Health workers face Ebola’s psychological effects

A World Health Organization worker trains Ebola health workers to use protective gear in Freetown, Sierra Leone.
A World Health Organization worker trains nurses to use Ebola protective gear in Freetown, Sierra Leone. (AP Photo/Michael Duff)

For some health workers, addressing the psychological effects of the Ebola epidemic in Liberia is as important as prevention or treatment.

Battling death and rumors

Rumors have fueled Ebola-related panic among the Liberian population, hampering a response to the epidemic and treatment of other major diseases, said Subarna Mukherjee, a director at Last Mile Health, a nongovernmental organization that is known in Liberia as Tiyatien Health. It was founded in 2007 by Raj Panjabi, then a physician at Brigham and Women’s Hospital and Harvard Medical School in Boston. The organization works in the Konobo region in the southeastern part of the country, where no confirmed Ebola cases have been reported.

[quote_right]”You go about your activities so you don’t endanger yourself and others.”[/quote_right]

Still, misinformation is rampant, Mukherjee said, and it complicates the group’s work. Last Mile Health recruits, trains and supervises health workers who provide care for the 10 most fatal diseases in remote villages. Recently, villagers have been afraid to see a health worker or go to the nearest health facility because they’ve heard a rumor that health workers kill those infected with Ebola.

As of September 18, the Ebola virus, transmitted through contact with infected bodily fluids, had killed more than 2,600 people in West Africa, according to the World Health Organization. Roughly half of those were in Liberia. Mukherjee, along with other U.S. staff members, was evacuated from Liberia after the Ebola epidemic broke out.

A health worker explains facts about Ebola to residents of Freetown, Sierra Leone.
A health worker explains facts about Ebola to residents of Freetown, Sierra Leone. (AP Images)

Ebola-related fear has some positive effect in that it drives people to be more careful, said Lorenzo Dorr, a Last Mile health worker. “You go about your activities so you don’t endanger yourself and others.”

Last Mile plans to shift its operations if the epidemic strikes in the locale where it operates. It will offer disposable protective equipment to suspected Ebola virus carriers in order to keep their caregivers and families safe. In mid-September, Panjabi, the founder, left for Liberia with Dr. Paul Farmer and members of Partners in Health, an international health nonprofit, to assess immediate needs.

Information as medicine

For now, the group focuses on refresher training for its workers on Ebola facts and ways to dispel rumors in “a culturally appropriate way.” The training includes nonmedical workers, Mukherjee said, because when those people talk to their families and neighbors, it is “a great opportunity to counter rumors.”

Last Mile Health worker Markson Farley cares for a child.
Last Mile Health’s Markson Farley cares for a child. (Courtesy Last Mile Health)

Last Mile wants to continue its most effective, life-saving interventions — treatments for pneumonia, malaria, diarrhea and malnutrition among children younger than 5 years of age. In 2013, around 50 of the group’s health workers treated more than 20,000 patients. But replicating that success won’t be easy. The Ebola epidemic has strained Liberia’s rudimentary health care system. Today, the health care facility that Last Mile works with has only two staff members, compared to seven or eight before the epidemic.

Last Mile Health workers on the way to patients.
Last Mile Health workers on the way to patients (Courtesy Last Mile Health)

U.S. help

President Obama is expanding a plan to help West African nations cope with the Ebola epidemic and counter the spread of the Ebola virus. The plan calls for sending around 3,000 U.S. military personnel (including more doctors and health care professionals), portable hospitals, laboratories, and other medical facilities, as well as expanded training for first responders and other medical workers. So far, the U.S. government has committed $175 million in medical equipment, supplies and technical assistance.

An airlift of 100 tons of medical supplies donated by nongovernmental groups, including Last Mile Health, left New York for Liberia and Sierra Leone on September 20.

Learn important facts about Ebola and its prevention so that you can stay healthy and correct myths. Stay up-to-date with news on Ebola from the U.S. Centers for Disease Control and Prevention.