Shortly before I left the U.S., I watched President Obama welcome Ebola survivors who had worked during the epidemic in Liberia to the White House, and greet them with handshakes and hugs. At the time, it struck me that beating those incredibly difficult odds was truly something to celebrate, and that those survivors, now members of a tiny club, must be among the happiest and most grateful people on earth.
Here, in what was previously the heart of the epidemic, something quite different is now taking place. Ebola is new to this part of Africa; poorly understood, and for many its very existence denied, but the reality soon became too stark and grim to ignore. In the days since, members of Health Promotion teams working tirelessly in every community, and incessant messages from every media outlet, government agency and NGO have done a good job of raising awareness about both the risks and the precautions necessary to stay safe. As a result, infections here and in other parts of Liberia have dropped dramatically in recent weeks. But the fear-driven messages that conveyed this urgency, and the isolating steps necessary to stay safe, have proven so effective that this is now creating an entirely different problem.
In previous Ebola outbreaks, there were so few who survived, that no one thought much about them. In most, the survivors could be counted on the fingers of one hand, and before this epidemic, all of the known Ebola survivors in history would have fit comfortably in the White House banquet room where President Obama held his reception. Now suddenly, they number in the thousands, and just as suddenly, find themselves the subject of fear, stigmatization and persecution.
Last week, I attended a meeting of survivors here in Monrovia. This is what I heard:
No one will help us.
How will we survive?
No one will come to my business.
No family members will allow us in their homes.
Nothing is working for us.
My home was burned.
We cannot go forward.
Even our parents won’t help us, they are afraid.
Who will take our orphan survivors?
It is better I die than to be alive now.
The incredibly cruel irony in all of this is that these survivors are not the slightest bit contagious, and the only ones in the community who everyone can be confident pose no risk at all of transmission.
It is many of the Ebola survivors who now work without fear in the Ebola Management Centers, often being called upon to care for the orphans and other children. It is the survivors whose antibody-rich plasma has already been used experimentally as a treatment, and appears to be one of the promising possibilities.
When the survivors are declared Ebola free, we give them certificates, and their doctors and nurses and health workers all applaud as they walk from the Management Center. We escort them back to their towns and villages without wearing protective equipment, so that everyone can see that we are completely confident that they pose no risk. But the fear remains. Alongside the old messages, the health promoters and media are now beginning to talk about “survivor stigmatization” as the next phase of the epidemic. Because here, the survivors are not thought of as heroes; they will never be seen by most on the cover of Time Magazine or at a reception in the White House. And that’s alright with them. They would just be happy to go home, celebrate their survival, and live in peace without fear. Hopefully that time will come soon.