News Comment

Thursday 18 September 2014

Ebola - no cure, no vaccine and the real danger of panic

Dom Hunt

Published 31/07/2014 | 02:30

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Medical staff working with Medecins sans Frontieres (MSF) prepare to bring food to patients kept in an isolation area at the MSF Ebola treatment centre in Kailahun.  Reuters
Medical staff working with Medecins sans Frontieres (MSF) prepare to bring food to patients kept in an isolation area at the MSF Ebola treatment centre in Kailahun. Reuters

Half a year into the Ebola epidemic, the virus is now in three capital cities and is spreading. More than 650 people across Guinea, Liberia and Sierra Leone have now died from Ebola. Health professionals including doctors and nurses have also died of the disease. Two American health workers have been infected in Liberia. Lagos, Africa's largest city (21 million people), is on high alert after a Liberian man died in the airport on arrival last week.

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The situation is escalating and is now officially the largest outbreak ever recorded of the disease. There is no known cure for Ebola, nor is there a vaccine.

I recently travelled to Sierra Leone and could see there are a range of factors that are hindering efforts to stop the spread of the disease. Traditional behaviour around washing dead bodies is still ongoing despite the bodies being highly contagious. The infectious nature of the virus means it can - especially with people such as agricultural workers with minor skin cuts - sometimes be transmitted from person to person with a simple handshake. Those most at risk, however, remain medical workers in the treatment clinics. Initial symptoms of Ebola are non-specific and in many ways resemble malaria. This means that everyone with these symptoms should be treated as a potential case of Ebola - no small task in a country with the fifth-highest prevalence of malaria in the world.

Rumours about the causes and sources of Ebola abound and are affecting the government's ability to control the outbreak. One virulent rumour is that the Ebola virus was purposely introduced to the population, either by the government or by foreign agencies. As a result of this rumour, people are too frightened to attend clinics or hospitals as they are suspicious of health workers, government staff and foreigners. A number of families have been found to be harbouring Ebola patients at home as they are unwilling to admit loved ones to an isolation unit to be treated by faceless doctors in protective clothing. The fear and confusion around the virus is palpable.

Although checkpoints have been established in order to screen travellers for Ebola, they are not always effective. In Freetown, I met a UN employee who told me that at one checkpoint, the officials were considering letting him pass without doing the mandatory temperature checks because he was a white man. Lack of protocols and protective materials is worrisome. Further hindering the efforts at the checkpoints is the long incubation period for the virus - asymptomatic people can easily pass through checkpoints and appear perfectly healthy.

Concern Worldwide is raising public awareness, up-skilling health workers and restocking health centres. Our work includes printing and distributing posters and leaflets and putting radio jingles on local stations. The crucial part of delivering these messages must come from influential people inside communities. It is vital to identify who is trusted and listened to within communities. These people may be imams, mullahs, priests, traditional leaders and healers, chiefs or elders.

In my mind, mental health is one of the big challenges to be addressed in a crisis like this - we need to manage the fear and loss of families who have ill relatives. Part of an effective response to bring a halt to the spread of the virus is managing and assuaging the fears of the population.

What is likely to happen next? There are a number of disquieting scenarios which may play out. The rainy season has begun in West Africa which could potentially spark an outbreak of cholera. Responding to both cholera and Ebola simultaneously would be extremely difficult.

There is a risk that the ripples of fear across communities and towns will evolve into panic and result in insecurity and riots. Just last week, thousands of residents marched on an Ebola treatment centre in Sierra Leone after a former nurse alleged that the virus was invented by health workers. What will happen if quarantines are put in place? Markets would close, travel would be limited, and the quantities of food being imported into and transported around the country would reduce significantly.

I am heartened to see so much information sharing, collaboration and coordination between the governments of affected countries and the humanitarian agencies responding on the ground. Concern Worldwide will do all we can, even as the case rates continue to rise, and to increase our monitoring of the security situation to ensure our staff remain safe.

Dom Hunt is Africa Director of Concern Worldwide

Irish Independent

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