Dr. William Perea is the Coordinator of the Control of Epidemic Diseases Unit in the World Health Organization’s Pandemic and Epidemic Diseases Department.
When I see the faces of the people dying of Ebola, I can see the stress and anguish it has on the victims. It’s a painful, horrible disease. The person knows that there is a high likelihood they’re are going to die, and due to the nature of the disease, they will be isolated from their loved ones and have to go through it alone. That’s what is so scary about Ebola.
This is why you can’t compare Ebola to any other outbreak – it goes beyond public health issues. Although, all outbreaks have something to do with politics, religion, or social behaviors, Ebola exacerbates those issues. Why? The fear factor. The fear that you will be admitted into the Ebola treatment unit (ETU) and never see your friends or family again. It’s a very human emotion that we all connect with and the emotional driving factor behind the spread of the virus.
So how can we play a role in easing this fear? How can we minimize the inherent feelings that come along with an outbreak of this nature? One of the main things that we’ve learned is the need for in-depth cultural understanding that respects burial ceremonies and traditions. Sounds simple, right? However, usually the burial traditions directly expose individuals to the virus, so those cultural traditions are the first to be eliminated in response efforts in order to contain the virus and save more lives. The repercussions of that can lead to mistrust between the community, health workers, and international relief organizations. Once that trust is gone, it’s a domino effect making it more difficult to gain control over the outbreak.
United Nations agencies and their partners have seen the damaging ripple effects that can occur and have made it a priority in the response to actively incorporate anthropological specialists. By having an in-depth understanding to guide this process more smoothly we have seen great progress. That expertise has led to an understanding that the burial process is very sensitive for the family and the community. Before starting any procedure the family must be fully informed about the dignified burial process and their religious and personal rights to show respect for the deceased before starting the burial. Cases like Nigeria and Mali are perfect examples of how trust can lead to success.
Through community engagement, cultural understanding, and education we can build and sustain trust. The underlying fear of Ebola cannot be eliminated, but our approach to the response can and is helping to ease those fears.