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Africa. Ebola – Missionaries on the Front Line

They stay behind despite a very real danger/fear of contagion because Africa is truly their home.

“At this moment of pain and uncertainty we cannot abandon our people; we can only try to bring them a bit of hope”. These are the encouraging words of Fr. Luigi Brioni, an Italian Xaverian Missionary living in Sierra Leone. His words echo those of so many Missionaries and Religious, foreign and local, who find themselves on the front line in the fight against Ebola – a virus that now holds the whole world in a grip of fear since it is officially responsible for well over 3,000 deaths in Guinea, Sierra Leone, and Liberia.
This news from West Africa is of growing concern to Europe and North America and yet the peoples of West Africa – with their missionaries – were dealing with this virus long before this epidemic broke and will remain there well after it is all over.

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In the fight against the Ebola epidemic, the Catholic Church is on the front line also because it has direct responsibility for some 60% of the health structures in the affected areas. Right from the start Catholic Missionaries and Religious, with their medical and ancillary personnel, were among the first to have to deal with this Ebola outbreak. And there has been a heavy price to pay in terms of lives lost.
In Liberia the virus has killed the director of St. Joseph’s Catholic Hospital in Monrovia, Bro. Patrick Nshamdze. Then, on 9 August, again in Monrovia, Sr. Chantal Mtwameme from the Congo also died. Three days after that Bro. Miguel Pajares, a missionary from Spain, died after having returned home for treatment. Both worked at the hospital in Monrovia.

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More recently (24 September), Fr. Manuel Garcia Viejo, a 69 year old Spanish missionary and doctor who had worked in Sierra Leone for the last 12 years, died despite being brought home to Madrid from the hospital of which he was the director in Lunsar, Sierra Leone. “For all of us, but particularly for the confreres in Sierra Leone”, wrote Bro. Jesus Etayo, Prior General of the St. John of God Order to which Fr. Manuel belonged, “this is a difficult time. Our intention in Liberia and Sierra Leone is to continue to be of service to the people, especially at this time when they need us most”.

Nigeria to Guinea – a common cause.

Despite the ever-present danger, male and female religious remained at their posts. The Salesians concentrate their efforts in the fields of education and prevention. In Ghana the ‘Don Bosco Redes Juveniles’ group runs a campaign aimed at prevention by educating people about Ebola through the use of video, audio and actual demonstrations. In Nigeria the Salesians have focused on providing information about Ebola in order to facilitate the work of prevention. Fr. Nicola Ciarapica, an Italian Salesian who has served for many years in Monrovia writes, “The Church is working to reopen hospitals and medical centres that had been closed and to better prepare other outlets which are still working; there is also the preparation and training of personnel who will assist the Medicine without Frontiers group and other health organizations; and we are taking on the paying of the salaries of teachers at Catholic schools and the provision of food to people who are still in isolation units”.

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Local religious are equally involved in the fight against Ebola. Indeed their contribution is key – as is explained by Fr. Joseph Turay, Rector of the University of Makeni and a member of the expert committee charged with the strategic planning required to fight this epidemic. Fr. Turay underlines that one of the greatest and most basic problems is, “ … the inadequacy of the local health system and in particular the lack of qualified personnel”. This where the local religious can make a significant difference. For example, in the Makeni district in the north of Sierra Leone, there are around 60,000 inhabitants who are served by three qualified medics. “The other big problem”, continues Fr. Turay, “is the total lack of the equipment most needed by both medics and volunteers, without which it is impossible to avert new cases of contagion among health workers themselves”.

Uganda recalled

This is not the first time that problems such as these have been encountered, something understood well by Bro. Elio Croce, a Comboni Missionary who lives in Gulu in the north of Uganda. Bro. Elio was there in Gulu during the Ebola epidemic in 2000. “We were completely unprepared,” says Bro. Elio, “but we set to work immediately, organizing a mobile network of 800 health workers and volunteers, and we succeeded in preventing the virus from reaching areas that were more densely populated”. When the Ebola epidemic broke in 2000, Bro. Elio was the Administrative Director of St. Mary’s Hospital, Lacor, Gulu, the main hospital for that region of northern Uganda. “Our student nurses,” recalls Bro. Elio, “began to die on 1 October. By the 9th we had sent samples to the Center for Disease Control in Atlanta and by 14th we knew that we were dealing with the Ebola virus”.

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The nurses and health-workers at St. Mary’s had smocks and masks but no access to the protective technologies used in the hospitals of Europe and North America. But then in Uganda the fight against Ebola started straight away thanks in good part to the help received from the USA. “On 18 October”, Bro. Elio continues, “a team of specialists from the Center for Disease Control arrived in Gulu bringing with them a machine that was able to identify the DNA of the virus and so to facilitate diagnosis”. The next step, essential if the virus was to be prevented from reaching Kampala or other regions of Uganda, was the deployment of the volunteers. “They kept an eye on the villages and warned us by radio at the first sign of illness”, Bro. Elio remembers, “and yet despite this system many people died. At St. Mary’s 12 nurses died and on 6 December Matthew Lukwiya, the hospital’s Health Director, who had survived the horrors of the civil war in north Uganda and had personally seen to the organization of St. Mary’s response to the Ebola epidemic, himself died.

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“In St. Mary’s the death rate among patients reached 48% and in the government hospital in Gulu town it reached 52%. Some 425 people were infected and of these 224 actually died. Thankfully, within a few months the emergency was over. The epidemic was officially declared over on 14 January 2001, 42 days (twice the incubation period) after the last case had been reported. The current epidemic in West Africa is significantly different to what we experienced or that experienced later in Congo and then around Lake Albert. Firstly, in Guinea, Sierra Leone and Liberia the virus has already reached the cities and centres of dense population. Secondly, it is likely that the seriousness of the problem was not recognised quickly enough and this, coupled with a lack of cooperation and collaboration between health-workers and the people, a reticence in reporting suspected cases of contamination, and a certain laxity in regard to the burial of those who had already died, all contributed to the compounding of the Ebola problem in West Africa today. It could so easily have escalated like this in Uganda in 2000”.

John Mutesa

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