The Fight Against Ebola

The chances of getting sick with Ebola in the United States are low (see “Is the U.S. at Risk?,” below). But Africa has experienced dozens of outbreaks of the disease over the past 50 years. And as many as half of all people who get Ebola die, according to the World Health Organization (WHO).

The current strain, or version, of the virus that causes Ebola is believed to have started in Mongbwalu. That is a gold-mining town in the northeastern part of the DRC. Many people travel through Mongbwalu looking for work. Tens of thousands of refugees also live near the town in camps for displaced people, forced from their homes by ongoing fighting in the region. They live close together with little access to clean water.

Those conditions help spread the virus. It passes from person to person through contact with blood or other bodily fluids of someone who is sick or has died from the disease. Contaminated objects such as clothes, bedding, and medical equipment can also give people the virus.

The first cases of the current strain likely arose in April or earlier, health experts say. Doctors didn’t realize they were fighting Ebola, so it spread undetected for weeks.

The DRC government officially declared the outbreak on May 15. However, many doctors in the affected area had no training in how to identify and treat Ebola. They didn’t have protective equipment or tests to diagnose the disease. And there is no approved treatment for this strain.

The DRC government and global aid groups sprang into action. They started sending health care workers to affected towns, sharing supplies, and training local doctors and volunteers. They are also setting up new treatment centers with separate areas for infected patients.

Health officials say they are fighting an uphill battle because the disease spreads so quickly. “Despite the good progress we have made . . . the outbreak is continuing to outpace the response,” said Tedros Adhanom Ghebreyesus in June. He is the head of the WHO.

With so many sick patients, some hospitals are running out of space. Sometimes a patient arrives at a hospital urgently needing treatment, but every bed is full, Sebushise says.

“We reach out to other treatment centers to see who has a bed. Everybody tells us, ‘We are also full,’” he explains. “Those are moments of panic.”

When that happens, doctors sometimes have to put patients together in shared rooms even though it would be safer to keep them apart.

Health care workers are trying to educate people about how to avoid Ebola. But even basic prevention, like handwashing, can be difficult. In Mongbwalu, only about 20 percent of people have access to clean water, according to the Africa Center for Strategic Studies.

In addition, family members in the DRC traditionally touch or kiss the bodies of their loved ones before burial. Many want to continue this practice. Yet even brushing against the body of someone who died of Ebola can spread the virus.

Volunteers are also trying to find people who may have been exposed to Ebola and urging them to stay away from others. That, too, is difficult, because symptoms can take up to 21 days to appear.

Fear is another challenge. After decades of war and violence, many people are wary of outsiders and government officials. Sebushise says false rumors have spread that anyone taken to a treatment center will never come home.

Some patients lie about their symptoms because they’re scared or they don’t want to leave their families. Many avoid the hospital until they are dangerously sick.

Seeing health care workers covered from head to toe in protective gear adds to their fear. “People come for help, but they are afraid of us too,” Sebushise says.

Even some doctors and nurses are frightened. After watching coworkers die of Ebola, some would not touch patients they thought might have the disease. At one hospital Sebushise visited, the staff refused to treat a woman who was bleeding, even though she had tested negative for Ebola.

Part of Sebushise’s job is showing health care workers how to treat infected patients without getting sick themselves. “We had to go and convince the workers: ‘If we don’t help her, she will die,’” he recalls.

Scientists are scrambling to find an effective treatment for this strain of Ebola. The U.S. is sending doses of an experimental drug, and the WHO is recommending medications to try.

Health officials have also sped up the development of three possible vaccines, which could help people build immunity against Ebola. But it will likely take several months for a vaccine to be approved for use.

In the meantime, the European Union, the U.S., and many other countries have pledged hundreds of millions of dollars to help contain the outbreak.

Sebushise says the key to stopping Ebola in the DRC is convincing people that medical providers can help them. He thinks those efforts are starting to work. By mid-June, he had begun to notice more people coming to the hospital when they first experienced symptoms instead of waiting until they were very sick.

Taking time to explain what will happen helps, he says. In June, when the 10-year-old boy’s father tried to stop the workers from taking his son into the hospital, Sebushise and his team reassured the father. They said people would care for the boy around the clock and that the family could visit from a safe distance.

“If we don’t act quickly, we could lose your son,” Sebushise remembers saying. “We still have a chance to save him.”

Finally, the father agreed.

The boy’s parents visited the hospital daily, from 6 a.m. to 10 p.m. Once a day, the workers wheeled the boy in his bed to an area where the family could see him through a plexiglass wall. They waved to each other. Through tears, every day, his mother said, “I love you.”

After two weeks, the boy had recovered enough to leave the hospital. It was a moment Sebushise will not forget.

“We all danced and celebrated,” he says. “It gives meaning to what we are doing.”