Ebola survivors have a problem: At least three months after they are released as being cured, semen and vaginal excretions can contain the Ebola virus. That turns them into a risk factor in the fight against Ebola. They can cause a new outbreak of the virus anytime, even though the fight might seem to be won already. The recent new case in Liberia, after 28 days without new cases, might have been caused by unprotected sex with a survivor. That might or might not be the case. The fact remains that survivors are a real “danger”.
However, from my perspective, the attitude of the Sierra Leonean governments is not leading into the right direction. Last week the front page of the daily newspaper Awareness Times carried the headline: “Ernest Bai Koroma Warns Survivors to Delay Having Sex”. This is a message from his Excellency the president himself. In the article they say that hard measures are to be expected in case a survivor is causing another case of Ebola. And as far as I know at least one person was sentenced to one year in prison already, because he infected a sex worker.
From my personal point of view that’s the wrong approach. First, I think it’s unrealistic that survivors abstain from sex for three months. My impression is that at least 2 factors are being overlooked here: 1. The strong human tendency to neglect. Ebola was long considered to be just a rumour sewn by the government to weaken the opposition, and according to my national colleagues, HIV is also being neglected. 2. Sex seems to be considered as an essential “human right”. That is a dangerous combination in times of Ebola.
On top of this, I’m sure that no wife will blackmail her husband if he has to go for one year to jail afterwards! In case the infected person is a sex worker I can imagine that he or she will report to the police. But the own wife or husband will surely not want to lose her or his spouse, especially after just having recovered from a severe illness and potentially being a main contributor to the family’s income. Being punished for sex with the own spouse is just not implementable. How on earth does any lawyer proof that the infection happened during sexual intercourse when the couple concerned is denying it?!
I think it would be better to distribute condoms in high quantities AND to explain how to use them. Best in pictures. Such information material is readily available from HIV campaigns. Of course, the acceptance of condoms is in most African societies not high and Sierra Leone is by no means an exception. But the pressure from Ebola could even being considered as the optimal point in time to raise this acceptance. In any case I believe that the people have to be mobilized, affected people should act, take up responsibility themselves instead of being punished or rewarded from a “higher power”. It doesn’t make sense to put draconian measures in place. Instead, try to seek the consent and voluntarily compliance of the population. But would do I humble aid worker know about politics…
This is a translation of my original article in German.