TORONTO – “We’ve noticed the people who go into your hospital don’t come out so we don’t want our family members to go in there,” he was told.
While on “ground zero” of the Ebola epidemic in Guinea with Doctors Without Borders, Canadian doctor Tim Jagatic is facing that sentiment from locals in West Africa.
His team of doctors and nurses have been chased out of villages, his advice to stay away from deceased victims is brushed aside, and the survivors he’s cured of Ebola are stigmatized by their community.
“When the virus is being spread, there are ideas of witchcraft, of this being a government conspiracy. These types of ideas come forth before basic public health ideas,” Jagatic told Global News.
READ MORE: What you need to know about Ebola
Health officials, such as Jagatic, are facing an uphill climb as they tackle the globe’s largest Ebola outbreak in history. It’s the first time in 20 years the virus has been reported in West Africa. Now, cases have been reported in Sierra Leone, Liberia and Guinea. As of Sunday, 844 cases – including 518 deaths – have been reported, according to the World Health Organization.
The international agency also released an update that shed light on why the disease is spreading.
“Some negative cultural practices and traditional beliefs, resulting in mistrust, apprehension and resistance to adopt recommended public health preventive measures,” was WHO’s first major factor.
Patients aren’t stepping forward for help. Their family members, meanwhile, are hiding them and even carrying out customary burying rituals when they’ve died. But victims are most infectious at death.
“So when somebody touches that body and transfers high levels of virus from the body to themselves, makes contact with the eyes, nose or mouth, that’s how the virus is being spread,” Jagatic explained.
Ebola haemorrhagic fever (EHF) is one of the most notorious viruses known to mankind and its marked by the sudden onset of intense weakness, fever, muscle pain, sore throat and headaches.
Victims’ symptoms include diarrhea, vomiting, multi-system organ failure, and internal and external bleeding. In its final stages, some patients bleed from their eyes, nose, ears, mouth or rectum.
“There are certainly diseases that are easier to catch than Ebola, but there are very few that are as scary,” according to Dr. Michael Gardam, director of infection prevention and control at Toronto’s University Health Network.
“It’s scary. It’s had movies made about it and it’s the ultimate scary viral infectious disease that people have heard about for decades,” Gardam told Global News.
It also has a “fairly rapid” incubation time, Canadian microbiologist and author Jason Tetro explained.
“You’re going to start feeling the symptoms and it’ll knock you down rapidly,” he said. This is why the experts say it’s unlikely the disease could migrate beyond West Africa.
“There’s very little likelihood someone will come into contact with a sick person and jettison off somewhere because the people who do come into contact with those infected are family members and health care workers,” Tetro explained. Sick patients, right now, also tend to be in rural areas of Africa where locals aren’t typically hopping onto planes for travel.
Even if a case made its way overseas, Gardam is confident that Canadian health officials have the safeguards in place to protect the public. Post-SARS, protocol for nurses, doctors and paramedics changed dramatically and surveillance is now in place brokering intelligence on rising diseases that could pose a threat.
Patients are now screened for a fever, cough or trouble breathing. They’re asked a critical, telling question: have they recently returned from another country? Frontline health care workers assessing them don masks, gowns, gloves and any other equipment that acts as a safeguard.
Hospitals have better ventilation, single rooms, and plexiglass walls act as a barrier between emergency room front desks and sick patients.
There’s also compliance to advice doled out by health officials. Gardam remembers SARS: those who felt sick abided by recommendations to stay home, families avoided visiting their sick family members in hospital, and Ontarians were careful with hand washing and personal hygiene.
But Gardam understands the hesitancy the public may have as an outbreak wanes on. “People got frustrated and sick and tired of being told what to do,” he said of the final stages of battling SARS.
The only glitch Gardam is worried about is if a case of Ebola is overlooked by the first few healthcare workers who see a sick patient.
Ebola typically presents as a respiratory illness, basically pneumonia, and because it’s so rare, some frontline healthcare providers may not immediately think of the disease.
“No one has invented a system of identifying somebody with a potentially dangerous disease immediately. It always takes awhile,” Gardam said.
In the meantime, Tetro and Jagatic are hopeful those in West Africa will work with the health organizations helping them.
Jagatic says that Doctors Without Borders managed to help dozens of sick patients in Guinea. He returned to West Africa on Sunday and he’ll continue to work with quarantined patients, help with community outreach and education and training local doctors.
Educating communities about how lethal Ebola is may be the pivotal turning point, Tetro said.
“Unless we comply to proper hygiene and infection prevention and control measures both in health care and the real world, this will keep coming around again,” Tetro warned.
“While we pray, the pathogens prey.”