Life after Ebola – The battle isn’t over yet Lidia Paladini, Germany

ebolaa Since the outbreak of the Ebola epidemic in March 2014 in western Africa, a total of over 8000 people have fallen victim to the virus. However, the epidemic still hasn’t been decisively beaten. While countries such as Liberia, Nigeria and Mali are officially declared to be Ebola free, the outbreak continues in Guinea and Sierra Leone. Wherever the disease breaks out, it leaves traces of atrocious destruction, despair and fear: of losing loved ones, of being infected and infectious and of losing everything you have.

With a total of 8700 infections and over 3700 deaths, Liberia was one of the worst affected countries in the West African Ebola outbreak. By March, the last known patient was released from treatment and on May 9, 2015 the country was declared to be officially Ebola free by the World Health Organization (WHO). “A previously affected country is considered free of Ebola transmission if it records no further cases over a 42-day period, twice the maximum incubation period of the virus. The last person known to have been infected in Liberia was safely buried on 28 March. But surveillance continues, particularly along border areas, and the partners in the response stand ready to act rapidly should there be a new outbreak.” (UNICEF Liberia). As Sheldon Yett, UNICEF representative of Liberia, accurately declared, “having achieved zero cases is the first step, now the challenge is to remain at zero. The threat won’t be over until there are no more cases in neighboring Sierra Leone and Guinea.” But the consequences of the epidemic are already disastrous. With schools remaining closed in fear of new infections, the marginalisation of survivors, and the relatives of victims not being provided any time to come to terms with the loss of beloved ones, the mental and economical ramifications are devastating.

“The life after Ebola is worse than the disease itself.” Amos Jessy, Ebola survivor.

Although the epidemic itself is over in Liberia, the tremendous fear it caused inside the people’s minds remains. Many people lost family members, friends and relatives to the virus. The children who lost their parents and family members to Ebola are now experiencing extensive trauma and are going through very hard times. Moreover, the fear of being infected by Ebola survivors or people who worked with affected patients is a acute, and causes these people to be socially excluded on all levels. In some cases, survivors are even abandoned by their families because the family members fear that they still could be contagious. Common habits of kindness and friendship, such as shaking hands and giving someone a hug, have become risky procedures, as one could theoretically get infected with the virus by doing so. The situation is incredibly difficult, especially for students.

How Ebola changed the lives of thousands of students

“Back 2 School” is a program that aims to support the process of making the schools of Liberia a safe place for students again and focuses on promoting hygiene practices at the school and community levels. I had the honour of interviewing Emmanuel Trokon Gibson, who launched this program, about the current situation of the people and more specifically, the students and schools in Liberia. He is the presenter of “Straight From The Heart” and “One Liberia Advocacy Online Radio”, a broadcast journalist and children rights activist. “The core activity of Back 2 School is to report the preparedness of National Government, School facilities, parents and students themselves in the resumption of school at the height of the outbreak in Liberia.”, he explains to United Youth Journalists. “The question of whether the schools were safe enough for pupils was a matter of concern for a journalist like me and an online new media like One Liberia Advocacy Radio. Basically, the program is radio and social media based and has been airing the views of parents, school administrations, students, health workers as well as locals in the most affected areas. Our focus has been reporting the welfare of students. We’ve managed to arouse the interest of other school based organizations to help with disinfectants, recondition classrooms, and provide learning materials for students. The fear that the Ebola virus could be spread through contact with an affected person at schools cannot be overemphasized though the World Health Organization has brought the virus under control.” Emmanuel explained that there has been a radical change in the way students now conduct themselves. He grew up and went to school in Liberia and he is aware of how students interact. “With the awareness of Ebola, students have to constantly wash their hands with disinfectants, do their daily body temperature check before going to class, they feel obligated to go to a health center when they feel sick. Mostly, they have cultivated the mindset of not congesting themselves in colonies [neighbourhoods] for any other activity. One of the most important questions I had was: What has changed about the students’ behavior since schools reopened in Liberia, and more specifically, which mental or physical problems do the students have to face? “Mentally, students face a problem of what I refer to as “distant association”. They have to re-orientate themselves daily after the effect of the Ebola virus and stay distant from each other. Some students lost their relatives to the Ebola crisis and have to live with that from now onward. One student told me that he “feels bad when he hears about Ebola”. Physically they are faced with numerous challenges ranging from lack of support due to the demise of relatives to getting school materials and not been allowed to shake hands with their colleagues, let alone eat together as [traditionally practised in Liberia and all of Africa.]” As a consequence of the outbreak, one would assume that students are still committed to Ebola prevention procedures and that hygiene measures play a huge role in the schools of Liberia to prevent a potential new outbreak. Emmanuel T. Gibson quotes Mr. Solomon Ward, the Principal of the Christian Bible Faith Mission High School: “Yes, students of my school are still committed to Ebola prevention procedures.” before going on to say, “I’ve noticed from my tours that some schools still have their hand wash basins, but no thermometers. Others do not have either. The awareness to stay safe at school has diminished, and media outlets in Liberia have reduced their Ebola awareness messages and programs. To some extent, I’ll say commitment to Ebola prevention procedures has become flexible. There are not many measures to raise the awareness of Ebola prevention in recent times, let alone promoting hygiene measures at some schools in Liberia, especially those in the hinterland, where access is a major challenge. This is where Back 2 School intends to focus its program in light to promote hygiene practices at schools and communities levels.” “The hardest challenges we have to face regarding the consequences of Ebola are improved health systems across the country with standard testing laboratory concentrations”, he explained. “Another is rebuilding the economy through trade and bilateral means. Like we noticed during our tough moments, many trade activities folded up, many companies had to reduce their staff ratio, etc. Socially, many people still have to grapple with the issue of burial practices. Now in Liberia, the family of the dead has to acquire permit from the national Ebola task force before proceeding with burial. Major sporting events like the national counties sports meet is yet to be staged; students cannot have their dance competitions, etc. “Economically, Ebola poses a serious challenge in school enrolment this academic year. Many parents could not respond to the pronouncement for the reopening of schools due to constraints financially. There is no aid agency at the moment to provide assistance in the areas of subsidies and scholarships for students to access education.” There are possibilities of contributing to and supporting the “Back 2 School” project in Liberia. If you are a member of a foundation or organization that can financially support the project or can consider promoting it, contact the responsible people through one of the links stated below. The link to their Facebook page: https://www.facebook.com/backschool

The link to their website: http://straightfromtheheartgroup.com T

he link to the online radio, One Liberia Advocacy: http://www.oneliberiaradio.org

Economical consequences

The Ebola epidemic did not only put people into states of anxiety and into deep emotional and social crises, but like Emmanuel T. Gibson already determined, it literally forced and still forces big parts of the population into life at the minimum subsistence level. The political economy of Liberia has been substantially impacted, in both affected and non-affected counties and the once-encouraging growth rates have been mercilessly felled by the virus. Important economical factors like trading and exports collapsed and had to be kept to a minimum. Overall, nearly half of the working population of Liberia has been unemployed since the crisis began. Those engaged in self-employment activities have been the hardest hit in most cases due to the closure of the markets in which they work. Before the crisis, over 30 percent of the heads of working households were self-employed, and according to a recent survey conducted by the Liberia Institute of Statistics & Geo (LISGIS), this is now down to just above 10 percent. The already inadequate healthcare systems experienced a deep blow, making the control of the disease nearly impossible. Major parts of the population didn’t have access to health services and  weren’t aware of the consequences of the disease and procedures for its prevention. In the three worst affected countries (Liberia, Guinea, Sierra Leone), almost 500 health workers lost their lives over the past year, a disaster adding to the already serious deficit of staff before the outbreak of the Ebola epidemic. Despite the problems faced in other spheres, the agriculture sector has proved to be resistant and sustainable even in the face of the outbreak. After the last survey round of LISGIS, it was reported that many people in rural areas are now able to return to farming and begin the harvest season in many parts of the country. In all likelihood, food prices and food security are two of the worst affected factors in Liberia’s economy. The price of nourishment increased to an inconceivable level and many people are worried of not having enough money to pay for their everyday food. Hunger, poverty, the breakdown of the health system and the state of emergency in the food sector: Whichever way you look at it, Liberia needs a well-conceived, actually working plan to be able to get the consequences of the Ebola outbreak under control and overcome the current economical and social crisis. Some important aspects of such a plan would be:

  • Rebuilding functional health systems in the region, starting with access to health services for the whole population
  • Providing households and public institutions with hygiene packages
  • Promoting the awareness of proper behavior in case of a recurring outbreak and the awareness of prevention procedures
  • Providing Ebola survivors, Ebola orphans and people having experienced the loss of beloved ones with the necessary mental and psychological support
  • Better preparation and cooperation among the international community to help to contain the epidemic in the shortest possible time

“In the long run there is a need to rebuild a better health system, with the capacity to identify and respond to any future outbreaks, be it Ebola, measles or pertussis. We need to continue to build on the decentralized and community-based surveillance, social mobilization and response systems that have been put in place […].” Sheldon Yett, UNICEF representative of Liberia

If you want to know more and stay updated:

The UNICEF Liberia website and facebook page: http://www.unicef.org/liberia/ https://www.facebook.com/Liberia.Unicef?fref=ts

Liberia Institutes of Statistics & Geo – Information Services: http://www.lisgis.net/index.php

Ebola situation reports of the World Health Organisation (WHO): http://apps.who.int/Ebola/Ebola-situation-reports

A simple explanation how the Ebola virus affects your body: https://www.youtube.com/watch?v=sRv19gkZ4E0

A very well-done and inspiring TEDxtalk by Javid Abdelmoneim “Ebola reflections: them, not us”: https://www.youtube.com/watch?v=ibKo2itlU-Q

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