Liberia: Surviving Ebola

There have been some steady gains in the fight against the Ebola virus in Liberia, but the struggle is far from over. Wade C. Williams spoke to survivors and health workers on the frontline in Monrovia to learn more.

As Diamond Dennis, 15, leaves the Island Clinic Ebola Treatment Unit in Liberia’s capital of Monrovia, she has a smile on her face. This is the first time in four weeks that she has been in the sunlight and her skin is pale because of it, but she is just relieved to have survived the deadly Ebola virus.

She joins other children in a colourful ceremony full of singing and dancing to celebrate the fact that they can finally return to their communities, and Diamond is given a certificate that she can show to her friends and neighbours that confirms that she is now Ebola-free.

“I will feel good because people said I had Ebola and didn’t come to hospital on time, so I thank God that I now have my paper [certificate],” she says.

There to pick up Diamond at the treatment centre is her eldest sister, Sarah Gargar. Sarah is also now Diamond’s guardian. Their mother and stepfather, along with one of their brothers, also caught the disease, but unlike Diamond, tragically they did not survive.

According to Sarah, their stepfather was the first to be struck down by the virus. As his symptoms got more serious, he was taken to the treatment centre where he died, but the disease had already spread to other members of the household.

“After he died, Diamond’s brother Morlu got sick with the virus and he started vomiting,” she recalls. She believes that it was through coming into contact with his vomit that their mother and Diamond contracted the disease too.

Overall, she says, eight people in the family have died from Ebola and she is now the only one left to care for Diamond. “I’m still around for her,” she says. “I will do what family can do. I can’t do it all but I’ll try.”

Corpu Gayflor, 15, was discharged the same day as Diamond, and while she is relieved to have survived, her story is similarly distressing.  Like Diamond, and indeed many of the 20 children discharged that day, she also lost family members to the disease.

Corpu had been living with her uncle and his wife in a house that was shared with other families. She says that a woman from another family caught the disease first.

“We got this Ebola from one woman,” she says. “She and most of her entire family died. Only her son and her husband survived. We were all living in the same house. My people used to go into her room, touch her, bathe her and feed her and make up her bed when she was sick. That’s how they got it from her and brought it to us.”

Corpu caught Ebola and became ill, suffering from vomiting and diarrhoea. “My body was weak and so my uncle brought me here,” she says, referring to the Ebola treatment unit. “They took me inside and I lay on the floor.”

At the medical centre, she came face-to-face with death. “People died in there,” she says. “The first day I came, 10 persons died and they came for the bodies but I had faith that I would make it. I used to pray day and night. Now I feel all right, my body is no longer aching, my head is not aching and I don’t have a fever.”

After weeks of pain and suffering, Corpu is tired and still coming to terms with her loss, but she is pleased that she can once again walk outdoors and see the beautiful sunlight and lush green scenery of her city.

Challenges continue
Although the Ebola outbreak is far from being contained in Guinea, Sierra Leone and Liberia, there is some evidence that the rate it is spreading at is stabilising, and in some areas of Liberia, the number of new cases has reduced significantly. There is always the danger that the outbreak may flare up again, when there are lulls, but a downward trend is always promising.

However, despite the slowing down of sirens racing across the country, there is a long way to go yet. After all, as Corpu and Diamond were being released from the clinic, many others were still being brought in.

Many of these new patients are transported to the clinic by ambulance drivers such as Sam Bropleh, but as he explains, this is not always an easy process. He recalls one recent example in which he went into a community called Mandela Field, a suburb of Monrovia, in order to pick up four members of a family who had lost their father to the disease. Bropleh said people in the community ran away when they heard the sirens.

“We are still facing difficulties in the field,” he says. “When we go for cases, some people try to deny that they are sick. The family will try to tell you that their relative is not an Ebola patient. Sometimes in some places when we go, the people will ask who called the ambulance. They try to put up resistance.”

In this instance, Bropleh says that some inhabitants tried to shield the ill, but the people he had been sent to pick up were already showing signs of the disease. Some of them could barely walk.

Bropleh took them to the Ebola Treatment Unit, but once they arrived, the health workers were not sure that the patients were suffering from Ebola and asked Bropleh to take them back to their homes. The ambulance driver refused, fearing that if it was in fact Ebola, the disease would spread further.

“It only takes four hours to get a test result,” he recalls thinking. “Why not keep the patients here and get their results? If they are negative, then we can take them home.”

Bropleh called his supervisor and relayed what the health workers had told him. The supervisor’s response was to tell him to take them to another clinic. But Bropleh insisted. He argued with the clinic’s health workers, and after almost an hour the unit finally agreed that the patients should stay.

Understanding up, Ebola down
Despite ongoing challenges, the gains that have been made in containing Ebola in Monrovia are heartening.

“When we compared the situation between September, October and November, we noticed that there was a remarkable improvement in our cases,” says Dr Augustus Quiah, head of the psychosocial team at the Island Clinic. Quiah explains that when the 200-person-capacity hospital first opened in late September, it filled up in a single day, but that admissions have now dropped considerably.

He attributes this in part to greater understanding of the disease amongst Liberians. “We are so grateful for the education that is going on,” he says. “The awareness in the communities is having a positive behavioural change.”

Quiah adds that the survival rate seems to be improving too, which is changing perceptions about the disease and leading to more patients admitting themselves to the clinic when they show symptoms.

However, while remaining hopeful, health workers emphasise that there is still a very long way to go and that this is not a time for complacency.

“Ebola is decreasing,” says Bropleh, “yet our people must continue to take the preventative measures. You don’t have to forget about washing your hands [and] stopping shaking hands.”

“Liberia is not yet Ebola free,” he stresses. “We are still in this fight.”

Indeed, the country will have to continue to work hard if it is to contain the disease. Thousands have died from Ebola in West Africa, thousands of children have become orphans, and local economies and livelihoods have been severely damaged over the past year. But led by the likes of the World Health Organisation’s Dr Atai Omoturo, the Ugandan doctor heading the Island Clinic Ebola Treatment Unit, Liberia hopes that Ebola can be contained and that the country can get back on its feet.