Liberians worry that next week's elections might spread Ebola

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Marco Werman: I’m Marco Werman, you’re tuned to The World. You’re probably not hearing as much about the deadly Ebola virus these days, even though it’s still raging in many spots in West Africa, especially in Sierra Leone. Officials there ordered a lockdown yesterday for the eastern district of Kono after authorities discovered a sharp spike in deaths and piles of unburied bodies. Next door in Liberia, the outbreak has calmed a bit with new infections significantly down in the capital, Monrovia. Still, those watching the outbreak unfold remain alarmed. Sheri Fink is a correspondent for the New York Times. She just returned to the US after spending two months in West Africa. Fink says in Monrovia, residents have no good reason to let down their guard.


Sheri Fink: There’s still about ten cases every day in the capital, and the fear about that is that people in the capital tend to move, people who get sick tend to go back home to their villages and there have been a few cases in recent weeks where new areas of the country have been affected by exactly this kind of movement. So, there’s a fear now with the holidays coming, with the end of the rainy season where it’s a bit easier to move around the country, even with elections, the Senate elections which are supposed to be happening next week, it’s a very controversial issue of whether they should go forward.


Werman: Elections are filled with rallies where people gather, packed in stadiums, getting people out in the streets -- how is the government reconciling the democratic process with practical issues about Ebola contagion?


Fink: There were two controversies. First was these elections had already been postponed once because of Ebola, from October, moved to this month. Then there’s been a big debate about whether it would be safe to have elections where people are going to march into the same polling booth and touch the same pens possibly. How do you protect people in that case? And then, of course, the issues of the rallies has been the big one because there was a big rally for this former footballer and thousands and thousands of young people were the streets. I actually got caught up, I was in a car on the main road, and we didn’t budget for a couple of hours. There were a lot of people doing things that are sort of shocking for Liberians to see right now.


Werman: In this age of Ebola.


Fink: Yeah, in the time of Ebola you don’t generally see people packed together, people with their arms around one another, people just in very close contact and that kind of tells you that people’s guards are a bit down now. I remember speaking to one of the health officials just after that rally and she said she had picked up the phone and called the incident commander of the Ebola response and said “We are in deep, deep trouble.” So, President Sirleaf had an executive order, she banned further rallies and then her son opposed that and took it to court, as well as all these other parties. The Supreme Court of Liberia has a bunch of things that it’s looking at this week, as to whether to hold the elections and whether to allow the campaigning to go forward.


Werman: Despite all the messaging about not shaking hands and proper burial techniques, like not doing it at all and letting authorities deal with that, there are still incidents, I gather, of people dropping their guard. Like, you were at a church service recently in Liberia and heard something that really flew in the face of safe practices.


Fink: In this case, at this church, the pastor was speaking about a congregant who had just lost his mother, just like in any religious congregation, announcing something significant, happened to mention that the guy had buried his mom late at night the night before, and the pastor was able to put me in touch with this gentleman who explained to me that, yes, this was a secret burial. His mom had died in the capital and his brother had taken her body back to their home village and they had buried her there wearing rain coats for protection. The reasons were many -- they had had another family member die recently, who they had to call the official phone number you’re supposed to call to have the body picked up by the safe burial teams wearing those moon suits that we’ve all become accustomed to, and it took them awhile to respond. Having a body in the home, after they’ve died, for some time is really disturbing. Then they never found out whether the family member had or did not have Ebola. So then, when the mom died, they took matters into their own hands. Of course, you had the movement of the body to a new place and that’s exactly what people are concerned about.


Werman: But for the most part, those messages seem to have gotten through? It’s just making sure they stick. I guess some of the panic in the city of Monrovia subsided precisely because of the success of some of those efforts, but I guess in rural areas, it’s still a big challenge? What did you find?


Fink: Thinking back on how things were in March, April, May, June, when there was so much fear around what Ebola was, there was so much confusion, there was even active resistance to the efforts of charities or health officials coming in. So, there’s been so much effort to improve the messaging, but in some of these really remote places where they’re just experiencing cases for the first time, there’s been a problem. I feel like when you see somebody this many months into this outbreak, when you see whole communities, whole families experiencing Ebola and being decimated, that is just really tragic because there are, at least in Liberia in most places, more resources.


Werman: And these are pretty remote areas, the parts of Liberia where these cases are popping up for the first time, and apparently you can only access them by helicopter and there seems to be some controversy over how those helicopters should be used.


Fink: In the one case, this area of Gbarpolu County, this group of villages is reachable really only by helicopter or by boat. For people from the affected village to get to official help, it required

a walk of about 4 hours through the woods to the edge of the river, and then people could be transported over that river and then on a road for about 4 more hours to the nearest treatment center. So, there’s been an effort to respond in that area by bringing in people with helicopters, but the helicopters, at least at that point a couple of weeks ago, were not taking blood samples out, so you couldn’t test people who had symptoms and find out if they had Ebola very quickly.


Werman: Why were they not taking the blood samples out?


Fink: There is an international standard for packing up these samples so that they’re safe to transport by helicopter, but it still wasn’t happening, so I’ve been told that that policy is changing or has changed, I haven’t seen it myself. But that was a real frustration to people. Of course, these air assets aren’t transporting patients at this point; they haven’t worked out how they would decontaminate the helicopters to do that. They aren’t even picking up responders, at least in the case of the US military a couple of weeks ago, if the responders had been on the ground in a hotspot for more than 24 to 48 hours, they weren’t willing to pick them up because they considered that they may have, at that point, contracted Ebola or had some possibility of having symptoms of being infectious.


Werman: Now that you’re back, I gather you’re doing your due diligence with a 21-day period of self-monitoring and just before this interview you got your daily call from the New York City Department of Public Health. Let’s just take a sample of what you guys spoke about.


[Audio excerpt from Sheri Fink’s phone call with the New York Department of Public Health]


Fink: It’s actually quite nice. As you can hear, they’re quite cheerful. It’s done in a very caring manner, so.


Werman: It is legitimate concern though, it’s not just being solicitous -- “You were there and now we just want to make sure you’re okay.”


Fink: Yeah, of course. It is of course for the purpose of keeping track of people who may have had some exposure. Anybody who has Ebola is only going to have a risk to the public if they’re having symptoms. But they’re just keeping track of everyone and making sure that they’re not any risk to the public.


Werman: New York Times correspondent Sheri Fink, thanks very much.


Fink: Thank you.