not," Rose insisted.

But they were right to be afraid. Only about 40 percent of those sickened in the outbreak have survived.

The head of the World Health Organization said Friday that the disease was moving faster than efforts to curb it, with potentially catastrophic consequences.

The assessment was among the most dire since the outbreak was identified in March. The outbreak has been blamed for the deaths of 729 people, according to WHO figures, and left more than 1,300 people with confirmed or suspected infections.

Dr. Margaret Chan, the WHO director general, met Friday with the leaders of the three most affected countries — Guinea, Liberia and Sierra Leone — in Conakry, the Guinean capital, for the introduction of a $100 million plan to deploy hundreds more medical professionals.

"This meeting must mark a turning point in the outbreak response," Chan said, according to a WHO transcript of her remarks. "If the situation continues to deteriorate, the consequences can be catastrophic in terms of lost lives but also severe socioeconomic disruption and a high risk of spread to other countries."

For some international health workers, the hardest thing isn't wearing the suffocating plastic suits in the humid West African heat. Nor is it the impossible-to-answer questions from terrified people as they watch loved ones being taken away.

It is the children in their cribs in the isolation units. Toys are placed in the beds with them, and the cribs are placed near windows, so people outside the unit can wave.

"The people inside the treatment center are completely alone. We can't be there with them for hours on end. We have to go in and out," said Monia Sayah, a Doctors Without Borders nurse who recently returned home to the United States after treating patients and counseling families for 11 weeks in Guinea.

Sayah said she was especially moved by the children. There was Rose, the 12-year-old who refused to give up. There were babies whom she sadly watched die. She saw no child under 4 survive Ebola.

Doctors Without Borders encourages family members of patients, especially relatives of small children, to don protective garments and go into the isolation ward to be with them. But some are too afraid.

Michael Stulman of Catholic Relief Services, currently in Sierra Leone, said the outbreak is likely to worsen.

"This is a scary virus and it can kill you, and the majority of people with it are dying. As soon as someone from the World Health Organization shows up and says your family member or friend has tested positive and we need to monitor you, people get scared and they hide."

One of Sayah's roles was to visit the homes of suspected victims and take people with her to treatment facilities. She encountered suspicion, mistrust and even hostility. Yet some people understand that the doctors are there to help.

When Rose's mother and aunt were at their lowest points in the Doctors Without Borders isolation ward, the girl was at her most determinedly cheerful. She knew all the staff and patients by name. She chirped and chattered.

"She was very brave, very mature," Sayah said. "She was taking care of her mother, who was very sick. She was very strong and very dynamic."

When her mother or aunt lost hope, she kept coaxing them. She told them to keep drinking water.

"They were very depressed and thought they were going to die," Sayah said. But they recovered and eventually went home. Rose, still infectious, had to stay on in an isolation facility.

Rose was one of the lucky ones. She recovered and went home. But afterward, she came back every day to the place where she had nearly died.

"She and her aunt came back every day to the facility to see us," Sayah said. "They just needed to come back."

 
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