Washington, DC – When Dr. Susan Shepler is being asked for what she feels in these days, she has to fight back her tears. She is standing in front of a group of students down the hall, in American University’s School of International Service (SIS). It is a cloudy Friday afternoon at the end of September. Shepler is standing behind a lectern, she is clutching it with her hands, her eyes are slowly wandering across the hall. It seems as if the 49-year-old professor at SIS is going through all of her thoughts – about the Ebola outbreak in West Africa, about her friends living there, her fear, the feeling of painful uncertainty. “My heart is breaking for Sierra Leone. It will never be the same after this. These people are in desperate need of help,” she says with a trembling voice, wiping away the tears.
Ebola is the fatal virus that, according to the Situation Report of the World Health Organization (WHO), has infected 8,399 and killed 4,033 people during the current outbreak since March 25 in Sierra Leone, Liberia, Guinea, Senegal and Nigeria. The first infected person who just entered the United States via passenger jet died in Texas on October 8. The patient, a 42-year-old Liberian, was treated in a hospital in Dallas. He infected his nurse, the second person in the U.S. who got haunted by Ebola. She is fighting against the virus right now.
This Ebola outbreak is the deadliest in world history, a worst case that has spread to a point where extensive global action is needed to control the situation. TV pictures show masses of dying people next to overstrained aides in terrifying looking protective gears, being unable to cope with the killing infection. The infrastructure of the countries totally broke down within the last weeks; volunteers are unable to build new hospitals as fast as people get infected with the virus. International help is being transferred reluctantly. There is no one out there who knows how this is going to end.
Shepler would be glad if she was able to predict. She specializes in Peace and Conflict Resolution, has travelled often to West Africa and is married to a college lecturer who lives and works in Sierra Leone. She has lots of friends in this country and is in contact with them – and she does not know to where the catastrophe may lead.
Since the outbreak of the virus, Shepler spent several weeks in the Ebola areas. She was, as she says, able to see a change. “People at the beginning did not really believe the virus is existing“, she says. “There is a long history of conspiracy theories and a mistrust in the state.“ It is a rainy day in the third week of September 2014, Shepler is sitting in her office in the School of International Service, just a few days before she is going to speak about her emotions at the Friday Forum “The Case of Ebola” in front of her students down the hall. “Each of my days starts in a sort of depression: I am combing through the Internet, checking Twitter and Facebook and all the online newspapers – just to make sure that I do not miss anything that happens in West Africa,” Shepler says. “What my husband describes is just scary. A lot of institutions have been shut down; schools, hospitals, government offices. Everyone is afraid of going to work. People shelter at home.”
The upward epidemic trend continues in Sierra Leone and most probably also in Liberia, official WHO documents state on the website on October 10. Statistics of the institution show that nationally, the situation in Sierra Leone continues to deteriorate, with an increase in the number of new confirmed cases reported. There have been 2,593 confirmed cases in Sierra Leone until now, 753 people died.
Everyone who did not get contracted is fighting on another field. “People still need to eat,” Shepler says. “But local prices have doubled and people are getting anxious of how to support their families.” Shepler’s husband who is working as a university professor has just left Sierra Leone a few days ago to come to Washington and to escape the increasing danger.
However, this danger is nothing new. Ebola has been around for a long time. The first human outbreaks occurred, according to an online article published by CNN on September16, in 1976 in Central Africa and Sudan. In 2000, a Ugandan outbreak resulted in more than 400 human cases and 224 deaths. “From a medical perspective, there has never been an outbreak like this,” Dr. Akua Asare says. The 37-year-old woman was born in Ghana but raised in the States. She is working as a physician-medical doctor in Washington. “The reason why Ebola is so fatal this time is that the virus occurred in urban areas. Prior cases were very isolated, the virus tended to burn itself out in rural areas.”
How Ebola destroys the human body has never changed though. People do not feel anything in the first 21 days after they were infected with the virus. “It starts all of a sudden with high fever, muscle weakness, headaches and sore throat. At the beginning, it feels like a flu,” Asare says. “You start vomiting, you get diarrhea and skin rashes. You start to bleed inside and outside.”
Humans can be infected by other humans if they come in contact with body fluids from an infected person or contaminated objects. Ebola is contagious only if the infected person has symptoms. It takes a few days to two weeks until a patient dies.
It took a bit longer than 14 days since the first case of Ebola this year until the international community recognized how powerful something invisible might get. The Obama administration is preparing to assign 3,000 U.S. military personnel to the afflicted region, an online article published by Associated Press states on September 30. The governmental initiative aims to train 500 health care workers a week and erect 17 health care facilities of 100 beds each. Health care kits should be provided as well.
Asare does not really agree on Obama’s decision to send troops. “That really disturbs me. It is a medical emergency, we do not need armed people there,” she says. “Troops provoke fear. And fear is the last thing we need in West Africa.” Her voice is getting louder. “There is a second virus named fear – which might be more powerful than any other deadly infection we know of.”
Asare leans back in her chair, she is sitting in a café in Silver Spring, Washington. One can hear people coughing, a mother shares her coffee cup with her daughter, a man blow’s his nose. Invisible bacteria is everywhere – but this is not West Africa, this is a first-world country and people are far away from being afraid. “If people find something scary,“ Asare says, “they often do not speak about what may threaten them. Seeing the military in their streets, people in West Africa might rather stay at home than showing themselves. Ebola infected persons might be afraid to reveal themselves.”
One might question whose fault this total collapse of economy, social life and medical care is – and who should be criticized for everything that happened and currently happens in West Africa. “We cannot blame anybody for acting wrong or too late”, Susan Shepler explains to her students during the Friday Forum. “Since the Sierra Leonean and Liberian people and governments were not taking it seriously, it would have been hard for others to act.”
The fact that there was someone in the U.S. who brought the virus here from West Africa in a passenger jet shows how close the danger is. As long as the tragedy happened on another continent, most people did not seem to care that much. But when it comes to their own neighborhoods, people prick up their ears. “Experts had said that such an event [the Ebola case in Texas, editor’s note] was increasingly likely the longer the epidemic rages,” Mark Berman and his colleges wrote in The Washington Post on October 1. The infected man from Liberia wanted to visit family members in Texas. Until then, the only known cases of Ebola in the United States involved American aid workers who returned to the country for treatment. All have survived. If the nurse who treated the patient in Texas will also win the fight against the virus is not sure yet.
Susan Shepler is sure that the disease will not be able to really threaten societies in the United States. Obviously, conditions in West Africa and the States cannot be compared. “If Ebola patients enter the United States, it is not a big deal,” Shepler says. “We have the infrastructure to control it. We have the systems to keep infected people isolated.”
What makes her more frightened is the uncertainty of what is going to happen next. Shepler closes her eyes for a few seconds. It begins to rain outside, treetops swing slowly in the wind. “It is so hard to focus on anything else. I am so overwhelmed with sadness. Sierra Leone is like my second home“, Shepler says. And then she refers to her friends who continue to live in this country. “Even though they are afraid, they keep on going. They sometimes even joke about the situation”, Shepler says. “During the three-day lockdown of Sierra Leone, my friends were sitting at home playing Scrabble. They said they wished I were. ” Shepler turns around. She looks out of the window as several sunbeams find their way through grey mountains of clouds. Shepler smiles. “If I only could be and play with them. Believe me, I would beat them. Just the way I always do.”