Washington washes his hands

“Nearly all of my friends thought it was a figment of someone’s imagination, but it was clear to me from the very beginning; I always thought it was real. I told them to search for information on the internet.

“Nearly all of my friends thought it was a figment of someone’s imagination, but it was clear to me from the very beginning; I always thought it was real. I told them to search for information on the internet. And like many others, they refused to believe it.” recalls Washington, Médecins Sans Frontières’ (MSF) driver.

“Deep inside I can understand it.” I answer and wonder to myself, can it really be true? All of a sudden an unknown disease reaches your country, it comes shrouded in mystery and rumour and you are told you have to believe that suddenly everybody is in danger. Something like that is not easy to accept.

“The truth is that everything is very strange." he admits, "Very, very strange. Some people say it was a bat, others that it was a monkey, but in the end the only thing that matters is that people are dying. You must have heard a thousand times about the invisible enemy, right? Well, this is it. When it comes to Ebola, there is no safe place to hide”.

“Do you know where it came from?” I ask. “Yes, of course, from Guinea. Well, at least this is what everybody thinks.”

“But, how did it get here?” I insist lowering my voice and feeling rather ashamed. Deep inside, I know very well that neither of us have the answer. I am suddenly struck by the idea that, probably, asking these types of questions and trying to force an answer is not very helpful. However, and I have to recognise this, I feel very curious to hear the answer. He reflects for a few seconds but I can see that he feels disappointed. Everyone, like me, who is expecting an explanation linked to witchcraft, will be disappointed:

“I don’t know. Nobody knows”, he concludes with an air of solemnity. “Or do you happen to know by any chance?”, he asks.

“And at home?” I ask him, trying rather unconvincingly to prolong our conversation following the earlier fiasco, and not at all sure where it will lead me. I realise that I am stabbing around in the dark and that I am about to make the mistake of asking him that horrible or disrespectful question that I’ve heard so many times before: ‘Have you lost any family members?’ We, Western journalists, usually ask this question to anyone we come across and we do it as if were asking people if they have ever lost their keys and how they managed to get back into their home.

“I don’t understand. What do you mean by 'at home?'” Washington asks me, waking me up from my reverie.

“I mean how do you manage?" I ask. “Do you take any measures to prevent anything from happening to you?” Another cliché question, but at least I managed to get out of trouble and I haven’t asked anything too risky.

“At home we have chlorinated water and we always wash our hands. When we run out of chlorine, we go to the shop and buy more. Prices have risen and chlorine is no exception, but the most important thing is that our hands should always be clean”. “And what about your family? Do you avoid physical contact?” I ask, reverting to my old obsession, the one that worried me so much before coming here and still is cause for concern during my nights in Monrovia. And it is not because of fear, but quite the opposite. It’s about the lack of contact. Having to keep your distance from everyone here, only serves to further reinforce how important is to be able to feel close, also physically, to the people you love.

"No, no. In Liberia now we try not to have physical contact with others”, Washington assures me.

“But of course, at home it must be different. How many people are in your family?” I ask.

“Four: my two children, my wife and me. We also avoid physical contact.”

"And then, what do you say to your wife? Go and sleep in another room?”

“But how I am going to tell her that?! Of course not; we always sleep together!"

“Aha….I knew it!” I cry out triumphantly.

“OK, you are right. But I can assure you that we always wash our hands. Without exception. And when the children come to wake me up every morning I ask them 'Have you washed your hands? Because if you have not, you know there is no hugging.’ In Liberia we all have learnt that. Now we also disinfect our homes and always wash our hands. This is why fewer and fewer people get infected. Whenever I see my friends, I miss not being able to shake their hands, but this is how it is now. As long as this lasts, we will keep behaving as carefully and respectfully as possible”.

And certainly, a good part of the credit for this change in habits should be given to the Liberian population. On the one hand, awareness-raising and health promotion policies have begun bearing fruit (radios, newspapers, the internet and TV across the country have shared the message in a proper way), and on the other hand, everybody has become aware of the gravity of the situation, and they have finally begun taking preventive measures. Patients are arriving earlier because they do not hide at home and people have got used to coming to the MSF Ebola management centres as soon as the first symptoms appear. These simple measures are increasing their chances of survival and reducing the chances of infecting others. But we cannot forget that while epidemics go down they can also go up, sometimes rapidly. So, even if everybody is washing hands, we all should remain alert and keep working in passing the right messages to the community.  

“And you, can you tell me how long MSF is staying in Liberia?” he asks me with concern.

“Are you asking this because of Ebola or your work?” I reply.

“Both: obviously because of my work, as here I am with you and I feel safe and I know that now driving my taxi puts me at risk. But also because of Ebola. I am fearful about  the time when MSF will leave and we will be on our own again and then Ebola will appears again to haunt us”.

Unfortunately, I cannot answer his question, but I can tell him that MSF is not going to be caught off guard. We are aware that the epidemic is still far from over and we know that new cases may crop up any moment. I can also assure him that we will keep our teams in place even if there is only one confirmed case and that we are adopting measures such as distribution of malaria prophylaxis and basic personal protection packages for the families.

On the other hand, we are working on setting up screening areas, including a reception area and a sorting area for suspected Ebola patients, a project that will be rolled out in the coming days together with Redemption hospital and will enable this health centre to gradually reopen its doors to the public. We are also looking into the possibility of creating an ambulance system as there are very few that are operational. So, to try to cheer him up, I explain it all.  

“We have arrived Fernando Torres." Washington tells me (here I am Fernando Torres, no traces at all of myself, Fernando G. Calero)

"Do not forget to wash your hands before going to bed.”

Fernando G. Calero is a press officer working for Médecins Sans Frontières. He wrote this post from Elwa 3, the MSF centre for Ebola patients in Monrovia, Liberia on 10th November 2014.