THE BURNED OVER DISTRICT

Both can kill you and neither has a cure. And that duo is showing its deadly prowess in West Africa right now. Thanks to Stupid, buttressed by ignorance, Ebola is spreading there, including urban areas with access to international airports.

The social stigma attached to Ebola, a hemorrhagic fever that kills as many as 90 percent of its victims, is complicating efforts to contain the worst-ever outbreak of the virus. The disease has claimed more than 600 lives in Guinea, Liberia and Sierra Leone since March, and will continue to spread for another four months, according to the World Health Organization.

Widespread misconceptions, denial and hostility to medical workers are slowing efforts to stop the virus from spreading, the United Nations Children’s Fund said this month. Some people hide when they fall sick, while others believe the disease isn’t real or that white researchers have introduced it to experiment on Africans. Those who survive are often treated as outcasts, Jamila said.

Once a female patient has recovered, she’s no longer infectious, while men can still spread the virus through sex up to seven weeks after recovering, according to the WHO.

The outbreak has exposed weaknesses in the health systems of the affected countries, which are among the poorest in the world and whose crowded capitals lack tap water or sewage systems in all but the wealthy neighborhoods.

“Health systems, particularly on a rural level, aren’t working well,” said Guido Borghese, an adviser on child survival for Unicef in West and Central Africa. “They need to be strengthened, and not just to deal with an epidemic.”

The illness spreads through contact with bodily fluids of infected people, according to the WHO. It causes fever, diarrhea and vomiting, and can lead to bleeding from the eyes, ears and nose. There is no specific treatment or vaccine for the virus, which was first identified in what is now the Democratic Republic of Congo in 1976.
Hygiene Guidelines

The latest outbreak began five months ago in small towns surrounded by dense forests in southeastern Guinea, near the border with Liberia. Since then, it has jumped across two borders and reached the three countries’ capitals. In Guinea, it was able to spread because medical staff ignored basic hygiene guidelines, Minister of Health Remy Lamah said in an interview. Some of the doctors and nurses who died in the first wave of the outbreak didn’t make a habit of washing their hands, he said.

“We paid a high price by not respecting basic standards of hygiene,” Lamah said.

At least 32 health workers have died in the current outbreak, according to the WHO. Medical staff in West Africa often ignore basic precautions, like using gloves for blood tests, Marie-Christine Ferir, emergency program coordinator for Medecins Sans Frontieres, said in an interview. Clinics in rural areas may lack running water or basic equipment like gloves and face masks, she said...

In Liberia, denial and fear are hindering the government’s efforts to contain the outbreak.

“There is high level of denial and there’s the stigma that goes with the disease,” Bernice Dahn, the country’s chief medical officer, told reporters last week. “They go to churches, they go to traditional healers, before they will go to a health facility.”

It’s been difficult to persuade relatives of Ebola victims that they can’t hold a traditional funeral, she said.

“Relatives do not want to see their loved ones buried in a thermic plastic bag,” Dahn said. “They want to touch the body, wash it, dress it.”

Persuading Sierra Leoneans that the disease exists has been difficult, Abubakar Fofanah, deputy minister of health and sanitation, said in an interview. Relatives have broken in to clinics to take patients diagnosed with Ebola home. Last month, youth in a village set fire to drugs they said were meant to kill Ebola patients.

“It’s worrying as more and more people are testing positive and more and more people are dying,” Fofanah said.

When medical personnel ignore basic precautions when dealing with this deadly disease, how can one blame ordinary people who cling to long standing traditions in time of crisis and let their fears lead them further into disaster.

Doctors Without Borders