Overcoming Ebola stigma takes time

Ebola survivors in Liberia and Sierra Leone are facing mixed reactions as they return home after contracting the deadly virus. While some have been welcomed back into their communities, most are facing discrimination and stigmatization, or have even been shunned.

"I returned back to the community very happy," said Ibrahim Thomas, who lives in Freetown. "I didn't have any problems with the community or anybody. The worshippers at my mosque used to pray for me [when I was sick], so when I came back, they were so happy to see me alive and well."

Thomas, who lost his wife and two of his children to Ebola, said many of his neighbours have been sympathizing with him and doing what they can to help.

But not all survivors are so lucky.

Non-acceptance

"I was devastated when I returned to my community," said 27-year-old Alhaji Bangura, who lost both parents, his wife and two children to Ebola in Sierra Leone. "I was very lucky to survive. but now some people are still afraid of me, even to come very close to me. I had so many friends before but now most of them have distanced themselves from me."

Bangura said most people will only talk to him outside their home and often refuse to give him any food or drink.

"One day I went to the well to fetch water. and when I came close nearly all the children and other adults started to move away from me," he said. "I have never had such an experience in my life."

Bangura is not alone. According to a survey by UNICEF, 96 percent of Ebola survivors in Sierra Leone have experienced some sort of discrimination. More than three-quarters of respondents told UNICEF they would not welcome back an Ebola survivor into their community.

"There is stigma for sure - although not in every single instance - but given the fact that Ebola is new to this area and that it is a deadly disease with no cure, people are afraid of association with people who have had Ebola," said Rukshan Ratnam, a spokesperson for UNICEF in Liberia. "It's not that they are purposely stigmatizing them, but it's linked to fear for their personal health and safety."

Abandoned

Naomi Teah, who was treated at Monrovia's ELWA 3 treatment unit, said her husband left her after she tested positive for Ebola.

"My man can't even talk to me," she said. "I was thinking that [he] was going to be happy, but since I came back, his ways changed towards me. He does not care how me and the children eat and I am not strong enough yet to go look for food. People say I don't have Ebola, but still my husband won't come near me."

Teah said she is now relying on handouts from neighbours in order to feed herself and her sons.

Ebola survivors need not apply

Abraham Turay used to work as a taxi driver in Sierra Leone's Port Loko District before he contracted Ebola. But as news of his survival has spread, he says people from his community are afraid to ride in his car.

"Now, I have to go far before I can find passengers," he said. "And when I come home, I just go straight inside because many people who used to sit and talk with me, no longer do that," he said. "So I am just by myself."

Thomas, despite his warm welcome, lost his job as a machine operator for a mining company upon his recovery.

A fresh start

Eighteen-year-old Pauline Joseph, who was treated for Ebola at the ELWA 2 treatment unit in Monrovia, said she had to leave the city to escape the stigma.

"When I came home everybody started looking at me differently," she said. "They all acted like they were happy for me to be back home, but the way we used to be together, they do not want us to eat together and do things together any more."

Pauline says she decided to stay with her aunt in Kakata, a town about 70km from Monrovia, until people's fear of Ebola has passed.

"You can't be somewhere where all your best friends are behaving like they are too busy to be with you," she said. "It makes me feel sad."

Fostering acceptance

To help ease the transition of survivors back into their communities, Sierra Leone's Ministry of Health and Ministry of Social Welfare say they have begun accompanying survivors to their homes. Officials explain to families and neighbours that survivors can no longer spread the disease through normal, day-to-day contact.

Similar messages are being spread door-to-door by volunteers, and even some religious leaders, to communities before the survivor arrives home, as well as broadcast nationally on radio and TV.

"Our message is that these people are no longer infectious and no longer a threat to anyone's health," said Sidie Tunis, a spokesperson for the Ministry of Health. "They should be embraced and welcomed back with open arms and open hearts into their families and communities."

In Liberia, the Ebola Survivors Association has been making similar appeals to get people to stop discriminating against survivors.

"[People] need to be receptive to the survivors," said Korlia Bonarwolo, an Ebola survivor and president of the association. "You have to show them love, you have to show them care, because they are already traumatized."

At least 400 mental health and social workers are now being trained by UNICEF in Liberia to provide psychosocial support to survivors, as well as do periodic follow-ups once the survivors leave the hospital.

Before being released, MSF also offers psychological counselling to help survivors understand that life after the centre will not necessarily be easy, and how they should handle any possible stigmatization or discrimination.

MSF presents all survivors with a medical certificate as proof of their recovery.

A slow process

"Often it is very difficult to be reintegrated into the community," said Suafiatu Tunis, a coordinator for Sierra Leone's community response groups, who has been organizing psychosocial counselling for survivors and their families in Sierra Leone. "Even after they are brought back, maybe by a chief or an elder in the community asking them to embrace these people, it will only last for some days. Then they will go back to withdrawing from these people."

Other times it just takes time.

"Some people were afraid to come close to me at first, but now they are getting more comfortable with me," said 14-year-old Hawa Turay, who contracted Ebola from a visiting cousin in September. "They know now, that as a survivor, the virus is no longer in my body."

Turay says she is able to move freely within her community, play with friends and do chores. She says that, if anything, people are actually nicer to her now.

"My parents were really supportive during the treatment period and they see me as a hero to have survived such a deadly disease," she said. "Since I returned home they have been very helpful to me and many other people are happy to see me alive and back home."

Tunis said it's important for people to remember that being an Ebola patient is not a crime.

"It's a health issue that anybody can have," she said. "Seeing an Ebola survivor should be a hope for others not to be afraid of the disease. So survivors should be able to have a free mind without fear of coming back into the society they once belonged to."

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