Jesuits' response to 'one of the most lethal diseases in human history'
“The Church’s health care apostolate in western Africa, which is suffering from Ebola at this time … is particularly important. I pray for the repose of the souls of all who have died in this epidemic, among whom are priests, men and women religious and healthcare workers who contracted this terrible disease while caring for those suffering. May God strengthen all healthcare workers there and bring an end to this tragedy!” [Pope Francis, 23 September 2014]Jesuits across sub-Saharan Africa reach out daily to people affected by AIDS and seek to prevent the spread of HIV. The African Jesuit AIDS Network (AJAN) coordinates their efforts, inspired by the vision: Empowered individuals, families, and communities working towards an HIV and AIDS free society and fullness of life. With the spread of Ebola, AJAN’s work has taken on a new significance, as its Director, Fr Paterne Mombé SJ, explains.
Ebola stands out as one of the most lethal infectious diseases in human history, with a fatality rate of up to 90% (although it is around 55 to 60% in the current epidemic so far). It is a virus that causes first fever, headaches, muscle pain and conjunctivitis, then moves to a more severe phase which include vomiting, diarrhoea, and haemorrhage (internal and external bleeding). Severely ill patients or people at advanced stages of infection are highly contagious.
The situation is serious: the World Health Organisation (WHO) recently declared a public health emergency – something it has done only twice before in its 66-year history – and called for “extraordinary measures”. Medecins Sans Frontieres (MSF) said the scale of the epidemic had been “vastly underestimated” and that the situation was “deteriorating faster, and moving faster, than we can respond to”.
Although we don’t know yet which wild animal (‘reservoir’ of the virus) transmits the Ebola virus to the human community, provoking here and there a new epidemic, we know it is transmitted and spread among humans through person-to-person contact, or through contact with or consumption of bush meat (primates). More specifically, Ebola is transmitted through direct or close contact with blood, body fluids, and tissues or cadavers of infected animals or persons.
Peter Piot, who co-discovered Ebola with his team in late 1976 when a mysterious pathogen was killing people in then Zaire, told Reuters he’s saddened and frustrated by this and other outbreaks – partly because they should be easy to prevent, or at least to contain. “What we're seeing is a pattern that's been repeated in nearly every single Ebola outbreak,” the former UNAIDS director told Reuters. “It started in people who live in the forest, or in close contact with it, and it's then transmitted around hospitals... and then spreads further either at funerals or in households though close contact.”
Most cases of fatal exposure reportedly take place when medical staff or family members are caring for the afflicted or when families are preparing deceased patients for burial. It can travel from one country to another via travel, as symptoms of Ebola infection can take two to 21 days to manifest. However the virus is not airborne and WHO has said the risk of transmission of Ebola during air travel is low.
Containing the epidemic
As of now, there is neither treatment nor vaccine. Still Ebola can be contained. As Dr Piot said: “It's about respecting the basics of hygiene, and about isolation, quarantine and protecting yourself – in particular protecting healthcare workers, because they are very exposed.”
At the level of public health in African countries, effective surveillance mechanisms are a must to contain and control the current outbreak. It’s also a question of resources or rather of lack of resources. According to an article penned by Jim Yong Kim, president of the World Bank Group, and Nkosazana Dlamini Zuma, chairperson of the African Union Commission, Liberia has one physician for every 70,000 people, Sierra Leone one for every 45,000. More healthcare workers need to be deployed, more clinics opened, and more equipment put in place.
At the individual, family or community level, revising aspects of life, relationships, reactions and interactions, especially around caregiving and mourning/burial practices, is important. Measures to contain the epidemic hinge upon widespread information-sharing, communication, sensitization and education in hospitals, at home and in any community gathering.
So far, in a context where the epidemic is moving faster than efforts to contain it, the response has been too little, too late. We can only hope that urgent calls for action are heeded and that international and domestic actors make up for lost time to contain Ebola before it gets completely out of hand.
There are those who believe Ebola is a hoax; some relatives are removing patients from hospital, while others blame healthcare workers for bringing Ebola themselves. Some rural communities refuse to comply with measures proposed by international NGOs (non-governmental organisations) and central authorities, which they see as the source of the problem. This means community leaders and organisations, and this includes the Church, have an urgent role to play to enlighten people and to avoid disaster.
AJAN has long experience in drafting and disseminating easy-to-understand and culturally appropriate material about the AIDS epidemic. The network now plans to draw on this expertise to produce IEC (Information – Education – Communication) materials about Ebola. The materials will be disseminated in communities where Jesuits and other Church agencies like Caritas are present. We are calling for support to produce illustrated posters, flyers and leaflets to bridge the big information gap and to address the fears of Ebola that people are experiencing everywhere in Africa at this point.
Our plan is to distribute the IEC materials in countries neighbouring those already affected, such as Senegal, Mali, Ivory Coast, Ghana, Togo, Benin and Cameroon. Depending on resources, AJAN also plans to cover other African countries where Ebola may yet appear, such as Uganda, Democratic Republic of Congo, Central African Republic and Kenya.
In a second phase of intervention, the illustrated posters, flyers and leaflets will be accompanied by workshops and training-of-trainers, to enable local communities to share accurate information that will help prevent the spread of Ebola.