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Ebola: “Until the number of cases reaches zero, we’ve still got work on our hands”

Emergency Health
Sierra Leone

After recently returning from Sierra Leone, where she coordinated Handicap International’s emergency operations, Nathalie Derrien talks to us about her experiences and the situation in the country worst affected by the epidemic.

Ebola prevention messages painted on to a wall in Freetown, Sierra Leone.

Ebola prevention messages painted on to a wall in Freetown, Sierra Leone. | © Gaelle Faure / Handicap International

Why did you join the emergency humanitarian relief effort?

I went because I knew I was capable of doing the mission, but also because I was curious. I wanted to understand what was really going on. It’s true that a lot of people were worried about it, and I was particularly aware of that before I left, but strange as it may seem, I found that people on the ground, in the countries affected by the epidemic, were a lot less afraid. On a day-to-day basis, it’s not so much fear you feel as the tight social restrictions. It’s impossible for people to live normal lives because they need to comply with really strict health protocols, which limit personal contact and travel. In my immediate environment, at least, there was no psychosis about Ebola, so I was able to work normally.
 
You were in the field when the statistics revealed a sharp drop in the number of new contaminations for the first time since the start of the epidemic. Did this change the way you worked?

The news did everyone a lot of good, and gave cause for hope, and that’s exactly what people living in affected countries need. After nearly a year of sacrifices, they are relieved to see their efforts are finally paying off. In Sierra Leone, on the other hand, the number of cases is still too high for us to make any significant changes to the way we work. We’re currently taking part in a nationwide awareness-raising campaign to ensure everyone gets prevention advice. Our messages are targeted particularly at people who are socially isolated, disabled or whose circumstances otherwise prevent them from accessing information correctly. They are still at a high risk of being contaminated and now is not the time to take our foot off the prevention pedal. Until the number of cases reaches zero, we’ve still got work on our hands. We need to keep giving it everything we’ve got.

What do you remember most about your experience? Did it differ from your work on other humanitarian emergency relief efforts?

What really stands out for me was how level-headed and conscientious people were when it came to tackling this huge challenge. There’s been a lot of talk about incidents between communities and relief teams, some pretty appalling, but very little was said about how most people are dealing with it in a very brave way. It’s a very unusual situation because you need to implement a large-scale and restrictive relief effort without causing panic or riots.
 
On a more personal level, it was different from my previous experiences because I was working on something that you can’t actually see. You see the coveralls, the control points, and you can sense there’s an epidemic, but life goes on regardless - under tight control, but it goes on. “The enemy” is there, but at the same time, it’s nowhere to be seen. We use indicators in our work to monitor the illness, but you only very rarely see it around you.
 
What was it like when you got back to France?

It was fine. It was a tiring mission, so it’s good to take a break. I’ve been warmly welcomed by my friends and family. They understand that I’m not a threat to them. They know that as long as I don’t display any symptoms, I’m not contagious. For an expatriate staff member not working in direct contact with sick people, the risk of being contaminated is very small. Other than that, I’m getting back into my old routine, like kissing colleagues and friends on the cheek. Although the two worlds are very different, the transition between them is easy.

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