Tackling Ebola, One Broadcast at a Time

GUÉCKÉDOU, Guinea — Diallo Fatou Traoré stands at the entrance of a rural radio station, of which she is the director, and asks that everyone entering use a hand-washing station. In less tenuous times, such a request would be unfathomably rude. But here in Guinea’s southeastern Forestière region, the heart of the current Ebola epidemic, extreme caution has become the norm

Traoré and her team of 18 journalists, technicians, and on-air presenters are probably not the first people who come to mind when thinking about those on the front lines of the battle against Ebola, but each have been deeply engaged in fighting the spread of the disease. "We had seven cases and four dead at the start, and people did not believe in Ebola," says Traoré, who recalls people calling into her station with personal theories and anecdotes. "We started interactive programming with a doctor answering questions and responding to phone calls, and the mentality changed."

Across Guinea, it is ordinary citizens like Traoré who are fighting Ebola despite limited resources and no prior experience with the virus. Attention and praise are rightly given to the health workers risking their lives to treat the sick; across West Africa, 382 health workers had become infected and 216 had died as of Oct. 1, according to the World Health Organization. But countless other people from a range of backgrounds — journalists, religious leaders, artists — have been doing their own small part to combat the disease, even as national and international leaders have equivocated and global health organizations dithered.

In places like the Forestière region, many radio stations are educating their listeners about Ebola, devoting hours of original programming every day to the virus. Despite unreliable power sources and outdated equipment, these stations translate communiqués from the capital, Conakry, and from abroad into several local languages to target specific communities. Station budgets are pieced together from advertising and support from foreign donors that have come to see rural radio stations as the most effective means of disseminating information to populations that are largely illiterate and lack access to other forms of media.

Yet before they were a source of reliable information about Ebola, local journalists themselves underwent a learning process about the virus and how it is transmitted. In April, Doctors Without Borders (Médecins Sans Frontières, or MSF) arranged to have an Ebola survivor appear on national radio, but the station would not allow him into the studio. Eventually, the interview was conducted via telephone. Fast-forward six months, however, and Ebola survivors are regularly on air and in studio, just one indication of how attitudes toward the virus have changed among some members of the media.

"If you go to the hospital right away, you have a good chance of recovery, but if you hide your symptoms, the chances are much worse," one survivor, a female medical student, told a nationwide audience from inside a studio in Conakry in mid-September. Fittingly, she signed off by encouraging her fellow Guineans not to stigmatize survivors.

Religious leaders such as El-Hadj Mamadou Saliou Camara have also used their influence to address the Ebola crisis. As the imam of the Grand Fayçal Mosque in Conakry, Camara is among the most important religious leaders in devotedly Muslim Guinea, and he has long advocated unity and reconciliation in a country heavily divided along ethno-political lines. His sermon during this weekend’s celebrations for the Muslim holiday of Eid al-Adha, or Tabaski as it is known in West Africa, touched on the need to overcome political differences in the fight against Ebola. "What I would say to people [is that] when we have a disease like Ebola, the president and his government must stand up to fight against the disease," Camara said. "If a [government] delegation arrives in a place to raise awareness, we must welcome them. Do not strike them or kill them," he continued, in reference to recent attacks on health workers in Guinea and concerns that the crisis is becoming politicized.

Some private businesses, from pharmacies to mobile-phone companies, are also contributing to the fight against Ebola. At Pharmacie de La Paix in downtown Conakry, a steady stream of customers looks to purchase hand sanitizer. "We used to sell mostly to business owners who buy in bulk, but now individuals are buying it," says Sako Ibrahima Sory, the pharmacy’s manager. "This is a chance to educate the public," he adds, stressing that even if demand begins to outstrip supply, his pharmacy will forgo a chance for greater profits and keep prices the same. Meanwhile, telecom giant Orange blasts text messages to its subscribers at least once a day that read, "Do you have Ebola? Prompt treatment in a health center can save you." 

Even Guinea’s musicians have taken to their studios to record songs about Ebola and authorize their free distribution. The airwaves boast everything from club bangers to ballads soaked in auto-tune devoted to Ebola, and were it not for the lyrics, they could easily be confused for party anthems and cheesy love songs. One such example, "A Gesture for Life," features an all-star lineup of some 20 musicians, including reggae stalwart Takana Zion, up-and-coming hip-hop duo G Force Sotigui, and songstress Khady Diop. Singing in multiple languages, the ensemble delivers basic health information about Ebola.

Taken together, the responses by average Guineans to Ebola add up to a less militarized approach than those pursued by its neighbors in Liberia and Sierra Leone, who have drawn criticism from public health experts for deploying their militaries to enforce quarantines and threatening to arrest those harboring infected persons. But appraising the efficacy of the response would be premature at this point. The virus is still spreading at an alarming rate, with more than 970 confirmed cases by the start of October. In the Forestière town of Macenta, health officials thought the outbreak was under control months ago, but dozens of new cases from surrounding villages that recently appeared in a span of only a few days have raised new questions about the extent to which people infected with Ebola may be hiding.

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Propping up Guinea’s weak public health system, a complex undertaking that requires outside support, remains the most important and challenging component of ending the crisis. At the MSF site in Guéckédou, new cases are coming in daily. A staff of 300, including Guineans and foreigners, oversee a site that contains 110 beds. In late September, the site was treating 45 confirmed cases — a number that is expected to rise. All people entering the site’s grounds must wash their hands with chlorinated water and have their boots sprayed. Inside, a web of orange fencing creates a labyrinth of one-way lanes that regulate movement; the traffic flows are designed so that people with confirmed cases are always at a distance from those who are suspected of having Ebola, who are in turn kept at a distance from staff and visitors. Interacting with Ebola patients requires health workers to wear personal protective equipment (PPE): a hazmat suit, goggles, rubber gloves, and rubber boots. "You need PPE for everything," says Caroline Scholtes, the MSF field coordinator in Guéckédou, who explains that all activities, from changing sheets to washing clothes to delivering food to patching up a hole in a tent, require staff members to put on PPE suits.

When an older woman confirmed to have Ebola arrives at the treatment center, she is greeted by a young foreign woman in full PPE, who sprays all of the newcomer’s belongings before placing them in a plastic bag. Then, a waiting game begins. The sick live with each other in an Ebola colony of sorts: sitting, chatting over meals and soft drinks, and praying that their immune systems are up to the task of defeating a virus that is claiming more than half of those it infects. Treatment consists largely of keeping patients hydrated, well fed, and on a steady diet of antibiotics to ward off other infections.

Back in Conakry, many businesses have taken to checking the temperature of all patrons, pointing a small thermometer that resembles a toy gun at their temples before they enter. Almost every building has a hand-washing station at its entrance, and billboards throughout the city urge people to text "115" if they think they have Ebola. Although a relative sense of calm pervades daily life in the capital, some doctors quietly fear that panic might be gradually setting in among their own ranks. "We are very worried," says Hassan Bah, a professor who at Ignace Deen teaching hospital. "Doctors are very exposed. Unfortunately, they do not have the means to protect themselves — that’s the truth."

The MSF site in Conakry is set up in the shadows of Donka hospital, Guinea’s main health facility, a dilapidated concrete structure built in 1959. On a day in late September, the MSF center is busy, with confirmed and suspected cases trickling in from areas previously thought to be unaffected from the epidemic. "Not good," says one MSF employee. "Still new cases."

A team of local doctors rushes to put on PPE suits as two new cases, both young children, arrive. Treating any incoming Ebola patient is complicated, but these particular cases are particularly challenging because the children will have to be separated from their mother, who has not tested positive for the virus. A few tents over, a woman who traveled some distance to accompany a sick relative is crying.

Thierno Sadou Diallo, a gynecologist, is on day 16 of isolation for Ebola — which, all things considered, is an encouraging sign. Thin and visibly weak, Diallo describes how he contracted Ebola while performing a Caesarean section on a woman who was later diagnosed with the virus. She would later die in the same isolation center.

Diallo praises the health workers helping him, including Marie-Claire Kolié, a doctor who comes by to greet him as he is speaking. They share a personal connection that predates the Ebola epidemic: Kolié had a very complicated pregnancy three years ago, and Diallo delivered her son.

"It makes me so proud and happy to help him," says Kolié, who describes providing care for Diallo as "an honor."

For Guineans, waiting for sufficient assistance, let alone a miracle, is not an option. And as the disease continues to spread throughout the country, countless men and women are coming together to combat Ebola.

"When I get out, I am going to take some time to recover," Diallo says. "But I’ll go back to work as soon as I can."