Posted on August 8, 2014

The Liberian Slum Where Ebola Spreads Death Among Killer Virus ‘Deniers’

Colin Freeman, Telegraph (London), August 8, 2014

If ever there was a likely spot for an outbreak of the deadly Ebola virus, New Kru Town in Liberia is it. A sprawling slum of the country’s war-ravaged capital, Monrovia, it is home to 50,000 people, and has next to no functioning lavatories, sinks or bathrooms.

Sewage runs openly through its maze of corrugated shacks, and in Liberia’s wet season–at its height right now–tropical torrents turn it into one vast, warm, moist, breeding pool for germs.

It hardly feels surprising then, in the wake of several locals dying from Ebola, to see health teams daubing blue crosses on a number of shacks around town.

These, however, are not to identify those who have caught the disease, but to mark the relatively few New Kru Towners who have been visited by the teams and accepted their advice on how to avoid getting it. So far, only around 500 houses have been marked–and with health workers themselves accused of spreading the disease, some parts of New Kru Town remain decidedly hostile.

“This is a very poor neighbourhood where sanitation is lacking and people are not well educated in the principles of hygiene,” said Tamba Bundor, leader of a team of hardy volunteers from local health charity Community Development Services, a Unicef partner, as he drove his car through wet, sandy backlanes.

“It is where the first victims of Ebola died in Monrovia, and most people who have been affected became so because they did not adhere to the messages of prevention.”

Nearly 1,000 people have now died of Ebola across west Africa. While the outbreak started in remote forested inland areas–possibly via fruit bats–New Kru Town is an example of the ease and unpredictability with which it has spread to urban capitals along the coastline, catching health officials off-guard.

When some initial cases first appeared in Liberia’s northern Lofa County back in March, health officials initially thought they had it under control. But in June, a resident of a district of New Kru Town known as Carpet Street died, as did several others. According to Dr Bernice Dahn, Liberia’s chief medical officer, three of the victims passed away while they were being sheltered in a local church–a sign of how many some people believe the disease is a curse that can be cured by prayer or witchcraft.

“We must stop keeping people suspected of Ebola in our churches on ground that we can heal them,” she warned at the time. “The churches are not hospitals.”

Liberian hospitals, however, do not always inspire the kind of faith that people have in Liberian churches. A fortnight ago, one the main local health facilities, Redemption Hospital, was stoned by a mob after a woman died in there from a suspected Ebola case, following nationwide rumours that health workers were themselves passing on the disease. Today, the squat, single storey building offers redemption no more, having been shut down temporarily amid fears from staff for their own safety.

Safety is a concern too for Mr Bundor and his colleagues, who were attacked as they tried to visit the house of the bereaved family on Carpet Street.

The deceased’s relatives were insisting that their loved one had died as a result of a family curse–a cause of death that, in New Kru Town anyway, carries less social stigma than dying of an infectious disease like Ebola.

“The family of the victim were angry, saying it was a curse, not Ebola,” said Anthony Worpor, another of Mr Bundor’s health team, who was clad in a teeshirt that said ‘save lives, wash your hands before you eat’.

“A crowd gathered, and some accused us health workers of spreading the disease ourselves. They even began touching a local journalist we had brought with us, saying: ‘if you think it is us spreading it, then here you are, we will infect you’.”

New Kru Town was originally named after the Kru, a powerful ethnic group who live in both Liberia’s interior and coastal fishing communities. They were traditionally known for a certain independence of mind, and European slave traders used to complain that they were particularly resistant to capture, to the point where their price as slaves was considerably lower.

They proved equally hostile to the freed American slaves who founded Liberia in the 19th century, when the latter tried to muscle in on their trading empires.

Today, New Kru Town is home to a wider mix of ethnicities, but even so, suspicion of outside messages persists. While Mr Bundor’s education programme has already enjoyed some success, he estimates that 40 per cent of New Kru Town’s residents are still “in denial” about Ebola’s risks, and the necessary health measures to avoid it.

Indeed, some residents see to treat Mr Tanga rather like a Christian door-to-door preacher, listening to politely to his warnings but not heeding them. For example, at Alan’s Bar, a dark, dinghy shebeen, a poster warning of the dangers of Ebola already hung on the front door. Yet official health advice is to avoid bars and other public gathering places altogether right now, a message that the groups of drinkers inside, listening to blaring African disco music, have chosen to ignore.

The owner of the bar, Alan Tokba, told The Telegraph that “no dancing was allowed” inside, and that visitors were being asked to wash their hands as they went in, but Mr Bundor admitted that it was “not satisfactory”.

Nor was he entirely happy with the efforts of mother-of-three, Tina Teeh, 26. Her house already bore the blue cross of one of New Kru Town’s hygiene-converts, but the bucket of chlorinated water she had for her children to wash their hands in did not have a separate container to drip the fluid onto their hands first.

“I can’t afford it,” she told the disapproving Mr Bundor.

“But what if you end up ill?” he asked her. “Then you will have to afford hospital fees.”

Another mother who claimed to have seen the light was Julie Life, 30, who admitted having been sceptical that Ebola even existed Mr Bundor first visited her home a few days ago. Then again, she said her main reason for changing her mind was in watching a deadly virus at work in the Tom Cruise film Mission Impossible II.

As Mr Bundor and his colleagues trudged off to root out New Kru Town’s remaining Ebola “deniers”, it seemed like an apt description of their task.