“The people living in these areas said there’s no such thing as ebola,” said a district doctor who spoke on condition of anonymity. “They have their traditional beliefs and their traditional cures and they look up to their traditional leaders. Until we can bring the traditional leaders onside, it will be very difficult to convince them that ebola even exists.”
As the death toll from the latest outbreak of the world’s deadliest virus climbed to 467 – far exceeding the previous most lethal outbreak which killed 254 people in Congo – officials and health workers are battling a surge of infections propelled by misinformation and doubt about the disease’s existence on one side, and mistrust of scandal-hit governments on the other.
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But an alarmingly wide spread is partly down to geography. “The deaths have been increasing because of traditional burial rites in that region,” said Tolbert Nyenswah, Liberia’s deputy chief medical officer. The Kissi ethnicity, found in all three countries, traditionally keep their dead at home for several days, and mourners touch the deceased’s head frequently before burial.
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A doctor in Sierra Leone said patients’ families often attempted to break them out of treatment centres – often successfully. “Some of them are in denial and that it is something they can treat at home, and faith healers are one of the problems for us. When you have patients disappearing like that, you don’t know where the virus will appear next.”
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Ebola was initially viewed as a government conspiracy to depopulate Sierra Leone’s Kailahun district, and fierce resistance to the arrival of health workers culminated in the stoning of a Doctors Without Borders vehicle. In Liberia, many remain adamant the outbreak is a hoax from government officials seeking to distract from a series of recent scandals, or for health officials to rake in public funds.
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Health workers at the frontline of the battle – often the first to die – face other challenges. Last week, riots broke out and an ambulance was attacked as family members fought to reclaim a victim’s corpse from a hospital in Kenema, Sierra Leone’s third largest city. On the same day, a three-man burial team was chased out of the Liberian town of Banjol where they went to bury a victim. “We need to find a special place to bury these corpses, if not, the bodies will keep piling up on us,” a member of the team said, adding that families often refused to come forward to identify dead relatives for fear of catching it.
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But when the outbreak first began, popular text messages circulating in Guinea said an antidote could be found in a concoction of hot chocolate, coffee, milk, raw onions and sugar.
“Ebola, ebola, ebola. I hear it everywhere,” said Adama Sherry from behind her market stall in Sierra Leone’s Tombo, a fishing village as yet unaffected by the virus. Sherry admitted she couldn’t list the symptoms, causes or precautions.
Nearby, a local school had recently emptied out when word spread of routine blood tests being carried out – rumour had it that the needles would infect children with ebola.
Liberia’s health ministry has begun putting images of ebola-ravaged corpses in newspapers and on television. “They are very graphic but it is working – people are starting to see that ebola is not just a spiritual thing that you can cure through going to church,” Nyenswah, the deputy chief medical officer, said.