The 25th May 2015 marked a special day: It was exactly one year since the first confirmed Ebola case occurred in Sierra Leone. One year trapped in horror, closed schools, unattended fields, destroyed economy. One year in which a single virus caused more than 3,500 deaths. Hundreds of children became orphans. And the fight is still ongoing.
The people in Sierra Leone are tired of the restrictions imposed by Ebola. They are tired of being scared of Ebola. Impatience and annoyance spread widely. Here is a fragment from the WhatsApp group “WHH Ebola Response”:
President Ernest Bai Koroma invited survivors to mark the sad anniversary and encouraged the public to abstain from stigmatization. He renewed his promise that all survivors who can present a genuine certificate of discharge will enjoy free health care in future. Until the 25th May, 4,013 survivors were registered nationwide.
Also Welthungerhilfe WHH will focus in the upcoming months on support to Ebola survivors. In the centre of our efforts stands economic support: food aid, cash transfers as well as counselling and preventive health care. We hope to give hope to the survivors who carry a heavy burden already. I’m hoping so much that Sierra Leone has only a few weeks left to suffer from Ebola. We ourselves at Welthungerhilfe want to go back to normal, back to our agricultural development projects and long-term perspectives that we’re trying to offer.
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.