Front lines of the ebola bio-war

In July 2014, health workers, wearing head-to-toe protective gear, prepare for work, outside an isolation unit in Foya District, Lofa County.

Flights into disaster zones are usually full of aid workers and journalists. Not this time. The plane was one of the first in after some 10 airlines stopped flying to Liberia because of Ebola, and still it was empty.

When I was last in Liberia in 2006, it was to work on reintegration of child soldiers in a time of peace. Now the country is fighting a “biological war” from an unseen enemy without foot soldiers.

As we enter the airport, an unnerving sight – a team of health workers kitted out with masks and gloves asks us to wash our hands with a chlorine solution and takes our temperatures.

It was to be the start of a new routine – the hours and days since, I have had my temperature taken about 15 times and have had to wash my hands with chlorine at the entrance to every building, every office, every store, and every hotel. Even in small villages. And yet ironically, despite all this, few health facilities are properly functioning.

The next morning, the breakfast room at the hotel is buzzing – a large group of scientists from the US Centers for Disease Control and Prevention (CDC) huddle around computers animatedly talking, checking charts and data.

The world’s Ebola experts are here – writing the first draft of Ebola history in real time.

The capital, Monrovia, reveals itself as a city branded by Ebola posters shouting out what people know all too well by now – Ebola is deadly, protect yourself, wash your hands. The talk in the car, on the radio is only about Ebola – people calling in want to know what to do when their child gets sick, they either fear health centres and hospitals or they are not treated.

A colleague tells me she has just lost a family member about to give birth. It was a normal pregnancy, but she was turned away by every hospital as staff were too afraid to take her in case she had Ebola. She did not have the virus, but she died because of delivery complications. Her baby at least survived.

News of the US obstetrician in Liberia who contracted the deadly disease while delivering a baby has helped fuel such worries. So far 169 Liberian health care workers have been affected by Ebola and 80 have died – a massive blow to a fragile health system.

 

A UNICEF worker speaks with residents about the symptoms of Ebola virus disease (EVD) and best practices to help prevent its spread, in Zorzor District, Lofa County, (taken in April 2014).

Next I prepare to go up country to Lofa county where more warehouse space was needed – UNICEF has delivered tonnes of equipment, including personal protective suits, chlorine and oral rehydration salts to Liberia – and more monitoring was required of those other now-neglected childhood killers like measles, diarrhoea and cholera.

Ebola has turned survivors into human booby traps, unexploded ordnance – touch and you die. Ebola psychosis is paralysing.

Heavy rains lash down over the weekend – I shudder to think of Medecins Sans Frontieres and health ministry workers and patients battling under plastic sheeting in such rains. Luckily the skies over Monrovia clear for the hour-and-a-half helicopter ride to the hot-zone border between Sierra Leone, Guinea, and Liberia.

In Voinjama, I’m out with a team of social mobilisers who interact and educate communities. They are playing our song – the one UNICEF Liberia set up, Ebola Is Here – on a megaphone through the village.

The jingle has got Liberians jiving and saving lives. We talk to families about protecting themselves from Ebola. They tell us about a survivor in their community. He came back from the treatment centre, but despite testing negative for the virus infected his girlfriend, who died. The semen of male Ebola survivors remains contagious for a minimum of seven weeks after infection.

The villagers ask if survivors can be isolated.

The doctor at the empty hospital we visit says they suspect any patient who comes with fever, diarrhoea or stomach pains as having Ebola. “Guilty until proven otherwise” is the motto – and people are sent away as medical staff do not have the facilities to cope with the virus.

In the grounds of the local district health office, a burial team comes in looking like crop sprayers, carrying visors and chlorine spray. They had just buried three people who died within 10km (6.2 miles) of each other.We keep a safe distance. Death has no dignity here. The dead are taken and quickly burnt with the plastic suits. Funerals, once a ritual, are now rare.

Ebola-is-real1

One of the psycho-social workers tells us she is dealing with 100 children affected by Ebola in Voinjama alone, many of them orphans. She is not sure what can be done. With schools closed at least until next year, perhaps the country’s 26,000 teachers could be used as trained carers?

Back in Monrovia, we hear a bombshell from the World Health Organization – a huge surge in Ebola is expected. The defence minister tells the UN Security Council Ebola threatens his country’s existence.

The hard times are far from over. They are stoic and brave but when I speak to ordinary Liberians they say they feel abandoned; they need help to treat other diseases too.

In the car with colleagues, they talk almost nostalgically about the long civil war here – a time when the enemy was seen, the rockets were heard, the bullets could be dodged. We try to focus on what we can do – more hygiene kits, beefing up the messaging, getting basic mother and child health care going again.

This is the most unusual and surreal field assignment I have ever undertaken. One of the joys of working for UNICEF is children, picking up babies, playing with them. Here we dare not touch babies; there are no handshakes, no hugs. It’s simply too risky.

Sarah Crowe is Chief of Crisis Communications for UNICEF, and she is currently in Liberia reporting on the epidemic.

A version of this story appeared on BBC News on 10 September 2014.

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