Cheikh Mbaye, WAHA’s General Manager, who has been in Guinea for nearly a month, pleads for a “more inclusive” approach in the fight against Ebola.
“A change of perceptions about the disease is urgently needed in the countries affected by the Ebola outbreak. There have been rumors that the disease doesn’t exist or that it has been imported by the West. Many also believe that you cannot survive the disease and that the bodies of their loved ones are being stolen from them. When people see men in ‘astronaut suits’ take away their children, they are terrified. When their sick loved ones ‘disappear’, confined in health centers with no contact with their family members, they do not understand. Draconian measures, such as closing borders, placing villages and cities under quarantine, mobilizing the army, and establishing curfews, are not the solution.
Countries are trying to contain the epidemic, but their populations are hiding the sick as soon as they get a fever. People are dying at home from malaria and other diseases, which could have been treated. The way Ebola is currently being treated has caused a lot of collateral damage. People are starting to fear one another. Lack of community awareness has led people to place the blame on others; the ‘white man’, or the foreigner. This is what led to the group of eight community mobilizers being killed in Womey, in the South of Guinea, a forest area that is geopolitically isolated and where the population is completely petrified.
Shifting the message
At WAHA, we want to focus on a different approach to the fight against Ebola. We want to work on the root causes of transmission, not just on the consequences of the spread of the disease. We worked with several sociologists and ethnologists, who stress that the epidemic is causing fractures within the affected societies. Populations are having a hard time dealing with these fractures and this has contributed to the further spread of the disease. First, people can no longer touch one another, whereas personal contact is very important in African cultures. Second, family members are losing contact with their sick relatives. Health centers are seen as detention centers; this needs to change. Finally, families are unable to perform funeral rites for their loved ones who have succumbed to the disease. Solutions are needed so that people are not hiding the dead, who are 10 times more contagious than the living. There is a need to attenuate the fear surrounding the disease.
We would like to launch a treatment program within the existing hospitals, not necessarily under tents in separate areas. This will lead to better conditions for the treatment and care of patients and will help reduce tensions. Instead of putting every person suffering from a fever – which can have multiple causes – in transit centers together, we need to create more triage zones, including to ensure the safety of medical personnel. We also want to install video cameras in the treatment centers so that the bond between family members and their sick loved ones remains intact. Hospitals should not be a source of fear, tension, or fractures but must remain safe places.
It is necessary to sensitize health workers. They are not receiving enough protection and they need more training. WAHA has therefore launched a new e-learning training program. At the same time, we will be mobilizing community and religious leaders and the people who clean the bodies of the dead so that they are protected. In Guinea, the Ministries of Health and Education have asked us to implement a training-of-trainers program for schoolteachers. The beginning of the school year has already been postponed twice due to fears that schools may turn into important transmission sources. In order to get children back in school, we will provide 1,000 schools with sanitation kits (hand washing equipment, etc.) and thermometers so that teachers can take their students’ temperature at the beginning and end of each day. We will also establish pediatric transit centers for children in each zone we are working in. Furthermore, we are working with local artists to create a cartoon awareness raising campaign. We will also be working specifically on women’s health because they have been disproportionately affected by the disease. They are the ones taking care of the sick at home and make up a large proportion of the health workers in the health centers.
Going door-to-door is not working anymore; there is too much suspicion and misunderstanding. What really hits me on the ground is the general psychosis and exaggeration, which is fuelling fears about the disease. People are either in absolute fear or in complete denial. Everyone is petrified. No one knows who is infected or can be infected. A more inclusive approach to treating the disease is necessary. The problem needs to be tackled from the source. The military interventions in the three countries most impacted by the disease aim to relieve Médecins sans frontiers, which is on the verge of saturation. However, their arrival may risk fuelling the general psychosis. They will need to remain subtle and tactful. Governments need to help NGOs working on the ground rather than feed fears. Treatment is essential of course, but we also need to work ahead of time to try to contain the spread of the disease. We need to try to change the behaviors that are contributing to the propagation of Ebola. We need to replace the message of fear with a message of hope.“
To learn more about our projects in Guinea, click here.