Dispelling Ebola Myths

Jungle trek across 4 flooded rivers, up hill and down dale
to reach some of our more rural communities. 

And what an emotional roller-coaster this one is. I can go from desperate sadness to frustrated anger to laughter to pride to fear in a matter of minutes.
Hearing the confusion and panic as people ask their questions about the realities of ebola and realising how many will lose their lives, not from ebola but from fear of going to a health clinic now for treatable diseases such as malaria, is just so incredibly sad.  The chief in Maronka told me when I arrived back in Sierra Leone that he knew I really loved Sierra Leone now, because I had come back to die with them!  Yes I love Sierra Leone and Yes, I love the Maronka community but No, I have not come back to die yet! The weight of the fear even in communities that are so so unlikely to come into contact with the disease, is incredible.  I have met one person since coming back who has ever met anyone who has met anyone who has had ebola.  She was a nurse training nurses and some of her students continued to treat people at home, despite clear advice not to.  Two of them died. Although we operate in the Port Loko District and there have been over 30 cases there now, they are far from where we work.  They are all focused around a hospital to which a number of Guinean patients came to see a particular Doctor who worked there.  This hospital is an hour's drive from where we work.
The irresponsible, in my view, reporting by the vast majority of the media will kill so many more people than ebola will.  When British Airways chose to stop flying to Sierra Leone and Liberia, the wave of panic that swept the country was incredible. And, as nearly all the foreigners that could, fled the country or cancelled their returns, what are the Sierra Leoneans to think but that ebola is indeed lurking behind every tree to catch them? I have not succeeded terribly well in controlling my anger at the lack of thinking that goes into sensationalising this situation. It has taken us over a decade to start to rebrand Sierra Leone as other than that country where people have their hands chopped off!  How long will it take us to rebrand after the panic-mongering from ebola?
The other anger making aspect is the corruption fiesta going on as government members fight each other for a slice of the ebola money pie!  How terrible and how hard to watch!
Since coming back on 9th August, I have been going from one EducAid site to another to clarify three simple messages:
1 Ebola is real (and not a government ploy to get money from donor countries or a trick by health workers to be able to harvest organs or any of the other conspiracy stories in circulation).
2 Ebola is avoidable. You have to be in direct physical contact with the body fluid of a seriously sick infected ebola patient or infected corpse. That means that if you are not a health worker or taking care of a sick person at home, you are very very unlikely to get it but to be doubly sure, avoid unnecessary travelling around the country and unnecessary touching: greet with your hand on your heart rather than shaking hands etc.
3 Ebola is survivable.  There are well over 200 Ebola survivors in Sierra Leone. If you report quickly, you are likely to survive because you will get treatment quickly. If you don't report you will likely die but it will more probably be of malaria or some other treatable illness than of ebola anyway. With any symptoms, get yourself to a clinic for treatment and call 117 if there are problems.
As we tell people these simple messages, we can see the tension in the room drop and people thank us profusely for coming with the information and making things clear to them.
And when we are tired from our trekking and our talking, all we need is a little bit of running in the rain, slipping and sliding in the mud to cheer us up and to have us laughing at the normal joys of life!
I am one very lucky woman to have such an amazing team of committed staff and students who love their country and believe in their ability to make a difference to situations by their love, integrity, determination and education! I am more than ever proud of the EducAid team.
This is a setback for Sierra Leone but we will survive and EducAid will continue to fight for thinking education for all.
If you read nothing else on ebola, I would like to recommend a really excellent article.  Please do read it and spread it far and wide.  It has such a helpful perspective:
http://www.theguardian.com/commentisfree/2014/aug/05/ebola-worrying-disease
If you would like to know more about EducAid's work with vulnerable young Sierra Leoneans, please go to www.educaid.org.uk

Great news from Augustine Bundor (EducAid's first Dr to be)

Augustine in his lab coat in class.

Augustine has just got in touch to say that he has received his end of 4th year results from the College of Medical and Allied Health Sciences (COMAHS). He is promoted to his 5th year studies with a credit in medicine!
Augustine came to EducAid, having left school for 8 years from 1995 to 2003. He had been training as a welder and an electrician
informally, when he heard about a new free secondary school in the area. When he first started with us, he was literally sleeping in a disused freezer down the road from the school. Life was far from easy.
Augustine decided to try and become a doctor after a particularly difficult argument with me. He had been given a long list of medicines at the hospital which they said he needed. I looked them up and discarded them as unnecessary one after the other and gave him some paracetomol. He was furious, at the time, and threw them at me. Later, on further discussion, it made him wonder about the qualifications and attitudes of those in the medical profession here and he resolved to do a better job himself, if given the opportunity.

Augustine Bundor's selfie in the 'boys' room' in Lumley.

Today, after many years of struggling with the various challenges of life in the College of Medicine, he is coming up trumps. We look forward to seeing him continuing on his path of success and are very happy and proud that he is one of ours.
All the very best as you continue your studies, Augustine. Congratulations on your successes so far. We are confident in your ability to run the race and to start soon to be part of the fight for better quality healthcare - so clearly a desperate, desperate need.
You are going to have an amazing story to tell your grand-children!
If you are interested in knowing more about EducAid's work with vulnerable young Sierra Leoneans, please go to www.educaid.org.uk

EducAid Position Statement on Recent Cases of Ebola Hemorrhagic Fever in Guinea and Sierra Leone

Ebola hemorrhagic fever (Ebola HF) is a Viral Haemorrhagic Fever. It is a severe,

often fatal disease in humans and nonhuman primates (such as monkeys, gorillas,

and chimpanzees).

President Ernest Bai Koroma has declared a state of emergency in response to the

current outbreak of Ebola HF in West Africa. It is essential that all students and

staff adhere to official guidance issued by the Sierra Leonean Government that

is aimed at controlling the spread of Ebola HF during the state of emergency.

____________________________

Volunteers

Volunteers must follow the advice issued by the UK government and the World

Health Organisation:

https://www.gov.uk/foreign-travel-advice/sierra-leone

http://www.who.int/ith/updates/20140421/en/

These sites are updated frequently and must be consulted prior to travel to Sierra

Leone.

Staff and students in Sierra Leone

How are Ebola viruses spread between humans?

   •    direct contact with the blood or secretions (including saliva and sweat) of an

         infected person

   •    exposure to objects (such as needles) that have been contaminated with infected

         secretions

The viruses that cause Ebola HF are often spread through families and friends

because they come in close contact with infectious secretions when caring for ill

persons.

What's the advice for members of the EducAid community?

Following these simple precautions will minimise your risk of catching Ebola virus disease:

•                don't handle dead animals or their raw meat

•                don't eat 'bushmeat'

•                avoid contact with patients who have symptoms 

•                avoid having sex with people in risk areas; use a condom if you do

•                make sure fruit and veg is washed and peeled before you eat it

•                wash hands frequently using soap and water (alcohol hand rubs when soap is not available), as this destroys the virus

How does it spread among people?

People can become infected with the Ebola virus if they come into contact with the blood, body fluids or organs of an infected person.

Most people are infected by giving care to other infected people, either by directly touching the victim's body or by cleaning up body fluids (stools, urine or vomit) that carry infectious blood.

Traditional African burial rituals have also played a part in its spread. The Ebola virus can survive for several days outside the body, including on the skin of an infected person, and it's common practice for mourners to touch the body of the deceased. They only then need to touch their mouth to become infected.

Other ways people can catch Ebola are:

•                touching the soiled clothing of an infected person, then touching your mouth

•                having sex with an infected person without using a condom (the virus is present in semen for up to seven weeks after the infected person has recovered)

•                handling unsterilised needles or medical equipment that were used in the care of the infected person

A person is infectious as long as their blood, urine, stools or secretions contain the virus.

Ebola virus disease is generally not spread through routine social contact (such as shaking hands) with patients who do not have symptoms. The virus is not, for example, as infectious as diseases like the flu, as such airborne transmission is much less likely. You'd need to have close contact with the source of infection to be at risk. 

What are the signs and symptoms of Ebola HF?

Typically: fever, headache, joint and muscle aches, weakness, diarrhea, vomiting,

stomach pain, lack of appetite.

Some patients experience: rash, red eyes, hiccups, cough, sore throat, chest pain,

difficulty breathing, difficulty swallowing, bleeding inside and outside of the body.

Symptoms may appear anywhere from 2 to 21 days after exposure to ebolavirus

though 8-10 days is most common. Contact a senior member of staff if a case is

suspected.

How can human to human transmission be prevented?

Travellers or residents in the affected areas of countries can minimize risk of getting

infected if they avoid:

   •    Contact with blood or bodily fluids of a person or corpse infected with the Ebola

         virus

   •    Contact with or handling of wild animals, alive or dead or their raw or undercooked

         meat

   •    Having sexual intercourse with a sick person or a person recovering from EVD for

        at least 7 weeks

   •    Having contact with any object, such as needles, that has been contaminated with

         blood or bodily fluids

When cases of Ebola HF are suspected or confirmed:

   •    Isolate Ebola HF patients from contact with unprotected persons

   •    Wear protective clothing (such as masks, gloves, gowns) if contact with the

         affected person is essential

The aim of these techniques is to avoid contact with the blood or secretions of an

infected patient. If a patient with Ebola HF dies, it is equally important that direct

contact with the body of the deceased patient be prevented by prompt burial

of the deceased.

Download and print this guide from this link: http://www.educaid.org.uk/EducAid-Ebola.pdf

James Boardman   |   30th May 2014   |   updated: 31st July 2014

Sources:

   •    Centers for Disease Prevention and Control

   •    UK Government

   •    World Health Organisation

Ebola, Education, EducAid

The sort of image that is causing panic and fear

Ebola - what is the reality of the situation on the ground?
For the last six months and more, ebola has been found infecting and causing the deaths of people in Guinea, Liberia and eventually Sierra Leone.
What is ebola? Ebola is a potentially deadly virus carried by primates and is transmitted mostly through contact with the body fluids of an infected and seriously ill person.  However, unless you are regularly in contact with ebola patients, it is quite a difficult disease to actually contract.  Basic precautions can contain it.  Previously regarded as all but 100% fatal, there are now many many cases where treatment has been administered quickly and patients have recovered.
A couple of days ago, the President of Sierra Leone declared a State of Emergency.  Why?
Until the president took this step, many Sierra Leoneans did not believe in the existence of ebola. Reckless unthinking behaviour was causing the spread of the virus. Understanding about health, healthcare and sickness issues is extremely low in general.  (e.g. There are even educated people who talk about getting malaria from oranges or Guinness.)  People die regularly of nothing and everything. Those who read this blog regularly will have noticed that this year alone we have had a stream of needless deaths because of poor health care and poor thinking on the part of medical practitioners.  No surprise then, if an illness like ebola is not handled with logic, professionalism, calm and clear thinking.

 

US Embassy ebola message

What has the State of Emergency achieved?
At least now the general population are taking it seriously. Everyone knows the disease is real and there is a lively respect for it now.  At least now there are bye laws being enacted and measures being taken to actually enforce the restriction of movement to and from infected areas. At least now there are measures being taken to ensure infected cases are isolated and that panicking family members can no longer raid hospitals for infected relatives to take them to the magic man and thus infect unknown people in the community.
On the minus side - there is still an illogical panicking that has occurred.  No surprise really but it will be so helpful if educated people take sensible precautions and spread information not alarmist panic.
Worth while actions:
Restricting travel to a minimum
Avoiding unnecessary touch
Carefully monitoring health of everyone
Immediately isolating and reporting those with any of the possible symptoms

However, let us be clear, people are far far more likely still to be ill with malaria or TB than ebola.  We need to use our education and our thinking to ensure we are part of the solution and not part of the problem.  Sensationalist panic spreading is unhelpful.  Let us share accurate information and cooperate with government and medical practitioners to protect ourselves and our communities.

For those of you who are concerned about EducAid and ebola: we are operating in areas where there has been little or no ebola and none in the general community.  The few deaths in our districts have been of people who have travelled from other areas in the country were infection was more common.
We are working with local medical and health practitioners so that we have accurate information and know what to do were a case to occur.  We are monitoring health very carefully of all children who have stayed with us during the holiday period.  We are ensuring that there is absolute minimum travel and have instructed staff and students to avoid unnecessary touch.  We are adhering to government advice.  We are confident that with these measures we will be able to protect our school communities.

If you are interested in knowing more about EducAid's work with vulnerable young Sierra Leoneans, please go to www.educaid.org.uk