Tidligere udbrud af ebola er forholdsvis hurtigt blevet inddæmmet og nedkæmpet. Så udbruddet i Vestafrika overrasker fagfolk, fordi det bliver ved med at brede sig. Eksperter mener, at det bl.a. kan skyldes lokale begravelsesritualer.
CONAKRY, 26 June 2014 (IRIN): A months-long battle to bring West Africa’s Ebola outbreak under control has stretched medical teams to the limit, while mistrust in some communities has impaired prevention work and raised questions about the delivery of health warnings.
The outbreak, which was first declared in March in southeast Guinea, should have been winding down now, with cases reducing as controls take effect, said Armand Sprecher, a public health specialist with Médecins Sans Frontières (MSF) in Guinea.
Sprecher, who has worked on haemorrhagic fever outbreaks like Ebola and Marburg in places such as the Democratic Republic of Congo’s Western Kasai area, explains that outbreaks normally run their course and eventually die down because they are contained within a limited geographic area.
That looked to be the case in May with optimistic signs that the outbreak had already peaked, or was even over. But those hopes have since faded, with new cases being identified in Guinea, Liberia and Sierra Leone. At least 340 people have died of the disease so far in the three countries, according to the World Health Organization (WHO).
Ebola still a stranger
In Guinea, the worst-hit among the three West African countries, traditional burial rituals are still being observed despite the health hazards and many people are reluctant to be traced for medical surveillance (as a precaution for having come into contact with those infected).
Still, there are those who believe that the disease is due to Satan’s wrath or sorcery. Others think it is because of korté, or an evil spell cast by a witch, according to Mamadou Rafi Diallo, director of Guinea’s National Health Promotion Service.
According to Sprecher of MSF, people familiar with malaria or diarrhoeal disease understand the benefits of standard medical treatment at a local health centre, but their faith in medical methods “does not require abandoning a traditional health belief model”. Sprecher explains further:
“I am pretty sure that people can hold both the belief that some illnesses – especially unfamiliar ones – are linked to sorcery, while others are amenable to medical therapy.”
It is a view backed by Barry Hewlett, an anthropologist at Washington State University, Vancouver, who has studied the influence of historical and cultural factors on a community’s response to Ebola.
He suggests people seeing Ebola for the first time may accept medical and scientific explanations for its origins and impact, but will still be convinced that sorcery is at play. He stresses that all health education messages must be presented in a culturally sensitive way; if doctors and nurses discount local traditions and beliefs, they risk losing the trust and acceptance of those they are trying to help.
Changing the messenger?
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