stigma

Gambian in New York recounts others fears of him

By Cherno Baba Jallow.

WestWestAfricaMap

As a West African, originally from Gambia, I am relieved that the glare of publicity about Ebola in New York City is waning along with the spread of the disease.

At the height of the Ebola crisis in the city, just around the time in October when Dr. Craig Spencer fell ill, I and other West Africans I knew here were scared of being tarred with the broad brush of Ebola, as if the deadly disease were endemic to the region and to us, even though its first flare up was in Central Africa in the 1970s.

Everywhere in the city, Ebola was a topic of discussion: in barbershops, in schools, in West African shops on 116th Street in Harlem. The barrage of Ebola news was inundating, inescapable for a West African like me.

One day I took a cab from 116th Street in Harlem heading home to Washington Heights. The cab driver, upon realizing my accent, asked about my nationality. I am a naturalized American but I replied, “Gambia.” He asked, “Where is that?” I responded: “West Africa.” Suddenly, and just as I had expected, an eerie silence fell upon us. A few minutes later, the driver, perhaps unsure of what to make of me, asked more questions: “So is your country safe from Ebola?” “How far is your country from Guinea?” “When was the last time you went home?”

I have not visited Gambia for years now, certainly not during the recent Ebola crisis in West Africa. But I reckoned that the driver was simply trying to be sure I had not come from any of the affected countries in the sub-region or gotten anywhere close to them. He was in danger-control mode. I wondered to myself that evening after he dropped me off if he had been comforted enough by what I had told him. Or if he was going to do his own “Ebola cleanup” inside his cab. I wasn’t sure.

On October 30, the famous singer Angelique Kidjo from Benin, West Africa, penned an op-ed in the New York Times recounting a similar encounter she had with a New York cab driver: “When I jumped into a taxi in New York recently,” she writes, “the driver asked me where I came from. When I said “I am West African,” he muttered one word: Ebola.”

The stigma of Ebola, like most stigmas, is fueled by ignorance, the reflexive inclination to lump all groups, and in this case, all countries, together. Yes, Ebola is in West Africa, but it is mainly in three countries: Guinea, Sierra Leone and Liberia. Yes, it is in those countries, but it is in certain areas, not the entire swathes of land, in each of those countries. Even though health agencies clearly labeled the affected countries on the African map, to help in the geographical understanding of the disease, some people still persisted in painting the entire West African region or the continent as a whole with the same image of Ebola.

It is hard to fight and overcome stigma, especially when it is ubiquitous and propelled into the public consciousness by a plethora of social media bent on providing information without context. In my interactions with some people in New York City, I have had to simply bat away their allusive comments about my West African-ness in connection with the spread of Ebola. I used to be upset. But I no longer am. Maybe because people have stopped asking me about Ebola.

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Focus on girls in Sierra Leone amid Ebola

Chernor Bah, a global youth advocate and education activist from Sierra Leone, recently returned from a visit to his home country. He discussed his findings with Judith Bruce.

Judith Bruce is a policy analyst at the Population Council, whose work helps build the health, social and cognitive assets of girls in the poorest communities in the developing world. Bah was one of the founders of the Sierra Leone Adolescent Girls Network, designed to reach vulnerable girls throughout the country.

Bruce: You have recently returned from Sierra Leone. In the course of your visit you focused on the impact on girls, and you also met with political leaders and those who control important policy decisions related to the national response to Ebola. How did you explain to them that we should also be focusing on girls at this time?

Bah: Here’s why we should be focusing on girls at this time: Dorcas is 17 years old. Her mom contracted Ebola when treating a patient in the clinic where she was a nurse. Dorcas took care of her mom when she was sick at home. Her dad, her elder sister and her mom were all infected and admitted. At the hospital, after her mom and elder sister died, Dorcas was helping to take care of her dad – even in the ward where they were both sick. Her father eventually died. Dorcas survived. She is left with her two younger siblings, who have become her primary responsibility. She is now the breadwinner and without support might be forced to engage in risky behaviors to fend for herself and her family. She is also unsure of returning to school, as there is no one to take care of her or pay her [tuition] fees.

Unfortunately, her story is not unique. Many of the 30-plus girl survivors of Ebola told me varying versions of a similar story. Girls in Sierra Leone are typically the primary caregivers in the home and in the community, especially for sick relatives.

Despite being primary caregivers, girls typically have less education and even lesser access to scientifically based information. And, despite carrying provisioning responsibility, they have less access to public services.

When emergency distributions are done in communities … girls, who bear the biggest burden, are the last to get anything.

If we don’t begin with the girls, we won’t get to them.

Bruce: We hear that there is a 70 percent mortality rate, but that also means 30 percent survive. How are female survivors being treated?

Bah: Girls who have survived Ebola are super girls. They are celebrated publicly for defeating the virus, but in their communities they have less social capital. They are stigmatized and have fewer friends; they might have lost parents, loved ones or benefactors, and have very little – if any – help from the government.

Fortunately, we mostly know who they are. If they have survived Ebola, it means they have been in a health clinic, where their data was recorded. Figuring out a way of first creating a support system for these girls will be crucial. Connecting them with each other in potential Ebola survivors’ clubs could be one way. It would provide social assets and capital, provide platforms to share their stories and support. They could also be powerful role models for girls, in a society where those are few and far between.

Bruce: Before Ebola, there was already a long-standing culture of sexual exploitation; that is, some girls depended on sexual exchange for basic necessities for themselves and their families. What is the situation now?

Bah: Every girl I spoke to expressed concerns about the increase in transactional sexual exploitation. In fact, girls in Port Loko, north of the country, which has been badly hit by the virus and is now under quarantine, told me that they have friends who are now pregnant and will never return to school. We have received reports of police officers – assigned to enforce the quarantine of households – sexually molesting young females. Bear in mind that typically during school holidays, when girls are at home, there is normally a spike in sexual abuse and exploitation and early marriage. Now you have communities that are shut down or economically depressed, men and young girls are home all day and no one knows when it’s all going to end. As one girl put it to me, it’s not a very safe time to be a girl.

Bruce: We’ve heard that many of the groups originally working on programs for girls have left the country or shut down their operations. Is that true?

Bah: Amid the shock of the epidemic, the government and the donors basically instructed that all programs that were not directly dealing with Ebola be shut down, and that funds all be redirected to fighting the epidemic. So these groups have, for the most part, been on the sidelines, watching helplessly as they see girls falling further behind. I worked with UNFPA (the United Nations Population Fund) to pull together a major meeting with the members of the network, and the first thing I should say was the sense of relief and excitement that they could come together to discuss how the virus was affecting girls and their programs. They were disappointed that their programs have generally been shut down, and many have been told they can’t proceed with their normal activities, including community outreach and other alternative social safety-net programs that they say are critical for the poorest girls they serve.

Some fear a spike in sexual violence and the exploitation of young girls, an increase in teenage pregnancy and forced marriages, an increase in fistula, an increase in maternal mortality and, of course, more girls will drop out of school permanently during this long, unprecedented break in education.

Bruce: How has the emergency affected policies and programs designed to reach girls and young women?

Bah: One of the critical challenges we often face in Sierra Leone is the invisibility of girls in national policies and programs. Youth programs, government policy and interventions – under normal circumstances – typically exclude girls. It gets worse in an emergency. As the president of the country told me in a private conversation, the government was shocked and overwhelmed by this epidemic, and has been playing catch-up ever since.

While in Sierra Leone I was able to review the Reproductive Health Strategy that was being proposed by the government and its partners to respond to the sharp decline in the availability of reproductive services during the outbreak. In some cases, there had been up to a 100 percent drop in the provision of basic contraceptive services for women and girls. The core concept of the strategy was to be the creation of 17 dedicated Reproductive Health Service Centers in each of the districts across the country, but it barely referenced the unique needs of girls or had mechanisms to foster their use of these services. Thankfully, working with the partners, especially UNFPA, we were able to review the proposal to include a stand-alone adolescent girls pillar. This will increase girls’ access to these services.

How Liberian children orphaned by ebola are stigmatized

Liberia children orphaned, ostracized by Ebola | BY KRISTA LARSON | OCT. 9, 2014

First 16-year-old Promise Cooper’s mother complained of a hurting head and raging fever, and she died days later on the way to the hospital.

The following month, her father developed the same headache and fever. Her baby brother grew listless and sick too, and refused to take a bottle.

That’s when Promise knew this was not malaria.

She had heard about Ebola on the radio. When she tended to her father, she washed her hands immediately afterward. Desperate to keep her three younger siblings safe, she urged them to play outside their one-room home. Yet she was powerless before an invisible enemy, as her family of seven disintegrated around her.

In the meantime, neighbors and relatives were starting to become suspicious. No one came by to check on the kids, not even their grandparents.

Word, like the virus, was spreading through Liberia’s capital:The Coopers had Ebola.

___

In Liberia’s large, deeply religious families, there is usually an aunty somewhere willing to take in a child who has lost a parent. But Ebola, and the fear of contagion and death, is now unraveling bonds that have lasted for generations.

At least 3,700 children across Liberia, Guinea and Sierra Leone have lost one or more parents to Ebola, according to the U.N. children’s agency, and that figure is expected to double by mid-October. Many of these children are left to fend for themselves, and continue to live inside infected houses.

Promise was used to looking after her younger siblings, and often carried a baby cousin on her hip around the neighborhood. When her mother was alive, they would alternate weeks of cooking. She knew how to make porridge for breakfast, rice with potato greens for dinner.

When her father fell sick, she took over all the things her mother used to do. There was no school because of the Ebola epidemic, so she had time to wash her brothers’ soccer jerseys and jeans.

But nothing she did could help 5-month-old Success, whose name reflected his parents’ dreams. Just like their mother, the little boy died. There was nobody to help them and no ambulance to spare, so his body stayed in the house for several days.

By the time the ambulance finally came to take away her father and the tiny corpse bundled in blankets, 11-year-old Emmanuel Jr. was stricken too.

Promise watched as medics packed half her family into the back of the ambulance. She was now alone with 15-year-old Benson and 13-year-old Ruth.

She could not afford a phone call to see how their father and brother were doing, even if she could get through on the hotline for relatives that was almost always busy. A taxi to the Ebola clinic across town cost even more. An uncle stopped by to drop off some money, but left without touching the children for fear of infection.

Promise resolved to keep the family together until her father came back.

She decided to use what little cash she had to buy plastic bags of drinking water. The family had a cooler, and she planned to sell the bags she bought at $1 a piece for $2.

Day after day, though, no customers came. Nobody wanted to buy water from the girl whose mother died of Ebola, and whose father and brother were at the clinic. Promise looked healthy, but fear was overcoming compassion in the St. Paul Bridge neighborhood where they lived.

If the children sat down somewhere, people would spray bleach after they got up. When they tried to buy something with what little money they had, vendors refused to serve them.

Neighbors didn’t want the Cooper boys playing with their children. And even though health workers had disinfected the path from the well that went right past their house, women took their brightly colored plastic buckets the long way around instead.

Promise, overcome with grief and beaten down by stigma, became depressed.

“Why don’t you want to talk to me? Why God does nobody want to come around?” she sobbed. “We are human beings.”

____

Finally she scraped together enough change from a cousin to take a taxi to the gates of the Ebola clinic. A security guard said he would check whether Emmanuel Cooper Sr. was on the list of the living.

Promise and Ruth paced outside the barbed-wire topped walls of the clinic for what felt like hours, waiting for an answer on when he would be coming home.

The guard came back. He said he was sorry, but their father was dead.

The girls broke down sobbing.

No one could tell them if 11-year-old Emmanuel was still alive.

___

Even as Promise lost both her parents, another man in the community was trying to document just how many children were orphaned in the St. Paul Bridge community. Kanyean Molton Farley, a human rights researcher by day, devoted all his spare time to making a list of the now 28 parentless children living alone. In most cases, teenagers like Promise are now raising their siblings amid an overwhelmed social welfare system.

“The story of the Cooper children touched my gut, and I never stopped coming back,” he said one morning, as he dropped off soap for the children.

The family’s rent was already paid through the end of the year, but they soon ran out of money to pay the electricity. Farley worried most of all that Promise could fall prey to an older man. At 16 and hungry, she was vulnerable to abuse.

Then the Cooper children caught a lucky break: Promise saw her brother’s face on television, among government photos of children who had survived Ebola at the city’s clinics but were still separated from their families.

“It’s him, it’s him!” she told Farley. Off they went to get Emmanuel — the first in the family to survive the plague sweeping their neighborhood.

Not long after Emmanuel came home, Ruth became feverish and unwell one night. How could this be happening again? A terrified Promise called their friend Farley late at night. He couldn’t come until morning because of the curfew.

So he told her to use the family’s mattresses as room dividers in the single bedroom where they all slept. Ruth would stay on one side; the healthy children would sleep on the other.

At first light, an ambulance called by Farley took Ruth to the hospital.

___

Now it is just Promise and the boys.

She insists they will never go live with strangers. Yet they no longer want to stay in the house where their parents lay dying and their brother’s body sat for days.

On a Sunday afternoon after church, there is no television to watch without electricity. The TV set sits gathering dust with a soiled stuffed unicorn on top of it.

The children sleep together in their parents’ bed at night, instead of crowding on the floor below as they did in their previous life. Some nights her brothers weep for their mother, and Promise tries to be firm but caring.

“I tell them Ma and Pa are no more, and that they shouldn’t worry about that,” she says. “We must concentrate on living our lives because they are gone.”

Just a few weeks ago, their aunt Helen came around to the house — the first family member to do so in months. She had been upcountry when the children’s parents died and wanted to see how they were doing.

It pains her to think of her brother, and what he would say about the children out of school, cooking and cleaning for themselves.

“I have to come back because everyone has abandoned them,” says Helen Kangbo, breast-feeding her 1-year-old daughter Faith after joining her nieces and nephews for a paltry dinner of rice. “I must have the courage to come.”

Of course, now that Helen is in contact with the children, she is shunned by the same extended family that fears Promise and her siblings.

Each day Promise mixes up bleach and water in bottles to keep the house and her brothers clean. “Don’t go around people. Don’t touch your friends. Anything you touch, you wash your hands,” she scolds them.

Days later, she says her prayers have been answered: After three weeks at an Ebola treatment center, 13-year-old Ruth is cured. She is still weak, so she is staying with Farley’s family. When Ruth is well enough she will return home.

Here in their house, there is little trace left of dead loved ones, because authorities have burned their parents’ clothing in a bid to stop the spread of the disease. The only photos of their parents are on their voter ID cards. And the only reminder of Success is the two bottles of baby powder, still sitting on a table in the room.

Follow Krista Larson at https://www.twitter.com/klarsonafrica

Interview with Fiancé of Ebola Victim Nurse Justina Ejelonu

Originally posted by

Dennis-Akagha

Dennis Akagha and his late fiance, Justina Ejelonu. See note at bottom about how the media doctored this photo.

Vanguard Newspaper interviewed Dennis Akagha, fiancé of nurse, Justina Ejelonu who died from Ebola.

She was pregnant and so her immune system was weak, which made it easy for her to contract the disease. On that first day which was a Monday, she was having some pregnancy symptoms, but I just encouraged her to go because it was her first day at work.

Sawyer (Ebola source) was her first patient. The next day, Tuesday, she didn’t work on Sawyer. Wednesday and Thursday, she was off. Then on Friday, Patrick Sawyer died. They didn’t know he had Ebola, it was three days later that they realized it was Ebola.

It was after Sawyer died that she told me she nursed him but that she was on gloves. She even thanked God that she didn’t have direct contact with him. The fever continued and we thought it was just pregnancy symptoms and even when she went to her hospital, they confirmed the same thing. She took drugs and ran tests, yet it persisted. At night, she was usually cold and feverish and her body temperature was usually very high. At a point, I began to suspect that she had contacted the virus. I did some research on the disease and realised that she was having similar symptoms.

On the 14th of August, it became serious, she started stooling and vomiting. I had to clean up everything. All of a sudden, she started bleeding and she started crying that she had lost the pregnancy. I had to call her relatives and other people. The bleeding persisted and I had to clean up everything.

Initially I was not wearing gloves because I felt I had already been exposed to the virus. But later I cautioned myself and started wearing nylon on my hands. But I couldn’t stay away from her. I kept consoling her.

Even when I took her to the hospital, she wanted to hold me and I told her to also consider my safety. She managed to hold herself and was able to find her way out in a pool of her blood. Justina was on the floor for 30 minutes before she was attended to. She was screaming that she was going to die. She was seriously bleeding, she had to come out of the taxi and lay on the floor. I ran around, trying to get doctors to attend to her. After everything, they took her in, took her blood samples and the following day, the result came out that it was Ebola. They washed the taxi with chlorine and also bathed the taxi driver and I with chlorine spray.

At that point, the taxi driver knew what was going on, he couldn’t even take me home because he was so scared. I had to look for somewhere to pass the night in the hospital. Early the next morning, I left the Hospital. The taxi driver is alive today, nothing happened to him. We have been checking on him and the last time we spoke he told me, he was fine.

14 days after I was exposed to Ebola, my temperature rose from the usual 35.2 degrees centigrade to 37.2. The Lagos State government gave me a thermometer the day I dropped Justina off at the centre. It took them two straight weeks to visit my home and to disinfect it. Before they came, I had already done what I could do. I used bleach and detergent to clean the whole house, furniture and clothes inclusive.

I contacted the virus because Justina was very sick and I was taking care of her without any appropriate protection. When we knew what we were dealing with it was almost too late for me as I had already contacted the virus.

The Lagos State government sent health professionals to check on me regularly to know how l was doing or if I had the signs of the virus manifesting. So they used to come around to check on me. At some point the Nigerian Government officials created scenes with their visits. I was embarrassed and I was stigmatized. I complained severely to them that I didn’t like what they were doing. Then, one Saturday they visited again, I complained about the pains I was beginning to experience; excruciating pains around my waist.

I started praying and asking people to pray for me.

The doctors, who were supposed to do an evacuation on her couldn’t do it because they claimed that an evacuation was too risky as she was heavily infected and may pass on the virus to another person.

Since nothing was done even after the bleeding had stopped, it led to more complications for her because the already dead foetus somehow got rotten in the womb and started a damaging process which led to further complication. Meanwhile, she was still stooling and vomiting and since nobody could dare to touch her, she was left on top of her excretions even when she couldn’t do much for herself due to her weak state. She was given her incisions and other drugs.

I wished I was a doctor myself; I would have taken the risk of doing the evacuation because it really affected her.

The last day I saw her, I had to go inside the ward because she was so unkempt as nobody attended to her. At that time, the quarantined patients were in the former facility where there was no water and she had messed up herself again. I had to look for water to clean her up, change her pampers and arrange her bedding. Since I was aware of what I was dealing with, I got myself protected while cleaning up the place. I made sure she looked better than when I saw her. Justina was shivering the last day I saw her, one side of her stomach was already swollen, and her legs were also swollen. I prayed for her. At a point, she needed oxygen and the hospital couldn’t provide it. Her friends had to provide it. That was the last day I saw her.

On Sunday Morning, I called her line like I usually did before visiting her, but she didn’t pick her calls. When I got to the hospital, I was told that she was dead.

Yes, in fact she called me that last day and I knew she was going to give up, because she was saying some funny things. She said I should tell my people to go and meet her father so as to finalize our marriage plans, that she’s leaving that place.

On how he survived Ebola
I personally don’t believe in taking medications. I had the mentality that I wasn’t sick. I told the government what I was experiencing. On the day they came to pick me up for treatment, all of a sudden, my temperature went back to normal. The shivering and pains were all gone. So they decided that they would be checking on me. But it got to a point people stopped selling things to me, because of stigma.

I was kept in a ward known as the “suspected ward.” The result came out and it was positive. I was then taken to a confined ward. One of the doctors from UNICEF, a white lady told me that they were having issues with the results and that they would have to re-run the tests. They did the tests again and it was still positive. I told them that it wasn’t my result and that I was healthy. I was even doing my usual exercises (press-ups) every morning. I kept telling them that I wasn’t sick. They took my blood sample the third time. That night, they told me that I tested negative in the last result and that I don’t have any reason to remain there. That was how I was discharged.

I believe the Holy Spirit healed me. The Sunday after I was released I thanked God on my own. I didn’t go to church or anywhere because of the already established stigma but today I can confidently attend church activities because I guess they all know I’m free now.

Dennis Akagha