Health workers face denial in Angola

Health experts fighting the killer Marburg virus in northern Angola said on Monday they were facing denial from families who are refusing to send their sick to hospitals or are taking them out of the city, worsening the risk of contamination.

A massive public awareness campaign is being put in place in the city of Uige as part of efforts to contain the haemorrhagic disease, which has claimed 203 lives, the worst epidemic to date of the Ebola-like virus.

“We must work on social mobilisation reinforcement. They must know the risk,” said Quiala Godi, Uige’s provincial health director.

“We must contact religious authorities and traditional chiefs for them to pass on the message to the population,” said Godi.

Isolation of victims is the only way to slow the spread of the disease, for which there are no drugs or vaccine, and which can kill a healthy person in a week by diarrhoea and vomiting followed by severe internal bleeding.

A total of 221 cases of the Marburg virus have been discovered in Angola, out of which 203 resulted in death, putting the mortality rate countrywide from the outbreak at 92%, the health ministry and World Health Organisation (WHO) said on Monday.

The WHO on Monday flew in three communications experts into Uige, the epicentre of the outbreak about 300km north of the capital Luanda, to try to help send a clear message to Angolans to take the necessary measures to fight the virus.

“We are going to go through the markets. We are going to go from house-to-house,” added Jose Manuel, the Red Cross’ representative in Uige, saying his organisation has enlisted the help of 45 local employees.

The WHO team of epidemiologists, virologists and anthropologists has faced public resistance to their measures to contain the outbreak, which first surfaced in October last year but which has claimed scores of dead in the last few weeks.

African traditional culture dictates that relatives spend a long time in the presence of the body of the deceased, which increases the risk of spreading the disease which is transmitted through contact with bodily fluids.

Local communities also do not want to accept that their relatives died of the killer Ebola-like virus.

“The residents are in a state of total denial.
When somebody is sick they prefer to say that it’s not Marburg,” said William Perea, a Colombian medical epidemiologist, as he travelled through the slum outskirts of Uige to look for suspected cases and deaths.

“They are calling us too late when the person is already dead, to dispose of the body,” said Perea, adding that on Sunday, mobilisation teams had “nine alerts, but only one person was alive”.

The body of Joana Manuel (38) was one of those being buried by the special teams on Sunday.

“Did you know that your wife was positive with Marburg fever? Did you know how it can be transmitted?” Perea asked her husband, Pedro Chingani, sitting in front of his hut with around a dozen other relatives close to the cemetery.

“Yes, I know. By sexual relations and close contact,” Chingani answered.

“But I was away, she was already like that when I came back. I didn’t touch her,” he said.

Godi said when the health teams from the WHO and Médecins sans Frontières (MSF, Doctors without Borders) arrived here nearly three weeks ago “we started to control the epidemic”.

But he added: “Now the situation is changing. People are starting to go away. Nobody wants to go to the hospital any more. People are dying at home. This is a great danger.”

Others are taking their sick along as they flee to nearby villages, Godi added.

“For example, we have a case 90km from here of a family who left with a child from [Uige] hospital.”

“When they arrived [at their village] the child died. Then the mother died and then the father,” Godi said.

The Marburg virus, whose exact origin is unknown, spreads through contact with bodily fluids such as blood, excrement, vomit, saliva, sweat and tears, but can be contained with relatively simple health precautions, according to experts.

The virus was first detected in 1967 when German laboratory workers in Marburg were infected by monkeys from Uganda. - Sapa-AFP

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