An epidemic of compassion

Not long before sunset last Saturday evening, a group sat in a small circle on the porch of Christ Kingdom Harvest Church, in the New Georgia Signboard community of Monrovia. We were listening to local leaders speak about how their community dealt with Ebola, and why they have been free of the disease for over two months.

Pastor John Ghartay, a soft spoken man with a slender build but a broad smile, told us how every Sunday, he and community leader Walker Dennis gathered the parish together to talk about Ebola. People voiced their fear and scepticism, questioned whether Ebola was real, and expressed their suspicion of the Emergency Treatment Units (ETUs) where people go never to return. The pastor and other leaders would listen, reassure, and gently convince their flock that the virus was not a conspiracy but a life-threatening disease. They used the materials and instructions provided by Unicef, taught people to come forward if they fell sick, not to touch patients or dead bodies, and persuaded the sick to go for treatment.

“When someone got symptoms, we chartered a taxi to take them to the ETU,” the pastor said. “Someone walked with them to the taxi — never touching — and took them to treatment. Someone from the community stayed near the ETU. When they could not visit in person, we passed notes through the nurses to let them know someone was with them,” he said. Mr Dennis chimed in, “We told them to keep faith. Not to give up, to believe that they will get through it.”

We sat quietly, listening in admiration, moved by the courage and humanity on display in this tranquil village. Then someone asked what the community had learned, and the pastor’s wife Ophelia, quiet until now, spoke up. “Ebola was hard”, she said “What got us through was togetherness, patience, and faith. We looked after each other, and protected each other. And when some of the children survived,” she continued, “we brought them back and cared for them.”

We walked with them a few hundred yards to where the orphan survivors now live. The children range from 2 years-old to the eldest, Hawa, who at 21 years-old is now their adopted mother. The children smiled shyly at the strangers and seemed hesitant to touch, as if aware of the stigma that still follows survivors around. The Church has paid their rent for a year, and provides their food. We all walked back to the church, moved by the human toll of Ebola, but also at the epidemic of compassion in this community.

New Georgia Signboard is small, but it sets a big example of what it takes to beat Ebola. As the rockstar epidemiologist Hans Rosling, who is in Liberia helping the government, put it: “Ebola is both a biological and a social phenomenon.” In other words it is as much about behaviour as beds, as much about trust as treatment. Privately, many of the foreign epidemiological experts in Liberia admit it’s unlikely that the (belated) influx of beds, logistics, money and aid workers in October explains the decline in new cases around the country since then. More than anything else, it was communities, people, Liberians, who changed their behaviour and turned the tide.

The example it sets is the reason why President Sirleaf chose this community, on Monday, to launch ‘Ebola Must Go’, a new mass awareness campaign to remind people that Ebola is still here, and that communities need to lead the fight. At around 3200 confirmed deaths, Liberia has seen the highest death-toll in this epidemic, although with new cases down from 100 per day in mid-October to 10 per day last week the country can finally get on the front foot. “But getting from 10 to zero will be harder than getting down to 10,” the President told a packed church, with Cabinet Ministers, heads of CDC, UNMEER, Unicef on her left, a children’s choir on her right, and hundreds crowding outside to get a peek. As the epidemic evolves and retreats into remote corners, she said, so the response has to adapt, become more agile, and rely more than ever on community cooperation and leadership.

“Stopping Ebola is everybody’s business”, urged the banner behind the stage, as John and Ophelia Ghartay told the story of New Georgia to the audience and the nation’s media. The message was echoed by speaker after speaker, each paying tribute to New Georgia and calling on everyone to take a pledge to “protect myself, my family and my community from Ebola.”

The lesson from this community, and others like it across Liberia which have managed to expel Ebola, is important. A virus like this, which preys on people’s cultural practices and burial traditions, as well as our universal human need to touch, care for each other and comfort a suffering child, cannot be beaten by States of Emergency or mass quarantines. It can only be beaten with the consent of ordinary people and local leaders they trust, adapting their behaviours and acting with courage, responsibility and compassion. And lest we kid ourselves that the West is so different, we do well to remember the fear that gripped the media and the public in the USA and elsewhere. We may have been only a few dozen cases away from panic.

The persistence of Ebola around the country (and in Liberia’s neighbours Sierra Leone and Guinea) remind us that the public education and sensitization efforts so successful in New Georgia — known in the jargon as ‘social mobilization’ — have not been replicated enough. It is a reminder that the response, both at country level and from the international community, came far too late for many people. And we should not forget that social mobilization must still be backed up by enough beds, burial teams, decent treatment, rapid lab testing and food security so that the delicate trust built by health workers going door to door in communities is not dashed on first encounter with the system. But as Tolbert Nyenswah, Liberia’s Ebola tsar, put it at the launch, “These systems alone will not stop Ebola. Ultimately, chasing Ebola out depends on the communities of Liberia.”

For this community, life feels almost normal again. “We will never forget Ebola”, though, says Ghartay. Most survivors face intense stigma and fear, and although New Georgia Signboard has embraced their survivors better than most, Hawa still does not feel completely accepted. The small house, at the end of a narrow path, sheltering seven children who have been through hell, is a reminder of Ebola’s human toll and the care that banished it.

Photo credit: NPR

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