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Still Fighting Ebola: A View from Liberia’s Front Line


A tomb determined in Liberia by a United Nations Mission for Emergency Ebola Response (UNMEER), Flickr

We’ve flattering many sealed off on Ebola in a United States — final week, President Obama withdrew a US troops sent to quarrel a illness — yet in Africa, a news on a widespread has seemed flattering good. The altogether series of famous cases stands during 22,894, with 9,177 deaths, distant next a dire predictions finished final fall that a widespread could disgust millions.

Progress during violence a illness is stalling, though. According to a World Health Organization, a series of new cases has gone behind up for dual weeks in a row. Sierra Leone, now a outbreak’s epicenter, still has what a WHO calls “widespread transmission,” and on Saturday a supervision quarantined partial of a capital. Guinea has had a spike in cases, and in several areas, mobs have pounded clinics.

The news is best from Liberia, where there were usually 3 new cases final week compared to 65 in Guinea and 76 in Sierra Leone. Liberia was hard-hit, with 8,881 reliable cases and 3,826 deaths — 300 cases per week during some points. But it also seems to have finished a many to quell a disease’s spread: Today, schools that had been sealed given final tumble are ostensible to open again.

Last week, though, we had a event to pronounce to a front-line Ebola warrior in Liberia, and what he told me underlined how unsafe that country’s swell is.

courtesy MAP International

F. Zeela Zaizay, pleasantness MAP International

F. Zeela Zaizay is a purebred helper and a Liberian group personality for MAP International, a Christian medical-assistance nonprofit. MAP, that is formed in Atlanta, has sent $1.7 million’ value of supplies such as “no touch” infrared thermometers and protecting apparatus for health workers, and helped classify Ebola-education efforts in townships and on internal radio.

“We are carrying an normal now of reduction than one box per day,” he told me in a Skype call from Monrovia, Liberia’s capital. “That shows we have finished extensive gains in a quarrel opposite Ebola. But a practices that led to a gains we are carrying are being deserted usually as a cases are disappearing too, so it brings about fear. If we are not clever we could have some-more cases again.”

I asked him what practices he meant, and he told me about a problem in persuading people to relinquish appreciated wake rituals: soaking and sauce a body, touching and kissing a corpse, and burying it nearby where a family lives.

“One of a practices we have is showering and showering a dead, and one of a ways we do respect to them is to dispose of them in their home city or village,” Zaizay said. “It is easy to say, do not hold a dead, do not hold a ill — yet if we have a passed family member that we so many honored, we could be tempted to pattern a plan to take a chairman behind to where they were from.”

Under a anti-infection practices promoted by a WHO, a bodies of people who died of Ebola are bagged and buried in special cemeteries, or cremated. In a past dual months, Zaizay said, dual outbreaks in adjoining counties were sparked by people who objected to that diagnosis and retrieved a corpses of desired ones from an Ebola diagnosis section and ecstatic them home for funeral — in one case, sauce a remains in wardrobe and propping it adult in a chair of a car.

The widespread of Ebola behind into communities is formidable to handle, Zaizay added, since some of a townships in Liberia are so lacking in resources and so remote. “Prior to Ebola, many communities had a problem with protected celebration water, since they use aspect H2O — rivers, creeks — for celebration and for bathing,” he explained. “So there is sewage, and also a H2O is really turbid from run off.” Yet removing purify H2O into remote areas is difficult: “Some places, a roads are too bad to drive, and to strech them, we have to go by canoe.” In one remote area, he said, 500-ml bottles of H2O cost 3 times what they do in a capital.

I asked about a upsurge of reserve into a country, and Zaizay mentioned problems that also flush in reports final month: a Liberian economy, already dented by years of polite war, has been undermined by a shelter of unfamiliar businesses and a slack in bland commerce and farming. The first-line recommendation for preventing Ebola is soaking in H2O peaked with whiten after any person-to-person contact, “but many people in Liberia can't means to buy chlorine (bleach),” he said. “Many persons are out of jobs, and with a stop of a tillage season, there is mercantile hardship in a panorama too.”

There are cost hikes as good in a cost of protecting apparatus — gloves, face masks — for health caring workers, he said: “Every health caring workman in Liberia now is really supportive to a use of personal protecting apparatus (“PPE”) and to not putting themselves in harm’s way. Comparing a daily expenditure of PPE and contra a liquid into a country, there is a outrageous demand.” The apparatus is not usually being used in Ebola wards, he added, yet in maternity wards and in surgery, so there is foe within health caring for where a reserve will go. Given a shortages, he said, health workers are tempted to re-use gloves and masks, even yet they know it is a risk.

I asked Zaizay what he suspicion Liberia indispensable many to quarrel a disease, meditative he would contend some-more gloves and whiten to start. Instead, during a tip of his list he put “high peculiarity medications” for diseases other than Ebola. “A third of a health caring offices are now usually conducting triage for Ebola,” he said. Patients with other diseases, such as leprosy and a bacterial illness Buruli ulcer, are fearful to come to those clinics. “If we could take them medications,” he observed, “they would not have to risk hit with ill people and a weight of illness would be less.”

After that, his list enclosed whiten and protecting equipment, and also constructional help: well-digging to urge purify H2O supplies, and connectivity to seaside adult a bad Internet entrance that keeps Ebola cases from being reported.

“We are job out to everybody to support us,” he said. “Support us with chlorine, with medications, with resources. We have proven we have a capability and a strategies and a aplomb to quarrel Ebola. But it is too early for us to contend we have beaten Ebola. We have usually shown that, if we get a support, we can.”


For some-more on a Ebola efforts during MAP International, go here.
This NPR post describes a plea of bettering funeral practices in Liberia, and this book by a initial anthropologists invited to join a WHO Ebola goal describes encountering a problem during progressing outbreaks.
In this post, a staff member during a Centers for Disease Control and Prevention describes a problem of removing to a remote Liberian town.

Article source: http://www.wired.com/2015/02/ebola-liberia/

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