News Africa

Tuesday 23 September 2014

'Some think Ebola is witchcraft so they don't come for treatment'

Colin Freeman and David Utekin Freetown

Published 31/07/2014 | 02:30

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Medical personnel spray disinfectant on a person who died from the Ebola virus in  in Foya, Liberia
Medical personnel spray disinfectant on a person who died from the Ebola virus in in Foya, Liberia
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
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

A British doctor fighting the Ebola outbreak in west Africa told last night how belief in witchcraft was hampering the fight to stop the spread of the deadly disease.

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Benjamin Black (32), a volunteer with the charity Medecins Sans Frontieres in Sierra Leone, said that some people in infected areas were not seeking medical treatment as they thought the disease was the work of sorcerers. Belief in witchcraft and traditional medicine is still prevalent in parts of west Africa, particularly the remote rural areas of Sierra Leone, Guinea and Liberia where the outbreak has been concentrated.

Dr Black, who completed a four-day stint earlier this week at an Ebola treatment clinic in Kailahun, near Sierra Leone's northern border with Guinea, said: "There is a section of population here who simply don't believe Ebola is real, they think it is witchcraft and so they don't come to the treatment centres."

Dr Black went to Sierra Leone in June, where he originally expected to be working in maternity wards.

He was seconded to an Ebola clinic in the wake of the spread of the epidemic, the largest of its kind in medical history.

More than 1,200 cases have so far been reported in the three affected nations, with 224 deaths in Sierra Leone, 129 in Liberia, and 319 in Guinea, where the outbreak is thought to have begun.

Among the fatalities in Sierra Leone was Sheik Umar Khan, a doctor who was playing a leading part in the fight against the disease.

Outbreaks

Avoiding a similar fate has been one of the main challenges for Dr Black and his colleagues in the 56-bed clinic at Kailahun, which lies in a densely-forested district that is at the centre of one of the worst outbreaks.

While treating patients, medics must wear an all-encompassing plastic yellow body suit, two face masks, two pairs of gloves, a plastic apron and medical scrubs. In Sierra Leone's humid, tropical heat – temperatures at this time of year are around 80F – those wearing the suits have to be careful not to pass out from the heat.

"I once tried working in it in the heat of midday and could barely last 15 minutes," said Dr Black. "Most of the time we try to start very early in the morning before the sun comes up."

After working, each medic disrobes in a special non-contaminated area, where each garment has to be sprayed with chlorine as it is removed. Outside of work, they also observe a strict "no touch" policy, and even handshakes are forbidden." "A lot of health workers have unfortunately contracted the illness already, and the risks are very high," Dr Black said.

The clinic, he said, operated a triage assessment system to work out which patients were confirmed as having the disease. Many Ebola sufferers do not seem particularly ill at first, complaining only of flu-like coughs or vomiting rather than the nose and eye-bleeds that characterise its later stages.

But doctors can go on certain warning signs, in particular patients saying that they have recently attended a funeral of a friend or relative. Local funeral customs often include the practice of touching and kissing loved ones' bodies, which by that stage are a prime incubator of Ebola.

Dr Black added that many of those referred to the clinic were children, some of whom had already lost both parents to the disease.

"We had one ambulance turn up with a mother and a child in it, but the mother had died during the journey to the clinic, leaving her daughter of eight on her own," he said.

Ebola has a fatality rate of around 90pc, but if treated early enough, patients can fight the disease off. During Dr Black's time at the clinic, every day "a couple" of patients usually pulled through and were discharged.

"The discharges were amazing, emotional occasions, where the whole clinic, from the cleaning staff to the head of the mission, would come out and give big applause," he said.

"The problem is that often the kids are coming out as orphans, and they may face stigma when they get home because they've had Ebola, although we send outreach workers with them to spread the message that they are OK."

Another problem, he added, was that the medics' spaceman-like attire frightened local people. In Guinea, some village chiefs have barred medics from entering, claiming that they are actually spreading the disease. Other teams of doctors have been threatened by mobs with machetes.

"Many patients who come to us are already very sick by the time they do so, and so often all people see at the clinic is a doctor sticking a needle in someone for a blood test and then them dying shortly afterwards," said Dr Black.

"That becomes a conspiracy theory that we are actually injecting them with something that kills them. There is a huge amount of work that needs to be done in terms of education on all this, otherwise this epidemic is just going to continue." (© Daily Telegraph, London)

Telegraph.co.uk

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