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Testimony from the field: “Morale is important to defeat Ebola”

When caring for patients during an Ebola outbreak, medical treatment is not the only aspect of the care. Oléa Balayulu, a clinical psychologist and the head of ALIMA’s psychosocial team in Beni, in the Democratic Republic of the Congo, where an outbreak of Ebola continues to affect North Kivu and Ituri provinces, explains why the psycho-social aspect of the response is essential.

Tell us, what is the role of a psychologist during an outbreak of the Ebola virus disease?  

A psychologist plays a very important part within the response to an Ebola outbreak. As you know, the Ebola virus can be dangerous and deadly, if it is not treated early. And people, they are scared to die, especially in such a quick and brutal way. So during an outbreak, particularly in a place like Beni, where this is the first time they are experiencing Ebola, people are scared. They are scared of the unknown, they are scared of being infected, they are scared of dying, they are scared of losing loved ones. Within the communities, there are many rumors circulating about Ebola: about its cause, about the vaccine, about what happens at the treatment center. And when the fear of death is high, this can cause problems when it comes to accepting help. It can cause problems when it comes to accepting that Ebola exists, when it comes to accepting treatment, when it comes to accepting a safe and dignified burial, if necessary. The common mentality is that if Ebola doesn’t exist, it means you can’t die from it.

So our job, as psychologists, in collaboration with community health promotion teams, is to dispel the rumors and to reassure people, to ease their fears. Whether it is within the community, or within the treatment center, or within another health structure, we are here to listen to people’s concerns, to answer their questions and to provide counseling. It is normal that they are stressed and worried, and our role is to support them and make them feel safe, and help them accept the treatment. Patients and their families, as well as health workers, need to be heard. And that is why we are here: to talk with them, to keep their morale high and to reduce their fear.

What are some of the key messages you pass along to patients and their families?

First, we explain what Ebola is – we explain the possible symptoms, we explain how the virus is spread, we highlight best practices and prevention measures, and then we describe the treatment and what kind of care they will receive at the center. Most importantly, we reassure people that not only can you avoid Ebola with certain prevention measures, such as washing your hands, and not touching anyone who appears to be sick or who has died, but also that with proper care, and early care, you can be cured from Ebola.

We explain that at the treatment center, there are specialized doctors and nurses who have been trained to care for patients with Ebola, and that we have had many survivors leave the center cured and alive. We also make sure people understand that all the care is free. Many times families worry that they can’t afford a long hospital stay or medications, and this adds to their stress.

During treatment, each day we spend time with and counsel the patients. They are, of course, terrified of the idea of dying. They are scared to be put into the CUBEs or the tents. So we reassure them that they can survive, we encourage them to fight, to take their medications, to eat the meals the doctors give them to maintain strength, and above all, to maintain hope. We tell them that they are stronger than Ebola, that they can beat this virus.  Many times, survival is largely about the mentality of the patient and their spirit. Morale is important to defeat Ebola.

Finally, for survivors, for suspected patients who were non-cases and the communities at large, we pass on messages about stigmatization.  We emphasize that survivors are no longer directly contagious and they do not pose a risk to people they come into contact with, except in rare cases of sexual transmission, for which we strongly recommend using protection. We encourage people to accept survivors back into the community and not to fear them. Then we explain to the survivors, that yes, some people might be afraid of you at first, that yes, you might experience stigma. We explain that some people might not understand at first that it is safe to be around you, but that with time they will accept you. We also urge survivors, when they return to the communities, to share their story, to talk about the treatment they received here and to spread the message that early treatment can save lives.

Photo: Jennifer Lazuta / ALIMA

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