Ebola

Maybe you’ve heard, maybe you haven’t – I’m really uncertain as to how publicized this has been in the outside world – but, Guinea, Liberia and Sierra Leone are dealing with an outbreak of Ebola.  My knowledge is like a patchwork quilt; various bits have been culled from Guinean news sources, the BBC, Peace Corps Guinea, the CDC, and a Peace Corps volunteer who did post-grad research on the virus. 

I’d like to share that knowledge, as well as some personal experiences in the hopes of shedding some light on the situation for you.

To begin, this is the first time the Ebola virus has been identified this far west in Africa.  The closest outbreak took place in 1994 in Cote d’Ivoire, and the most recent was in 2012 in Uganda.  The virus was originally identified in 1976 in the Ebola river of Zaire (now the Democratic Republic of Congo).  Among its natural hosts are chimpanzees, monkeys, bats, and rodents.  Animal-to-human transmission has occurred when people come into contact with the bodily fluids of infected animals, generally through consumption of undercooked meat.  It’s suspected that Guinea’s introduction to Ebola happened when people in the southeastern Forest region ate undercooked bat meat. 

In humans, the virus initially presents flu-like symptoms, but quickly transitions into a much more extreme illness.  People suffer from high-fever, diarrhea, vomiting, and both internal and external bleeding.  As of yet, there is no medicinal cure or vaccination for Ebola, so treatment involves strict isolation and fluid-replacement.  Unfortunately, the fatality rate in this outbreak has been in the 75%-85% range.  Currently, Doctors Without Borders, the World Health Organization, and Red Cross are collaborating to contain the virus and treat those infected in Guinea, Liberia and Sierra Leone.

Human-to-human transmission occurs when people come into direct contact with the bodily fluids of an infected person who is severly symptomatic.  It’s not airborne, so it’s not transmissible as the common cold is transmissible.  Transmission requires a significant amount of exposure to a violently ill person and so, as in the past, those who have contracted Ebola in Guinea have been family members and medical staff that provided direct care to Ebola patients.  Now, since it sounds like containment of Ebola should be a quick fix – just don’t touch sick people, right? – here’s a little explanation as to why the virus has endured for so long this time around.

Guinea, Sierra Leone and Liberia share similar customs when it comes to treating sickness and dealing with death.  Family members are expected to visit the ill, to lavish care upon them, and to spend a significant amount of time in their presence.  If the sick person passes away, family members clean the body by hand before burial.  When a person passes away due to Ebola, their body remains a source of contagion, a previously little-known fact to those living in rural West Africa.  Unfortunately, hygeinic practices in these rural regions vary widely, dependant mainly on the amount of education of the parties involved and the accessibility of soap, clean water, and bleach.  As you might expect, rural West Africa faces a dearth of adequate medical facilities, trained health care providers, well-trained health educators, and cleaning agents.  Before Ebola was confirmed in Guinea, many unsuspecting people traveled to pay their respects at family funerals, came into contact with the deceased, contracted the virus, and then returned home in Guinea, Sierra Leone, and Liberia.  Now, people can contract Ebola and remain asymptomatic for up to 21 days.  During this time they are not contagious, and do not appear to be sick in the slightest.  This has been the reason for the wide geographical spread of Ebola.

Overview completed, on to the more personal aspect of the outbreak now.

Misinformation and stigma have contributed to the continuation of the outbreak in Guinea.  In Macenta a group of people attacked a Doctors Without Borders isolation unit, taking their sick family members out and returning home.  The family members threw rocks at the health care providers, and so the organization temporarily vacated the site to protect their staff’s safety.  There are rumors floating around, inspired by distrust of foreigners and foreign aid, blaming non-Africans for conspiring to spread the disease.  Many people still do not understand how Ebola is transmitted, hell, most in my village have a very limited understanding of how viruses work at all, but I don’t want to give the impression that there is widespread panic in Guinea.  I think certain newspapers have already done an adequate job of painting this area as a chaotic mass of mindless and virulent savages, I want to do my part to quash that image.  Please take all information you read or see on the TV with a grain of salt.  People are not panicking, but they are confused.  Fear is definitely a player here, but what appears to be most frustrating for Guineans is the seeming lack of interest on the part of governing bodies, both domestic and foreign.  Thanks to collaboration between the aforementioned international organizations and Guinean citizens, I have seen improvements in hygeinic practices within the past few months, both myself and other volunteers have participated in awareness-raising campaigns, and Ebola has become a topic of intellectual discussion as opposed to a symbol of destruction.  I have witnessed students educating their parents, and have heard of medical staff training villagers to complete their religious duties while protecting their health.  As a Peace Corps volunteers, we’re kept up-to-date on Ebola outbreak developments, and we are prohibited from spending time in medical facilities.  Overall, there is calm and there is hope over on this side of the Atlantic.

There now, that concludes this rather worrisome post.  

I’m working on a big culminating entry, so keep your eyes peeled!

Much love!