Ebola survivors, three orphans and their uncle, receiving Certificate of
Medical Clearance as part of the Firestone Ebola Survivor Reintegration
Program - Firestone District, Liberia, 2014
Posted by
Florida Gazette
West Africa--The case fatality rate in West Africa’s ongoing Ebola epidemic –
estimates range from 60 percent to 70 percent of those hospitalized –
hides a hopeful statistic: the fact that many Ebola patients survive.
There now are thousands of Ebola survivors.
In this epidemic as in
past Ebola outbreaks, survivors often face stigma, income loss, and
both grief and survivor guilt over the loss of family and friends. Many
if not all of their possessions have been destroyed to prevent disease
transmission. In some cases, families have been reluctant to accept
orphaned children.
Two reports in the December 12 early release issue of CDC’s
Morbidity and Mortality Weekly Report
(MMWR) detail programs in Liberia and Sierra Leone to help Ebola
survivors reintegrate with their communities and resume their lives. As
survivors are thought to have some protective immunity to the strain of
Ebola that sickened them, many survivors now work as caregivers for
other Ebola patients.
“Nothing says more about the resilience of
the human spirit than Ebola survivors who become role models for their
communities,” said CDC Director Tom Frieden, M.D., M.P.H. “They show
others that Ebola can be defeated and provide care, support, and
inspiration for others stricken by this terrible disease.”
Support Services for Survivors of Ebola Virus Disease — Sierra Leone,
According
to an August 2014 survey by the Sierra Leone Ministry of Health and
Sanitation, CDC, and other partners, 96 percent of the general
population reported at least some discriminatory attitude toward people
with Ebola. This stigma discourages people from seeking Ebola testing
and treatment and increases the already difficult task of contact
tracing. It extends to Ebola survivors, who may be shunned by their
communities.
CDC staff joined a consortium of members of the
Sierra Leonean government, nongovernment organizations, and donor
agencies to assess the needs of Ebola survivors. The group performed a
study of three districts heavily affected by Ebola, convened a National
Survivor Conference, conducted focus groups with survivors, and observed
counseling sessions at a survivor wellness center.
The study
found that survivors faced immediate and long-term concerns about
physical and mental health, stigma, psychosocial issues including shame
and survival guilt, reintegration needs, and financial needs. Despite
these needs, survivors reported inadequate counseling, community
reintegration, and material support.
Survivors showed great
interest in contributing to the Ebola response through activities such
as sharing their stories directly through radio and other broadcast
media. They also expressed interest in participating in direct Ebola
care and treatment support in and providing spiritual support to other
Ebola patients to give them hope. Survivors said that supporting
themselves with this work would help restore their own dignity.
The
consortium now is coordinating financial and psychosocial support for
survivors. This support includes a “survivor packet” that includes cash,
bedding, clothing, and other essentials of daily living. Counselors
will accompany survivors when returning to their home villages to
facilitate reintegration, and trained counselors are speaking with local
traditional authorities and other community members about the
importance of survivor acceptance. Survivor support centers are being
established at the district level, and plans are underway to integrate
survivors into Ebola response activities.
Reintegration of Ebola Virus Disease Survivors into Their Communities — Firestone District, Liberia,
In
August 2014, the Firestone District of Liberia, where Firestone Liberia
Inc. provides health care to 80,000 residents, enrolled their first
patient in a model Ebola survivor reintegration program. The program was
designed to offer survivors psychosocial support as well as to lessen
stigma, provide hope, and motivate community members to report suspect
Ebola cases and to seek care early in the course of disease.
“Well-coordinated
survivor reintegration programs help stop the spread of Ebola and heal
communities,” Dr. Frieden said. “Businesses can follow Firestone’s
excellent example and contribute to the effort to get to zero in this
Ebola epidemic.”
From August through October, 2014, 22 patients
with laboratory-confirmed Ebola recovered from their illness at the
Firestone Ebola Treatment Unit (ETU). During the three days between
their first negative Ebola test and a second test confirming that they
were Ebola free, survivors were transferred to a recovery room in the
ETU and given education and counseling.
Meanwhile, a reintegration
team began preparing the survivors’ communities. The team met with the
survivors’ neighbors and community leaders, emphasizing that survivors
are no longer sick and are Ebola free. On the day of return, Firestone’s
medical director, the ETU coordinator, and other medical staff traveled
with the survivor to the community accompanied by the reintegration
team, radio station personnel, and clergy. Community volunteers
decorated the survivor’s home with traditional palm leaves to signify
the festive occasion.
Each survivor received a “solidarity kit”
including a new mattress, bedding, towels, an insecticide-treated
mosquito net, soaps and toiletries, a 110-pound bag of rice, three
gallons of cooking oil, toys (for children), clothing, and cash for food
and personal necessities. After the reintegration ceremony, the
physician-led Firestone medical team visited all survivors at home every
week for three months, both for a clinical checkup and to provide
social and psychological support.
No major reintegration problems
have occurred to date. Reintegration ceremonies continue to be
well-attended by dozens of community members, and the events have been
celebratory rather than confrontational events.
