Fieldset
Ebola stigma: another barrier in the battle

Working as a doctor in Sierra Leone a couple of months ago I was showered in flattery. Not just me, all of us. A team of “selfless heroes”, out in the midst of the worst public health emergency in living memory, trying to assist the communities collapsing around us.

Working as a doctor in Sierra Leone a couple of months ago I was showered in flattery. Not just me, all of us. A team of “selfless heroes”, out in the midst of the worst public health emergency in living memory, trying to assist the communities collapsing around us. Arriving back in the UK I had more invitations than I could have ever taken up. The public thirst to hear first hand what it’s like over there was unquenchable.

I write this on my journey back to West Africa, where despite all the pleas my colleagues and I made we are still one of few responders on the ground. Big promises still waiting to become realities. As I was preparing to leave I became aware that the public opinion was beginning to uncomfortably shift. The Western introspective paranoia of Ebola suddenly reaching our shores was competing with the sympathy for the plight of the actual people suffering. And me? I am no longer the selfless hero, but the selfish vector.

“Don’t you think it’s a bit selfish to go over there? You could end up spreading it back here.” I’d have forgotten the comment and put it down to a mis-informed individual, but reading the comments online it is clear that this was not an isolated opinion, but a growing consensus.

Stigma and infectious disease have walked hand in hand for years. As a medical student I wrote papers on HIV stigma and the efforts curb it, never did it occur to me that I would one day write about the stigma of healthcare workers doing a desperately needed job. Last time I returned there were a few people who hesitated before shaking my hand, but always with a slightly embarrassed smile. I’m not expecting anyone to be smiling at me when I come home next time.

The media and public health information on the disease have been consistently confusing. On the one hand there are horror stories and heart wrenching images flowing out of West Africa, where the focus has been on galvanising urgent action against a deadly disease that is spreading uncontrolled. On the other, the public at home are being told “don’t panic” there’s nothing to worry about here. In essence both are true, but for many the context needed to differentiate between the West African situation and the Western predicament is lacking.

This epidemic has graphically demonstrated the huge public health disparity that exists between the world’s richest and poorest nations. Reasons being a dense mix of educational, economic, political, and gender-based differences; to name a few. The combination leaving the population less resilient to withstand an emergency of this kind. In a word, they were already far more vulnerable on day 0 of the epidemic than any Western country would be.

Stories of increasing irrationality are being reported by returnees everyday. Science and grounded knowledge appear to be taking a back-seat to misplaced anxieties. As people who have sat face to face with Ebola, watched the people suffer and lived within the epidemic we understand what it is like to be scared of an invisible threat. The reality is though, that that threat does not exist in the West, and that includes from returning aid workers.

So in the interest of some basic health promotion, here’s the facts. Again.

  • Ebola is transmitted through direct contact with body fluids
  • An individual is only contagious when symptomatic and unwell, not when in the incubation period
  • The virus itself is weak, surviving for only a short period of time outside the body, and eradicated with simple measures like soap, bleach, heat and sunlight
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We are living in frightening times, all of us. Knowledge is power, so let’s arm ourselves appropriately. Hysteria and paranoia will only serve to be counter-productive in achieving the one thing that we all want: to end this epidemic.