Interview with Dr. Carmen Valle about Ebola Crisis

As reported earlier, our work in countries affected by Ebola has been scaled down. Our Africa West Regional Office is closely monitoring the situation and has good access to local information. Basic hygiene practices are in place and information on the disease has been disseminated to staff to prevent exposure to the disease. Expatriate staff has been preventatively evacuated from Sierra Leone and Guinea. They are now relocated to Togo from where they provide remote assistance to CBM’s partner organisations. Although CBM is presently no longer active in any direct Ebola related programmes, we are supporting partner organizations that support health workers counselling those that have lost family members to Ebola. 
 
Featured below is an interview with Dr. Carmen Valle. She is implementing a mental health programme funded by the European Union in Sierra Leone, through a comprehensive approach that includes capacity building, awareness and advocacy.

Interview with Dr. Carmen Valle

What does your work as a psychosocial specialist comprise of?
As a psychosocial specialist my priority is mental health. Health professionals in West Africa are under tremendous stress due to this overwhelming situation. They are few in number and cannot respond quickly to the outbreak. They work non-stop and are trying to contain the situation. Some are even marginalised by their own families as they work with Ebola patients. We are offering health professionals and nurses additional training to be able to respond to the crisis. Psychological first aid guidelines from the WHO have been adapted specifically for the Ebola outbreak. 

We are also supporting Child Protection Agencies in their work with children and especially those recently orphaned due to Ebola. They are further expelled from their families and communities as they are feared to be carriers of Ebola. We address the trauma and stigma attached to the families of Ebola patients and strive for their psychosocial welfare. CBM additionally is pushing for the inclusion of persons with disabilities to make sure the health messages about Ebola are accessible to them.

What is the current situation regarding the Ebola crisis in Sierra Leone?
There are about ten to fifteen new cases being reported every day. Twelve out of the thirteen districts in Sierra Leone have reported Ebola cases. There are stringent restrictions on movement and travel and even NGOs dedicated to the outbreak need special permits to move to the affected areas.

Reviewing the current situation, virologists and specialist working in the outbreak are considering that the peak of the crisis could hit the country as late as December this year. More optimistic resources talk about October. 

What are the reactions of the local population regarding Ebola?
There are a range of attitudes in Sierra Leone regarding Ebola. Some people, especially in urban settings, are aware and concerned about this deadly disease. In cities you can find buckets of chlorinated water to wash your hands almost in every restaurant, market, health center, etc. 

However it is a different story in the rural areas. Some believe the Ebola situation is a lie fabricated by the government to extract money from the West. Others believe that international NGOs are doing experiments and trying new medication on them, and trafficking organs and blood. Various tribes are turning against each other, believing that they are responsible for all these deaths. 

The symptoms of Ebola are the same as those for other tropical diseases such as malaria and typhoid- they all start with a fever, then diarrhea, headaches and muscle pain. Hence many locals have mistaken Ebola for other diseases, and therefore haven’t sought adequate medical services. 

Widespread rumors, superstitions and misinformation regarding this vicious disease are our main problem. If we can address these and convince the local populations to accept medical services then we can contain the outbreak of Ebola. Nevertheless the situation is somehow improving- we have local health professionals and community based organizations and leaders involved in information dissemination- people who the locals are more inclined to listen to and trust.

What is the current plan of action?
International NGOs are engaging and coordinating with the Sierra Leonean government on ways to halt the outbreak. New measures are being put in place. There are more restrictions on movement and efforts are being made to have easy access to information and smoother coordination between stakeholders. A new Committee has been set up- the Emergency Operations Centre (EOC) comprising the Ministry of Health in Sierra Leone, Médecins Sans Frontières (MSF or Doctors without Borders) and the World Health Organization. This is the coordinating board which meets every day to review the situation and send reports once a week to international NGOs. MSF and WHO have leading roles in the EOC and are coordinating international efforts to respond quicker to the Ebola crisis. 

In addition there has been a Task Force right since the beginning of the outbreak. This Task Force, comprising the Ministry of Health and many international NGOs with offices in Sierra Leone, is responsible for managing new cases, surveying the extent of the outbreak as well as communicating and coordinating with external stakeholders about the situation on the field. An important component of this Task Force is psychosocial support where CBM plays an important role- ensuring health professionals as well as children have access to mental health support so that they can handle the stress and trauma that accompany this disease. 

Do you think that Ebola will spread to other parts of the world?
The chances of Ebola spreading to the rest of the world are relatively minor. We must look at the reality on the ground. In the West we are extremely well equipped to handle Ebola- our health systems are sophisticated, our preparedness allows us to quickly swing into action. We have financial and political resources. Unfortunately West Africa doesn’t have such means. Sierra Leone is financially and economically affected due to Ebola. Its health system has been dysfunctional for a long time and the outbreak is having a very negative impact on it. West Africa needs more financial, economic and logistical support and we really need to focus on supporting the people there.