Distrust and suspicion: the underlying dangers of Ebola


By Iain Whitfield

Over 10,000 people have been infected in one of the deadliest outbreaks of Ebola since it was first discovered nearly 40 years ago.

When Ebola was first reported in Sierra Leone, health facilities were overwhelmed and president Koroma declared a state of public emergency on 30 July.

Emergency aid was mobilised and international medical professionals flurried in. International expertise is vital, but the fundamental role of government cannot be ignored. The government must show leadership and regain lost trust.

Inherent suspicion

In some communities, there is a perception that Ebola was created by spirits, international organisations and or the government. As a result, some of those infected have absconded – threatening efforts to contain the virus.

Misinformation and stigma have been prominent in some areas during the Ebola outbreak. “We have been told there is no cure for Ebola, so when you enter a facility you never come out alive,” says one villager.

Stories of healthcare workers giving lethal injections to Ebola patients are some local explanations for why villagers tend to not return from treatment centres. “They are experimenting on us. We have become guinea pigs. The instrument is full of Ebola to transmit the disease to us,” says another women pointing to a thermometer.

What can be done?

Engaging local expertise and strengthening institutional healthcare will help erode suspicion and equip Sierra Leone to better cope with current and future emergencies.

“We are all vulnerable to this disease, even doctors and nurses are dying while trying to save lives. We are working around the clock, but there are only so many areas we can reach. It is vital we are alerted when someone is sick so they can quickly be treated. We have set up a neighbourhood watch scheme so communities can help us,” says a Ministry of Health and Sanitation adviser.

Funded by the Department for International Development (Dfid), Adam Smith International has been providing technical assistance to the Ministry of Water Resources and the Ministry of Health since 2011. The programme has been central in reforming and providing strategic leadership within the water and health sector. The programme quickly adapted its support to help both ministries manage the Ebola crisis. The programme has already trained over 3,000 people, including 1,900 nurses. Over 100 journalists have also been trained on accurate information dissemination and 160 Ebola care units now have improved water, sanitation and hygiene services.

With Adam Smith International’s support, the Ministry of Health is also helping to ensure proper burials to contain the outbreak. “Respecting traditional burial customs is very important. If burials are not dignified then relatives refrain from informing us and conduct their own ceremony, which is very risky in terms of contamination. Systems must be put in place, and we need to lead those systems,” says an official from the Ministry of Health and Sanitation.