TIME ebola

New York Ebola Survivor Says He was Treated Like a Fraud After Diagnosis

Dr. Craig Spencer smiles during a news conference November 11, 2014 at Bellevue Hospital in New York.
Don Emmert—AFP/Getty Images Dr. Craig Spencer smiles during a news conference November 11, 2014 at Bellevue Hospital in New York.

"My U.S. colleagues who have returned home from battling Ebola have been treated as pariahs"

A doctor who worked in Guinea treating Ebola victims says he was labeled a “fraud, a hipster, and a hero” after he was diagnosed with contracting the deadly virus on his return to the U.S.

In an essay published on Wednesday, Craig Spencer, who is New York’s first and only Ebola patient, says how politicians and the media accused him of putting the public at risk.

“I was being vilified in the media even as my liver was failing and my fiancée was quarantined in our apartment,” he wrote in the New England Journal of Medicine.

Spencer, 33, documents how his work in the Ebola treatment center in Guéckédou, Guinea, was rewarding, but that it also took a toll on his psychological and physical health.

“Back in New York, the suffering I’d seen, combined with exhaustion, made me feel depressed for the first time in my life,” he writes.

On Oct. 23, Spencer was hospitalized at Bellevue Hospital after reporting a fever and fatigue and was later diagnosed with Ebola.

Though the clinician had been monitoring his temperature in line with the Center of Disease Control and Prevention protocol, Spencer says his movements before the diagnosis were heavily criticized by the media and politicians.

“The whole country soon knew where I like to walk, eat, and unwind,” he said. “People excoriated me for going out in the city when I was symptomatic, but I hadn’t been symptomatic — just sad.”

Spencer slammed New York and New Jersey Governors Andrew Cuomo and Chris Christie for imposing extra, and what he believed to be unnecessary, quarantine measures for health workers returning from Ebola-stricken countries.

“Politicians, caught up in the election season, took advantage of the panic to try to appear presidential instead of supporting a sound, science-based public health response,” he said.

Spencer was discharged from Bellevue Ebola-free after 19 days of treatment.

TIME ebola

Liberia’s Children Go Back to School but Ebola Is Not Over Yet

Students stand in line before heading to their classrooms at Don Bosco High School in the Liberian capital Monrovia on Feb. 16, 2015.
Zoom Dosso—AFP/Getty Images Students stand in line before heading to their classrooms at Don Bosco High School in the Liberian capital, Monrovia, on Feb. 16, 2015

All across Liberia, streets are filled with the excited laughter of children returning to school after a six-month hiatus. The children, decked in the smart cotton uniforms of both public and private schools, line up in front of their classrooms to wash their hands in chlorine solution and wait to get their temperatures read by teachers wielding infrared thermometer guns.

Once inside they will pick up lessons abandoned in August, when an Ebola epidemic cut a swath through the country, infecting nearly 9,000 and killing at least 3,826. “The Ebola outbreak has had a devastating effect on our health and education systems and our way of life in Liberia,” Liberia’s Minister of Education Etmonia Tarpeh said in a statement. “We have managed to beat back the spread of the virus through collective efforts. Reopening and getting our children back to school is an important aspect of ensuring children’s education is not further interrupted.”

Ebola taught the nation to fear contact, to avoid unnecessary gatherings and to distrust a government and an international community that seemed both unwilling and unable to bring the crisis to an end. But with the start of school — deemed safe by the Ministry of Education, even though the virus has not been completely eradicated from the country — Liberians are regaining a sense of normalcy and can allow themselves to hope for a time when Ebola is little more than a bad memory. “It’s a good sign,” says school nurse Iris Martor. “We can’t let down our guard, but we can start thinking about the future again.”

Not all schools have opened. Some have yet to receive basic sanitation kits from the government and the U.N. Children’s Fund, and others are still being cleaned up and disinfected after having served as holding centers for the ill. Some, like Martor’s More Than Me Academy, which serves underprivileged girls from Monrovia’s West Point slum, won’t open their doors until March 2.

Schools have already reopened in neighboring Guinea, where the outbreak started in late 2013, and are expected to open in Sierra Leone, which has seen the highest number of infections, at the end of March. Of the three most affected countries, Liberia has recovered the quickest. It has seen just a handful of new cases every week since January, compared with an increase from 39 to 65 new cases in Guinea and 76 new cases in Sierra Leone in the week ending Feb. 8, according to the World Health Organization (WHO). Still, it’s a dramatic decline compared with the hundreds of new cases every week during the peak of the epidemic in September and October.

On Monday, officials in the three countries announced that they had set a target of reducing the number of new cases to zero within 60 days. It is an achievable goal, but similar targets have been set in the past, only to be undermined by a sudden flare-up in unexpected areas.

Ebola, which kills nearly half its victims, is spread through contact with infected bodily fluids. Practices like the washing of the dead are deeply ingrained in West African society; all it takes is one improperly conducted funeral for a new chain of transmission to start, undermining weeks of work. The WHO, in its most recent assessment, noted that Guinea reported a total of 34 unsafe burials last week.

Elsewhere in the country, village mobs attacked health workers from the Red Cross and Doctors Without Borders, accusing them of bringing the virus. Sierra Leone was forced to quarantine a fishing community in the capital, Freetown, after the discovery of a cluster of five new cases. “We are very, very far from the end of the outbreak,” Iza Ciglenecki from Doctors Without Borders told reporters at a science conference in California on Saturday. For most illnesses, it is enough to get the number of cases down to a low rate for doctors to be satisfied they have an infectious disease under control. Not so for Ebola. Until the number of new cases stays at zero for 42 days — twice the maximum incubation period — no one can afford to let their guard down, not even the students washing their hands in chlorine in the schoolyard.

TIME ebola

The Ebola Virus Is Mutating, Say Scientists

Guinea West Africa Ebola
Youssouf Bah—AP A health care worker, right, takes the temperatures of school children for signs of the Ebola virus before they enter their school in the city of Conakry, Guinea, Monday, Jan. 19, 2015

The outbreak has so far claimed 8,795 lives across the affected West African region

Scientists at a French research institute say the Ebola virus has mutated and they are studying whether it may have become more contagious.

Researchers at the Institut Pasteur are analyzing hundreds of blood samples from Guinean Ebola patients in an effort to determine if the new variation poses a higher risk of transmission, according to the BBC.

“We’ve now seen several cases that don’t have any symptoms at all, asymptomatic cases,” said human geneticist Dr. Anavaj Sakuntabhai. “These people may be the people who can spread the virus better, but we still don’t know that yet. A virus can change itself to less deadly, but more contagious and that’s something we are afraid of.”

Although virus mutations are common, researchers are concerned that Ebola could eventually morph into an airborne disease if given enough time.

However, there is no evidence to suggest this has happened yet, and the virus is still spread only via direct contact with an infected person.

Institut Pasteur, which first pinpointed the current Ebola outbreak last March, is hoping that two vaccines they are developing will reach human trials by the end of the year.

Current figures indicate 8,795 of some 22,000 cases across Liberia, Guinea and Sierra Leone — around 40% — have been fatal.

[BBC]

TIME ebola

Doctors Without Borders Sees Fewer New Ebola Cases

SWITZERLAND-HEALTH-EBOLA-REDCROSS-AID-TRAINING
Fabrice Coffrini—AFP/Getty Images Health workers of the International Federation of Red Cross (IFRC) and medical charity Doctors Without Borders take part in a pre-deployment training for staff heading to Ebola areas on Oct. 29, 2014 in Geneva.

“We are on the right track," said Brice de la Vingne, the group's director of operations

The medical aid group Doctors Without Borders, or Médecins Sans Frontières (MSF), says it’s seeing declines in new cases of Ebola in its centers in Guinea, Liberia, and Sierra Leone.

There are just over 50 patients currently in MSF’s Ebola treatment centers across the three countries, the organization announced on Monday.

“This decline is an opportunity to focus efforts on addressing the serious weaknesses that remain in the response,” Brice de la Vingne, MSF director of operations said in a statement. “We are on the right track, but reaching zero cases will be difficult unless significant improvements are made in alerting new cases and tracing those who have been in contact with them.”

There is still work to do on that score; in Guinea and Liberia only half of the new cases are people who are known contacts of people with Ebola. Since just a single case can spur an outbreak, more contact tracing is needed.

MORE: TIME Person of the Year: Ebola Fighters

In Sierra Leone, incidences of Ebola have dropped to their lowest levels since August, though there are still hot zones like the country’s capital of Freetown. Guinea’s caseloads are also dropping, but more cases are coming from regions that were previously thought to be leveling out. Liberia has experienced some of the greatest drops out of all three countries. MSF says that on Jan. 17, there were no Ebola cases at the organization’s ELWA 3 Ebola management center in the capital city of Monrovia, and currently there are only two patients.

The latest case numbers from the World Health Organization (WHO) show cases have reached 21,724 with 8,641 deaths.

TIME ebola

The Ebola Fight Has Reached a ‘Turning Point’ in West Africa, the WHO Says

Guinea West Africa Ebola
Youssouf Bah—AP A health care worker, right, takes the temperatures of school children for signs of the Ebola virus before they enter their school in the city of Conakry, Guinea, Monday, Jan. 19, 2015.

But the World Health Organization says vigilance is imperative to prevent reinfection in seemingly eradicated areas

The fight against Ebola has reached a “turning point,” according to the World Health Organization (WHO), as the three West African countries hit hardest by the deadly virus — Liberia, Guinea and Sierra Leone — see a precipitous drop in the number of new cases.

Liberia, which reported almost 9,000 cases since the deadly outbreak began in 2013, only detected eight new cases last week, reports the BBC. On some days, no new cases materialize at all, a heartening sign in a country where doctors once saw 509 new cases weekly at their peak.

“I would have identified the turning point as the beginning of the decline, first in Liberia and then later in Sierra Leone and Guinea,” Dr. Christopher Dye, the director of Ebola strategy for the WHO director general, told the BBC. “The incidence is pretty clearly going down in all three countries now.”

In Sierra Leona, where the health crisis once saw 748 cases flooding into hospitals each week, numbers are also stabilizing. The story is similar in Guinea, where the Ebola crisis reached a crescendo at 292 cases per week late last year.

Worldwide, Ebola has killed nearly 8,700 people and infected over 20,000 in one of the largest public health emergencies in recent memory.

Still, health officials at the WHO are exercising caution and warning that Ebola can reappear if risks are not properly mitigated. “Contact tracing,” or detecting everyone who ever came into contact with an Ebola-afflicted patient, is crucial to thwart future infection. Even one case cropping up can re-infect seemingly eradicated areas.

TIME ebola

Priests Assaulted in Guinea After Being Mistaken for Ebola Workers

They had gone to a local village to spray insecticides

Three priests from a church in Guinea were physically assaulted while visiting the village of Kabac on Tuesday, as locals suspected they were health workers who would expose inhabitants to the Ebola virus.

The villagers beat up the priests, who had planned to spray insecticide around the area, the BBC reported. They also vandalized the nearby town council building, setting fire to it after burning the priests’ car.

Guinea, one of the three West African countries worst affected by the Ebola outbreak, has lost nearly 2,000 people to the disease. The nation’s schools reopened earlier this week following a five-month break, soon after the U.N. said the number of cases nationwide had fallen to its lowest weekly total since August.

[BBC]

TIME Photojournalism Links

Photojournalism Daily: Jan. 5, 2015

A compilation of the most interesting photojournalism found on the web, curated by Mikko Takkunen

Today’s daily Photojournalism Links collection highlights Daniel Berehulak‘s stunning work from Liberia, Guinea, and Sierra Leone for a comprehensive New York Times account that charts the devastating resurgence of Ebola in West Africa last year. One of the photographs captures the Guinean village where a one-year-old boy, considered to be Patient Zero of the outbreak, died just over a year ago. It’s both painterly yet haunting, as it captures the birth place of a health crisis that has led to thousands of deaths.

Daniel Berehulak: How Ebola Roared Back (The New York Times) See also the slideshow: Ebola Ravages Economies in West Africa

Ross McDonnell: Notes from Underground (TIME LightBox) Pictures show civilians in eastern Ukraine sheltering in Cold War era bunkers

Brendan Hoffman (BBC Radio 4 World at One) Hoffman about his work in Ukraine and on the MH17 crash site

Toward A New Documentary Expression (Aperture) Stephen Mayes reflects on documentary photography’s shifting terrain

PhotoBooks 2014 (Vogue Italia) The magazine asked photo editors, artists, photographers and photography experts to choose the photobooks that defined the year

TIME ebola

Ebola Cases Reach Over 20,000

Health workers push a gurney with a dead body at a Red Cross facility in the town of Koidu, Kono district Eastern Sierra Leone on Dec. 19, 2014.
Baz Ratner—Reuters Health workers push a gurney with a dead body at a Red Cross facility in the town of Koidu, Kono district Eastern Sierra Leone on Dec. 19, 2014.

There's close to 400 new cases in just four days

Cases of Ebola in Sierra Leone, Liberia and Guinea have reached over 20,000.

New numbers released from the World Health Organization (WHO) on Monday show Ebola has infected 20,081 people and killed 7,842. That’s nearly 400 new cases of the disease in just four days.

Despite missions launched by countries and international groups like the United States and United Nations in the last few months, the disease continues to spread. Sierra Leone has passed Liberia in number of cases. Many are anxiously awaiting a vaccine that’s been estimated to become available in the early part of the new year and researchers are also working on developing drugs to treat Ebola.

Some experts believe the epidemic will last a full second year.

MORE: TIME Person of the Year: Ebola Fighters

TIME ebola

Ebola-Stricken Families to Receive Cash Payments

Hawa Musa with her mother and children. Of 25 people living in the house, 17 have died from ebola, including her husband.
Carly Learson—Carly Learson / UNDP Hawa Musa (blue) with her mother and children. Musa used to rent rooms for income, but no one wants to rent her rooms anymore. She previously had 25 people living in her house, but 17 died of Ebola including her husband and a few of her children. She's taken in 10 more kids.

In 2015, the three Ebola-affected countries will start offering cash payments for families hit by Ebola, as well as survivors having trouble re-acclimating to society out of stigma for the disease.

Every aspect of Guinea, Liberia and Sierra Leone’s societies have taken a hit from Ebola, and the disease has shocked what were once fragile but growing economies. Public spaces are now forbidden, so markets are empty, tourists are no longer traveling into the countries and international companies have largely pulled out, including large industries like mining. The World Bank estimates the aftershock of Ebola to already weakened economies will be “devastating.”

“We are seeing a backwards slide of development of about 10 years,” says Boaz Paldi, chief of media and advocacy at the United Nations Development Programme (UNDP). “The outlook is not good. We are fearful for these countries.” That’s why instead of waiting for caseloads to reach manageable numbers, the three countries, with the help of UNDP and other partners, are laying the groundwork now for rebuilding the damaged economies. One of the first major initiatives to be rolled out in the new year are cash transfers and payments to families who no longer have breadwinners and survivors out of work. Many women in the Ebola-affected countries have taken in orphaned children of their family members or neighbors, despite having no steady income.

Dudu Kromah's husband died recently from ebola. She is looking after ten children, many of them orphans including a 3-month-old baby.
Carly Learson—Carly Learson / UNDPDudu Kromah’s husband died from Ebola. She is looking after ten children, many of them orphans including a 3-month-old baby. She has no income.

According to UNDP leaders, plans for the payment process are still being refined. Lists of names of affected families and survivors are being collected and coordinated for small pilot programs, starting early next year, to test the effectiveness of the payments in preparation for widespread efforts. UNDP has calculated that around $50 will keep a family of five going in the three countries with essential needs for one month, with some variations by country. The group is anticipating making monthly payments to 150-200,000 people in each of the countries.

Ultimately, the payment program may develop into a cash-for-work model, with payments in exchange for work rebuilding communities in an effort to inject cash into the local economy and enable people to earn a living.

Ideas for how to get youth involved are also being considered. In Sierra Leone, Ruby Sandhu-Rojon, the deputy director of the UNDP Regional Bureau for Africa, spoke to young people concerned that since residents can no longer go to their local markets, they are unable to buy the food they need. “So why not start a delivery company to have food delivered to the different communities? How can we provide the start-up capital for young people who want to initiative those types of activities?” says Sandhu-Rojon.

The three countries and the U.N., which launched the U.N. Mission for Ebola Emergency Response (UNMEER) earlier this year, are also looking to the private sector. On Dec. 11 the U.N. held a U.N.-Business Collaboration for Global Ebola Response meeting as a way to get the private sector involved in both the response and recovery. A panel of high-level representatives from U.N. Missions in the affected countries, the U.S., U.K., and France put out a call for help from companies in areas major like logistics. Ultimately, the greatest plea was for companies to return to the countries and invest.

Sadly, all three countries were experiencing high growth rates before the start of Ebola, after coming out of conflicts like civil war. Sierra Leone had only recently launched its “Agenda for Prosperity,” a high-level initiative to become a middle-income country by 2035. High growth rates could largely be attributed to extractive industries like mining, which have now largely decreased their production or shut down, causing a government shortfall in revenue and massive loss of employment. Remaining national resources have been reallocated to the Ebola fight.

“It’s very disheartening, because all three of these countries were on their way up,” says Sandhu-Rojon.

The hope is cash payments will be a boost to help people get by. But increasingly more support and funding will be needed from the international community and private sector to get the countries back on their feet. Whether the countries will make it back to pre-Ebola growth may be a much greater, and longer battle.

TIME ebola

5 Million Kids Aren’t in School Because of Ebola

Schools closed in Sierra Leone after Ebola outbreak
Mohammed Elshamy—Anadolu Agency/Getty Images A classroom of a school stands abandoned on Aug. 25, 2014 in Kenema, Sierra Leone. Schools closed and villages quarantined after dozens of its congregation died with Ebola symptoms.

Children from Guinea, Sierra Leone and Liberia are still out of school. Here's what's being done

Public schools in Guinea have been closed since March. Schools in Sierra Leone and Liberia never opened after the summer holiday. All told, the children’s rights and emergency relief group UNICEF estimates that 5 million children ages 3 to 17 are out of school due to Ebola.

“This Ebola crisis has been predominantly seen as a health crisis but its implications go way beyond health,” says Sayo Aoki, an education specialist for UNICEF working in the affected countries. “It’s time we start looking at it from other perspectives, and education is part of that.”

Some schools were closed out of fear the disease could spread in large gatherings while others had no access to water, making handwashing impossible. But the longer a child stays out of school, the less likely it is he or she will return—which is why UNICEF is working closely with the Ministry of Education and Ministry of Health to come up with protocols necessary to implement in order to let children back into the classrooms. The draft—which calls for measures like Ebola screenings, hygiene requirements and a plan in the event a suspected case—is currently being reviewed by experts at the Centers for Disease Control and Prevention in the U.S. and the World Health Organization.

MORE: TIME’s Person of the Year: Ebola Fighters

In the meantime, UNICEF and partner NGOs have trained out-of-work teachers to act as “social mobilizers,” going door to door to spread messages about how to identify Ebola and prevent its spread. UNICEF and partners are also using the radio programs to offer long-distance learning while kids are kept at home. “We are trying to make [the radio shows] simple and more interesting so children will get some learning,” says Aoki. “If they listen to it at a certain time of the day during the week, it gives them a routine they’ve lost from not going to school. It brings them a sense of normalcy, some sort of stability and hope.”

Stability has been largely destroyed for many children living in Ebola-affected countries. Many have seen family members, friends and neighbors get infected, and many have become orphans as well. Ebola has also changed social mores. “Nobody shakes hands in public,” says Aoki. “It has put a lot of stress on children. There’s no cuddling, no hugging, no kissing. The simple joys of life have been taken away.”

Even before Ebola, Guinea, Sierra Leone and Liberia were economically troubled countries still emerging from conflict and civil war. Guinea and Liberia were in the process of increasing their school attendance numbers—Guinea was at 58% and Liberia was at 34%—and experts worry that Ebola has set progress back. School closures, including private schools, are also a bad economic indicator. Jeff Trudeau, the director of The American International School of Monrovia (AISM) told TIME in August that he lost more than half his expected students for the 2014 school year, many of whom were children of foreign families who moved to the region for jobs in Liberia’s burgeoning business sector. That school’s earliest possible start date is January and for others, there appear to be “moving” deadlines for reopening. Guinea is aiming for January while Liberia and Sierra Leone are hoping for March.

But all the countries will have to patiently wait until their caseloads are under control, since a premature opening may only add fuel to the fire.

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