Has An Ebola Corner Been Turned? One Perspective: 'No, No, No, No'

Aug 15, 2014
Originally published on August 18, 2014 8:35 am

Emily Veltus, a health educator working in Sierra Leone, says her organization, Doctors Without Borders, is "maxed out" in dealing with Ebola and that more help is needed to control an outbreak that is still raging.

Speaking with NPR's David Greene, she said the outbreak continues to pose enormous risks. Asked if a corner had been turned in managing the disease, she answered, "No. No, no, no, no. Not at all. Absolutely not. The number of cases is spreading throughout the country now. Liberia is also really out of control. It's not under control here at all. We're managing. We see small improvements. But this outbreak is far from over, unfortunately."

What would help? "It would be great if there was more response," she says. "Really the response needs to improve. MSF [Medecins Sans Frontieres, French for Doctors Without Borders] is managing the treatment center here, the health promotion outreach, but we're at max capacity and a lot more needs to happen."

There are many pressing needs, she says. More people are needed to bury the dead quickly. Better ambulance service is needed, as are health workers who can do "contact tracing — if someone's infected, seeing who they were in contact with."

Another critical need, she says, is for staff to monitor and care for children orphaned after their parents succumb to Ebola.

Veltus spoke about the situation in Kailahun, Sierra Leone, at the heart of the Ebola outbreak. MSF runs an 80-bed hospital that has admitted 320 patients in recent weeks. Of the hospital's 204 confirmed Ebola cases, 53 have survived, Veltus says.

Working daily with small primary health clinics in far-flung villages, Veltus has had to overcome rumors, confusion and fears about Ebola as she explains the disease's sources, transmission and treatment. In that arena she has seen progress.

"There's been an amazing transformation in the last month," she says. "Health workers have been trained to go back and spread the message to communities, and people are really starting to understand."

The Sierra Leone military has placed the Kailahun region under a military quarantine in an attempt to thwart the spread of disease. "We've seen an increasing number of checkpoints in the region," Veltus says, "and they're taking the temperatures of people passing through, and blood pressure. The military is in Kailahun but it is still pretty similar to what it was a couple of weeks ago."

The 53 Ebola survivors treated in MSF's hospital provide a glimmer of hope in an otherwise grim landscape. Veltus accompanies survivors back home after they've recovered from the disease. "It's incredible when people realize there's a survivor inside the vehicle. It's very special," she says. "Each time we bring a survivor home, we hug the person in front of their family and friends to show they're not a risk. And we like to get the family together and take a photo with them. We have a wall of survivors in our office."

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The World Health Organization says there are almost 2,000 cases of the Ebola virus in West Africa and more than a thousand deaths.


The WHO also says there's evidence these numbers vastly underestimate the magnitude of the outbreak. In Sierra Leone, the military has set up blockades around affected areas, but people on the ground say the checkpoints are porous. One aid worker there told us that people are being stopped to have their temperatures taken, but things have not improved in the past few weeks.

GREENE: That aid worker is Emily Veltus, and we're about to hear her account from the front lines. Emily's 29. She's from Wisconsin and now works with the aid group Doctors Without Borders, which is known internationally as Medecins Sans Frontieres, MSF. Right now, she's in the Kailahun district in Sierra Leone. Her job is to educate communities, but she said the first challenge was just getting into villages to talk to people.

EMILY VELTUS: When we would arrive, they would say go away. Some people thought that we, in fact, were the ones bringing Ebola. They thought that when we disinfect couches, the chlorine spray that we're using was Ebola. I think most of them are just really, really terrified.

GREENE: Terrified because this area has been so devastated by the virus.

VELTUS: The first places that were hit were the primary house care units because people would become sick and go there and the staff didn't know what Ebola was or how to protect themselves. So, actually, throughout the entire region and even within the Kailahun district, a lot of healthcare workers have died of Ebola. And so, sometimes, it is a little bit - I get a little bit nervous when I'm entering into the village because some villages have lost, you know, 30 people to Ebola. So we're very careful not to have meetings inside of the health posts but to have them in a more open area.

GREENE: So you don't want to be in homes or buildings where people have had the virus and died.

VELTUS: No, they're supposed to be disinfected, but that doesn't always happen right away. So we're very careful not to touch anything when we do enter a health post. And then we use chlorine spray for our hands, and then we have a more concentrated chlorine solution for our feet - to spray our her feet before we get back in the vehicle.

GREENE: And you're saying health posts - these are like mini hospitals in some of these small communities?

VELTUS: Yeah, they're just small clinics - just a few rooms.

GREENE: Now, Doctors Without Borders has a special Ebola hospital where you are based. What is the situation there? Are there enough beds for people or are your colleagues able to treat everyone?

VELTUS: In the past month, we've gone from about a 30-bed hospital to an 80-bed hospital. In total, we've had about 320 admissions. We've also had 53 survivors, and we've had 110 deaths.

GREENE: Fifty-three survivors - I guess those are the cases that give you a moment to feel some optimism.

VELTUS: Yeah, it's wonderful. I'm lucky I get to go out into the communities with the survivors and bring them home. Usually, what we do is we go, first, to the paramount chief in that area, and we have the person present their certificate. If there are any questions, we answer them because, of course, people are nervous when they have an Ebola survivor come back, at least, the first one in a community. We do a lot health promotion there, as well. And then, we bring the person back to their family. And it's incredible when you're driving around the road and people realize that it's an MSF vehicle coming and that there's a survivor inside and they get their family and they get their friends and they just start yelling the name of the person and chasing the vehicle and waving and crying. And it's very special. Yesterday, I brought one survivor home, and his son who is probably four years old, walked up to me and put out his hand to shake my hand because he was so happy to have his father back. But, of course, I can't touch him because there is a no touch policy nationwide right now.


VELTUS: I wish I could.

GREENE: So you said there's a certificate involved. Is that a certificate officially saying this person longer has the virus - you don't have to worry about them?

VELTUS: Yeah, it's a discharge certificate, and it does say on there that they don't pose any risk anymore - that they can no longer get infected and they can no longer infect anybody else.

GREENE: There's a photo that I saw online of you hugging a little girl who did survive, and I wondered if you know - besides recording what must have been a very powerful moment for you - there was another reason to take that picture and just send a message that it is safe to embrace someone who has survived this disease.

VELTUS: Yeah, so, actually, we do that every time we bring a survivor home. We hug the person in front of their family and friends and the chief to show that they are not a risk. And then, we also like to get the family together with the person and then take a photo.

GREENE: Emily, how worried are you about your own health?

VELTUS: You know, I trust MSF, and I trust the protocol. And to this date, they've never had one of their staff members become infected with Ebola. I think, maybe, there was one, but he was infected at home. And so with that, I feel safe. I feel protected. But I'm in the middle of the largest Ebola outbreak in history, and we're constantly surrounded by it. So, of course, there's always, perhaps, a little bit of paranoia. But I think, in general, I feel pretty safe.

GREENE: You have been working in unimaginably difficult circumstances with communities that are so poor and are now dealing with a health crisis that is killing so many people. I just wonder is there a moment that has sort of stood with you as you've watch these people fight this?

VELTUS: My first day, the first Ebola patients that I met had a husband and a son who were in the affected area and they were negative. And I remember kind of playing hide and seek with the little boy around a chair and a couple of weeks later, found out that he ended up getting infected, and then, he had passed away. And so that was difficult because you do see a lot of families, and you know them from the beginning. And you know they're going to break your heart.

GREENE: And let me just ask, Emily - from your vantage point there, do you feel like a corner has been turned in...


GREENE: ...Fighting this?

VELTUS: No, no, no, no - not at all. The number of cases is spreading throughout the country now. Liberia is also really out of control. And it's not under control here at all. So we're managing, and we see small improvements, especially in how receptive the communities are. But this outbreak is far from over, unfortunately.

GREENE: Emily, thank you so much for taking the time to speak with us. And best of luck to you and your work there.

VELTUS: Yeah, thank you.

GREENE: That's Emily Veltus. She works with Doctors Without Borders right now in Sierra Leone. Transcript provided by NPR, Copyright NPR.