DEALING WITH EBOLA’S DOUBLE BLOW

Before the 2014-2015 Ebola outbreak ravaged West Africa, little was known about the possible medical and psychological consequences of beating the deadly virus because only a small number of people had ever survived the disease. But the unprecedented scale of the last epidemic revealed a profound and unfulfilled, need for medical and psychological follow-up care for survivors. More than 28,700 people contracted the virus and today there are more than 10,000 Ebola survivors in Guinea, Sierra Leone and Liberia. To respond to the needs, Médecins Sans Frontières (MSF) set up specialised survivor clinics in the three countries between January until September 2016.
A MSF health worker seen inside their Ebola treatment center in Conakry in November 2015.A MSF health worker seen inside their Ebola treatment center in Conakry in November 2015.
No object that cannot be chlorinated can exit the high risk zone. Dona Ebola treatment center in Conakry. Oct 2014

No object that cannot be chlorinated can exit the high risk zone. Dona Ebola treatment center in Conakry. Oct 2014
A nurse watches on as a nanny gives a bottle to baby Nubia at the Nongo Ebola Treatment Clinic in Conakry, Guinea on November 26, 2015

A nurse watches on as a nanny gives a bottle to baby Nubia at the Nongo Ebola Treatment Clinic in Conakry, Guinea on November 26, 2015

In Guinea alone, during a nine month project, MSF teams conducted 1850 medical and close to 1000 psychological consultations for survivors and other people indirectly affected by the outbreak, such as victims’ family members and health professionals. It closed in September because the medical consequences of Ebola – mostly ophthalmological and neurological problems – have disappeared in survivors, and psychological support is now being provided by other organisations.ESCAPING DEATH TO FACE STIGMA
An estimated 30,000 people today in Guinea were affected by Ebola, either because they survived the disease, were related to people who were infected, or because they were health professionals working on the frontline of the fight against the virus. Nobody in any of the three affected countries can forget the fear of Ebola. Even today, anyone who came into close contact with the virus may still experience fear, under the wrong suspicion that they could still be carrying, and therefore spreading, the virus.
The stigma that still surrounds Ebola can make it very difficult to surmount the survivor’s shock of having survived the terrible ordeal and rebuilding their shattered personal lives. To ease their transition back to society MSF conducted intense health promotion activities: in all three countries, more than 18,300 people received also anti-stigma information, either in groups or in their homes during door-to-door outreach programs. Our teams explained that survivors could not spread the virus anymore and therefore should not be shunned.
Health Promotion teams prepare their daily activities at the MSF facility in Nongo, Conakry.
Health Promotion teams prepare their daily activities at the MSF facility in Nongo, Conakry.
Health Promotion teams walk the streets of the Yattaya Fossidé neighbourhood while conducting anti stigma activities with the population.

Health Promotion teams walk the streets of the Yattaya Fossidé neighbourhood while conducting anti stigma activities with the population.
A group of people in a street cafe listen to the the Health Promoters anti stigmatisation campaign.

A group of people in a street cafe listen to the the Health Promoters anti stigmatisation campaign.

Angeline Teinguiano, the Health Promotion Coordinator, talks with a group of moto-taxi drivers in Sinfonia Gare I neighbourhood.
Angeline Teinguiano, the Health Promotion Coordinator, talks with a group of moto-taxi drivers in Sinfonia Gare I neighbourhood.

A group of moto-taxi drivers in Sinfonia Gare I neighbourhood (Commune Ratoma, Conakry) talk with the MSF Health Promotion team.

A group of moto-taxi drivers in Sinfonia Gare I neighbourhood (Commune Ratoma, Conakry) talk with the MSF Health Promotion team.

“When we explain our (Ebola) stigmatisation message, there’s a positive reaction from the community because we are working with Ebola survivors in our teams who can directly explain their experience. I think it’s already positive that the community want to listen to us and that they want to share the anti stigma information with their relatives.”

Angeline Teinguiano – MSF Health Promotion Coordinator“People in my neighbourhood thought I was dead… at first people said that Ebola was not real, I helped them understand that it was a real disease, I had to explain to them how the ETC (Ebola Treatment Center) worked, as people believed if you were sent there they would kill you…”

Camara Djenab, 22 years old – MSF Health Promoter and Ebola survivor.Ebola survivors who found themselves isolated found strength in associations across the country who mobilised those who survived the disease, their relatives and people from their communities to fight fear and stigma. These associations are crucial for reintegrating people who had Ebola back into society.

This area (Forecariah) is mainly a rural area where people live from agriculture. Through the association we have created work teams to jointly farm the fields and give an opportunity to the survivors to work again and move on with their lives. We just want to live like everyone else, we don’t want to be stigmatised.

Camara Soriba – President of the Association des Personnes Guerís d‘Ebola de Forecariah (Ebola survivors association of Forecariah)

Angeline Teinguiano (left) and Catty Youmbouno (right) from the HP team walk to the fields of Kalia region to meet the members of APGEF.Angeline Teinguiano (left) and Catty Youmbouno (right) from the HP team walk to the fields of Kalia region to meet the members of APGEF.Portrait of members of the APGEF – Association des Personnes Guerís d’Ebola de Forecariah (Ebola survivors association of Forecariah).

Portrait of members of the APGEF - Association des Personnes Guerís d'Ebola de Forecariah (Ebola survivors association of Forecariah).These Ebola survivors associations are very important to fight against the stigmatisation of survivorsand to conduct anti stigma activities

These Ebola survivors associations are very important to fight against the stigmatisation of survivorsand to conduct anti stigma activities

 

EBOLA: THE WOUND THAT REMAINS

Not only was the scale of this outbreak more than 60 times larger than any previous outbreak, Ebola was completely unknown in West Africa before 2014. The unknown nature of the disease and the magnitude of the outbreak fueled the fear that gripped the country and can still persist today.“When I returned home after leaving the Ebola Treatment Center, only my sons and daughters approached me, all the other people were too scared to. Now the situation is much better but I’m still affected by cataract and because all eye surgery on Ebola survivor is forbidden I cannot be operated on” Salematou Camara, 61 years old – Ebola survivor

“When I left the Ebola Treatment Center, I felt isolated, I thought I was alone, nobody approached me, everybody was scared of me…”Esther Loua, 27 years old – Ebola survivor.

“My father’s brothers died of Ebola, this was part of my motivation to come and work at the ETC. We cannot stigmatise the survivors, we need to approach and encourage them.”

Binta Savone, 24 years old – former nurse in the MSF Ebola Treatment Center

“Those affected by Ebola did not choose to be ill… I would like to tell people to approachthem, do not be afraid, to accept them and helpthem forget what they have lived through”.

Thierno Diallo – former hygienist in MSF Ebola Project

“I want to tell to people not to isolate them (Ebola survivors), they are not ‘dangerous’anymore. I’ve been working with them for the last nine months, we eat together, we have fun together, we live together.”

Bolde Thierno Hamidou, 27 years old – Nurse in MSF Ebola survivors project. Before the end of the project, Bolde Thierno Hamidou is inventoring the drugs to be donated.

Before the end of the project, Bolde Thierno Hamidou is inventoring the drugs to be donated.

Camara Djenab, health promoter, scheduling patients visits.Camara Djenab, health promoter, scheduling patients visits.

Esther Loua joking with MSF staff.
Esther Loua joking with MSF staff.

Outside the MSF facilities in Nongo, a poster says “All together agains Ebola, remain always vigilant”
Outside the MSF facilities in Nongo, a poster says "All together agains Ebola, remain always vigilant"

Inside MSF facilities in Nongo, Conakry.
Inside MSF facilities in Nongo, Conakry.

BABY NUBIA, SYMBOL OF RESILIENCE

Nubia is most likely the first newborn to ever survive Ebola, and she was the last patient to be discharged from MSF’s Ebola treatment center in Conakry – a symbol of hope and resilience. Nubia’s mother succumbed of Ebola when giving birth on October 27th 2015.

MSF staff care for Nubia, a three-week old girl and the last known Ebola case in Guinea who has now recovered from the virus.MSF staff care for Nubia, a three-week old girl and the last known Ebola case in Guinea who has now recovered from the virus.Nubia is carried outside (by a maternal assistant who is herself a survivor of the virus) MSF Ebola Clinic in Conakry. Nov 2015

Nubia is carried outside (by a maternal assistant who is herself a survivor of the virus)  MSF Ebola Clinic in Conakry. Nov 2015

Nubia is carried outside (by a maternal assistant who is herself a survivor of the virus) MSF Ebola Clinic in Conakry. Nov 2015Nubia is carried outside (by a maternal assistant who is herself a survivor of the virus)  MSF Ebola Clinic in Conakry. Nov 2015The outbreak tore apart her large family, killing two out of the three wives of her father – Nubia’s mothers in the extended African family. While some family members, including a brother, remained in the small thatched hut of their village of Kindia, Nubia now lives in Conakry with her maternal aunt Mabinty Soumah.

Nubia’s half brother, M’Bemba, lives in another part of the city with an aunt. They meet when coming for checkups at MSF’s clinic – M’Bemba also is an Ebola survivor. With the closure of the MSF clinic, both Nubia and M’Bemba will be under the care of Guinean doctors working for the Ministry of Health.

Nubia (11 months old) and her half-brother M’Bemba (1 year and 2 months old) with their aunties and foster mothers Mabinty Soumah (right)Nubia (11 months old) and her half-brother M'Bemba (1 year and 2 months old) with their aunties and foster mothers Mabinty Soumah (right)

Nubia with Dr Marie Claire in Nongo during the last visit of Nubia before being transferred to the Guinean health care system.
Nubia with Dr Marie Claire in Nongo during the last visit of Nubia before being transferred to the Guinean health care system.

Nubia (nine months old) plays with her brother/cousin M’Bemba (1 year and 2 months old) during the medical consultation by Dr. Daouda Berete
Nubia (nine months old) plays with her brother/cousin M'Bemba (1 year and 2 months old) during the medical consultation by Dr. Daouda Berete

Nubia with her foster mother Mabinty Soumah and Dr Marie Claire in the MSF facilities in Nongo
Nubia with her foster mother Mabinty Soumah and Dr Marie Claire in the MSF facilities in Nongo

 abinty Soumah in their way to MSF coordination to be transferred to the National Healthcare System
Nubia and her foster mother Mabinty Soumah in their way to MSF coordination to be transferred to the National Healthcare System

FOOTNOTES: Pictures by: Samuel Aranda, Julien Rey, Tommy Trenchard and Albert Masias.MSF
Story By MSF 

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