“Whenever you arrive at a village to examine people suspected of having the Ebola virus you wear protective gear, but not as elaborate as in a clinic,” explains Dr. Eyal Reinich, an Israeli doctor who works for Doctors Without Borders. “Full protective gear looks threatening and we don’t want to arouse fear when it’s unnecessary. It still doesn’t calm the locals. We’ve had more than one case in which people undergoing examination turned hysterical, bit a team member and fled. We are no longer dealing only with the virus but with the psychosis surrounding it.”
Reinich, one of several Israelis involved in the global fight against Ebola, is currently in Geneva for final tests before returning to Israel, after spending four months near the meeting point of Guinea, Liberia and Sierra Leone, the epicenter of the outbreak of the Ebola epidemic.
The growing testimonies accumulating in the media point to an inconceivable situation, certainly not in the 21st century. This wasn’t a civil war, a violent fundamentalist campaign of conquest, a tornado, earthquake or volcanic eruption. This was a lethal virus, known to the medical community for 40 years, managing to turn the wheels of history. It evokes primal fears and emphasizes yet again every conceivable gap between two extremes of human societies, so separated by geography, economy, technology, ethnicity and culture.
Citizens of Western countries are closely following events, showing great interest. “There needs to be a clear differentiation between the human tragedy unfolding in western Africa, which stemmed from a failure of health services infrastructure and inadequate public systems, and Western nations. Despite the isolated cases appearing in developed countries they are not at risk,” says Prof. Zvi Bentwich, chairman of Physicians for Human Rights-Israel, who knows the area well. Ebola, with all its attendant symptoms, physical and sociological, bewitches as much as it terrifies.
Last month a group of nine people, consisting of government representatives and local World Health Organization workers, aid organizations and journalists, went to the small town of Womey in southeastern Guinea, near the Liberian border. Their purpose was to raise awareness about the spread of the disease. This was their second visit, after local residents had previously caused them to run for their lives. This time it ended in the murder of eight members of the group. The sole survivor managed to escape and hide on the outskirts of the town.
“This town lies in the most afflicted region, between the town of Nzerekore and the Liberian border, and that is where people are the most hostile toward us,” says Reinich. “On this occasion the villagers did not stop at shooting arrows and throwing spears at the group, or burning their vehicles. They simply surrounded the group and killed them with stones and machetes.”
“The causes for the spread of the epidemic are bad government policies, and a lack of clinics and hospitals, doctors and nurses,” says Dr. Yaron Wolman, an Israeli doctor who heads the clinical division at the United Nations Children’s Fund (UNICEF) and has been living in Freetown, Sierra Leone for the last two and a half years. “It is abetted by a lack of trust and superstitions held by the local population. These are deeply held convictions, and their culture involves much touching, hugging and stroking, as well as ceremonies for healing or burying, all involving considerable touching.
“We’ve been trying to deal with the epidemic for two months with no success. The number of dead or infected people in Sierra Leone only continues to rise. The official numbers given are 900 dead and 3,000 infected people. More realistic estimates are three to four times higher, in Liberia and Guinea as well as in Sierra Leone,” says Wolman, whose organization serves as a local health ministry in Sierra Leone.
“We help by bringing in experts and managing the logistics of distributing medicine, bringing in vehicles and protective gear. We work with local communities, trying to convince people to change their patterns of behavior. Since UNICEF usually mainly deals with children, we also deal with many orphans or children whose parents are hospitalized, or children who survived Ebola but whose communities reject them.”
Wolman is not optimistic and sees no end in sight. “We’re now talking of six to nine months until we bring the epidemic under control, but no one really knows how long it will take and at what cost. There is consensus, however, that if we don’t take control in the next few weeks, the epidemic will get out of control.”
Lack of control over the virus and the population is felt in all the infected countries. When Michal Bruk landed in Monrovia, the capital of Liberia, she was required to take her temperature at the airport. When she reached the city, in which a third of the country’s population lives, she realized how the terror evoked by Ebola affects the masses. “I quickly realized that the shanty town of West Point with its 75,000 inhabitants is under isolation and surrounded, following riots and looting in the Ebola clinic located there. In the evenings the city streets were empty,” she says.
Bruk is a project manager and a consultant to various organizations. She arrived in Monrovia as part of an advance team sent by the UN to combat Ebola in Liberia. “As soon as we reached Liberia we realized that logistical assistance to the government and humanitarian groups is critical but complex. There was a shortage of equipment and clinics, and we needed to set up many treatment centers, which locals viewed as infection centers,” she relates.
On Monday, the World Health Organization declared that the outbreak of the Ebola epidemic is the worst and most dangerous health crisis in modern times. Since its detection last March in western Africa, the virus has claimed the lives of at least 4,400 people. More than half of them (2,316) were residents of Liberia. Sierra Leone and Guinea had 930 and 778 casualties, respectively. There were eight deaths in Nigeria, which has declared that it has stopped the spread of the virus. More than 8,900 cases of infection have been documented so far.
The fear of Ebola and the harsh treatment it requires wear down medical teams and lead to a shortage in manpower. “We need more professionals. If we don’t recruit more in the next few weeks there will be disastrous results,” confirms Wolman.
“This is war and we’re on the front lines. This is the time to mobilize. As medical professionals we know the stories of epidemics such as the plague, and we were all educated so that in emergencies we would show solidarity and enlist in order to prevent a similar epidemic in our times. This is the first epidemic on such a scale and we need anyone who can help.”
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