Fear and education play crucial role in Ebola crisis

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Counsellors at an Ebola treatment hospital in Liberia were busy last week with some unusual clients: two landlords who had evicted hospital staff from their homes because of their Ebola-related work.

It took hours of counselling on the low risk of Ebola contagion, but finally the landlords overcame their nervousness and reversed their decision. The hospital workers would be allowed to stay in their homes.

It was one small victory in a crucial campaign to ease the Ebola stigma and educate West Africans on how to survive the devastating epidemic, which has killed at least 3,866 people in five countries.

A huge army of volunteers has fanned out across the Ebola-afflicted countries spreading a message of hope and safety to millions of people – from landlords and taxi drivers to families and the Ebola patients themselves.

Médecins sans frontières (Doctors Without Borders) has hired more than 400 workers to go door-to-door across the country, telling people what Ebola is and how to protect themselves.

The group runs an Ebola treatment centre in Monrovia, where the two staff were evicted by their landlords last month.

"There's a lot of fear, and we fight that fear by giving the proper information," MSF emergency co-ordinator Laurence Sailly said in an interview.

"There's still a lot of stigma in the community towards the patients, survivors and staff. The staff in the Ebola treatment units are not a danger to others. They are protected when they work. In fact, if I have a treatment centre worker in my neighborhood, I should be okay, because if I get sick, he knows what to do."

Billboards and posters are visible on every main street and major building in Monrovia, warning that Ebola is real and can kill. The virus can destroy entire countries "quick quick quick," one billboard says.

Among the thousands of "social mobilizers" recruited to spread the message are health workers, teachers, religious leaders and youth activists. Groups such as Unicef have produced videos and catchy songs to reach people in a country where more than half of the adult population is illiterate.

One such song, Ebola is Real, has become one of the most-played tunes on Liberian radio stations. Unicef estimates it has reached about a million Liberians with these messages.

Yet despite months of awareness efforts, Liberia is still plagued by false rumors and denial. "Some people think Ebola is a manmade virus," said Amos Sonyah, supervisor of psychosocial counselling at a new Ebola treatment centre in Monrovia. "I've heard a lot of people say that."

The stigma and rumours are causing huge damage to the effort to contain Ebola. People with the virus often refuse to get treatment because of the rumours, and suspicious mobs have attacked Ebola health workers. In Guinea last month, eight health workers and journalists were killed by hostile villagers. A Red Cross burial team was attacked in a separate incident.

Getting people to accept the reality of Ebola is "the first step," Mr. Sonyah said in an interview. "We still have people in denial. Most people don't believe it – they want to see it physically. I tell them, 'It's where I work, I see it daily.' But for most of them, it must hit them at their doorstep before they see reality – a friend or family member must come down with it. This is where we come in to fill the gap. We tell them, 'This mustn't happen before you believe.'"

In their Ebola treatment centre, Mr. Sonyah and his seven-member team go from ward to ward, trying to boost the spirits of severely weakened and disoriented patients who sometimes lack the will to live. "Have you eaten food?" they ask the patients. "Have you gotten your medications?"

Many patients are convinced they will die. "A lot of them think it's over when they come here," Mr. Sonyah said. "We tell them, 'You don't have to lose hope, there's still a chance of living.'"

At Liberia's weekly briefings on the Ebola crisis, broadcast on radio stations across the country, Information Minister Lewis Brown is blunt and emotional. He tells Liberians that family members with Ebola must be kept isolated. He urges them not to illegally sell the donated health kits from Unicef. And he tries to quell a bizarre rumour that Liberian soldiers are evicting patients from hospitals.

"People, stop lying to each other," he says, his voice rising. "Stop these lies to each other!"