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Originally published July 27, 2014 at 7:54 PM | Page modified July 28, 2014 at 7:20 AM

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Fear hinders teams trying to treat Ebola in rural Africa

Health workers say they are battling two enemies: the Ebola epidemic that has killed more than 660 people in four countries since March, and fear, which has produced growing hostility toward outside help.


The New York Times

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KOLO BENGOU, Guinea — Eight youths, some armed with slingshots and machetes, stood warily alongside a dirt road at an opening in the high reeds, the path to the village of Kolo Bengou. The deadly Ebola virus is believed to have infected people in the village, and the youths were blocking the path to keep health workers from entering.

“We don’t want any visitors,” said Faya Iroundouno, 17, president of Kolo Bengou’s youth league. “We don’t want any contact ... wherever those people have passed, the communities have been hit by illness.”

Health workers here say they are now battling two enemies: the Ebola epidemic that has killed more than 660 people in four countries since March, and fear, which has produced growing hostility toward outside help. On Friday alone, health authorities in Guinea confirmed 14 new cases of the disease.

Workers and officials, blamed by panicked populations for spreading the virus, have been threatened with knives, stones and machetes, their vehicles sometimes surrounded by hostile mobs. Log barriers across narrow dirt roads block medical teams from reaching villages where the virus is suspected. Sick and dead villagers are infecting others.

“This is very unusual, that we are not trusted,” said Marc Poncin, the emergency coordinator in Guinea for Doctors Without Borders, the main group fighting the disease here. “We’re not stopping the epidemic.”

Efforts to monitor it are grinding to a halt because of “intimidation,” he said. People appear to have more confidence in witch doctors.

Health officials say the epidemic is out of control, moving back and forth across the porous borders of Guinea and neighboring Sierra Leone and Liberia — often on the backs of the cheap motorcycles that ply the roads of this region of green hills and dense forest — infiltrating the lively open-air markets, overwhelming weak health facilities and decimating villages.

It was in this rural area, 400 miles over bad roads from Guinea’s capital, Conakry, where the outbreak was first spotted, and where it has hit hardest. More than 80 percent of those infected have died in this region, and Guinea has recorded more than twice as many deaths as the other countries.

In Koundony, more than one-eighth of the population, including the headman, is dead; many others have fled.

There is no known cure for the virus, which causes raging fever, vomiting, diarrhea and uncontrolled bleeding in about half the cases and up to 90 percent of the time, rapid death. Even touching an infected person or a victim is dangerous; coming into contact with blood, vomit or feces can be deadly.

Now the fear of aid workers, principally Doctors Without Borders and the Red Cross, is helping to spread the disease. Villagers flee at the sight of a Red Cross truck. When a Westerner passes, villagers cry out, “Ebola, Ebola!” and run away.

This month, Doctors Without Borders classified 12 villages in Guinea as “red,” meaning they might harbor Ebola but were inaccessible for safety reasons.

In April, the epidemic seemed to be under control. But in the past two weeks, its center appeared to have shifted across the border to Sierra Leone. The sick are being hidden and the dead buried, without any protection.

Last week, the Sierra Leone Health Ministry reported that its lead doctor fighting Ebola had contracted the disease, and the virus had spread to a fourth country, with a confirmed fatality in Nigeria.

The Liberian government said Sunday that one of its most high-profile doctors had died of Ebola. Dr. Samuel Brisbane was treating Ebola patients at the country’s largest hospital, the John F. Kennedy Memorial Medical Center in Monrovia, when he fell ill. He died Saturday. A Ugandan doctor died earlier this month.

Over the weekend, an aid organization working in Liberia, Samaritan’s Purse, said that two Americans, a doctor who was treating Ebola patients and an aid worker on a case-management team, had tested positive for the virus.

Kent Brantly is in isolation and receiving treatment, North Carolina-based Samaritan’s Purse said on its website.

Brantly, a doctor, is the medical director of the aid charity’s Ebola center in Monrovia, Liberia’s capital. Nancy Writebol, who works for the manager of the hospital treating people with the virus in Liberia, has tested positive for Ebola, the charity said on the website Sunday.

Doctors Without Borders has set up an emergency treatment center in the regional capital, Guéckédou, but a nurse there said it had diminishing appeal.

“Here, if the people come in, they don’t leave alive,” said Fadima Diawara.

It may not help win confidence that the medical teams wear top-to-toe suits and masks, burning much of the outfit after helping a patient.

The wariness against outside intervention has deep roots. This part of Guinea, known as the Forest Region, where more than 200 people have died from the disease, is known for its strong belief in traditional religion. The dictator who ruled Guinea with an iron fist for decades, Ahmed Sékou Touré, was only partly successful in a 1960s campaign to stamp out these beliefs, despite mass burnings of fetishes.

Addressing villagers this month in Bawa, where a woman had just died, the regional prefect from Guéckédou, Mohammed Cinq Keita, warned: “There is no root, no leaf, no animal that can cure you. Don’t be fooled.”



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