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  • June 13, 2014

  • started as a routine Friday

  • in Redemption Hospital in Monrovia, the capital of Liberia.

  • Redemption is the largest free public health hospital in the city.

  • We are called upon to serve hundreds of thousands of people.

  • In the best of times it puts strain on our resources.

  • Monthly supplies run out within weeks,

  • and patients without beds would be seated in chairs.

  • That summer, we had a nurse who had been sick for a while.

  • Sick enough to be admitted in our hospital.

  • But our treatment didn't seem to be helping her;

  • her symptoms were getting worse:

  • diarrhea, severe abdominal pain, fever and weakness.

  • On that particular Friday, she developed severe respiratory distress,

  • and her eyes were menacingly red.

  • One of my fellow doctors, a general surgeon,

  • became suspicious of her condition.

  • He said her symptoms were suggestive of Ebola.

  • We kept a close watch on her, we tried to help her.

  • We were treating her for malaria, typhoid and gastroenteritis.

  • We didn't know it, but by then it was too late.

  • The next morning I walked in to check on my patient.

  • I could tell by the look in her eyes that she was filled with fear.

  • I gave her reassurance, but shortly after ...

  • she died of Ebola.

  • For me, her death was very personal.

  • But this was just the beginning.

  • A virtual biological bomb had exploded.

  • But the word spread faster than the virus, and panic spread across the hospital.

  • All the patients ran away.

  • Then, all the nurses and doctors ran away.

  • This was the beginning of our medical tsunami --

  • the devastating Ebola virus

  • that left an indelible scar in our country's history.

  • I was not trained for this.

  • I had just graduated from medical school two years before.

  • At this time,

  • my total knowledge about Ebola came from a one-page article

  • I had read in medical school.

  • I perceived the disease as so dangerous,

  • this one page in essence had convinced me to run out of the hospital, too,

  • the moment I heard of a case of Ebola.

  • But when it finally happened, I stayed on and decided to help.

  • And so did several other brave health care professionals.

  • But we would pay a heavy price.

  • Many persons and health professionals had become high-risk contacts.

  • This actually meant 21 days counting to potentially disease or death.

  • Our health systems were fragile,

  • our health workers lacked skills and training.

  • So in the weeks and months that followed,

  • health workers were disproportionately affected by the Ebola virus disease.

  • More than 400 nurses, doctors and other health professionals became infected.

  • Unfortunately, my friend, the general surgeon

  • who correctly identified the symptoms in that first case

  • became one of the casualties.

  • On July 27, the president of Liberia

  • imposed quarantine on the worst-affected areas.

  • She closed all the schools and universities

  • and shut down many public events.

  • Four days later,

  • the United States Peace Corps

  • pulled out of Liberia, out of Sierra Leone and Guinea

  • due to Ebola.

  • In August, six weeks after the nurse died,

  • hundreds of people were dying of the disease each week.

  • People were dying in the streets.

  • Over the months that followed,

  • West Africa would lose thousands of people to Ebola virus disease.

  • In August, I joined a team to set up the Ebola treatment unit

  • at JFK hospital in Monrovia.

  • I was charged with running the second Ebola treatment unit in the city.

  • Our unit provided hope for thousands of patients, families and communities.

  • I not only provided care, I came face to face with Ebola.

  • Living every day as a high-risk Ebola virus disease contact

  • during the worst of the outbreak

  • was one of my worst experiences.

  • I started counting 21 days every day.

  • I lived every moment anticipating the onset of symptoms of the disease.

  • I measured my body temperature several times.

  • I showered with chlorinated water,

  • more concentrated than actually recommended.

  • I chlorinated my phones, my pants, my hands, my car.

  • My clothes became bleached.

  • Those days you were alone,

  • people were so afraid of touching anybody.

  • Everyone was counted as a potential contact.

  • Touching would make them sick.

  • I was stigmatized.

  • But if that was what it was for me, who was symptom-free,

  • imagine what it was for someone who actually had symptoms,

  • someone who had Ebola.

  • We learned that to treat Ebola successfully,

  • we had to suspend some of the normal rules of society.

  • Our president declared a state of emergency in August

  • and suspended certain rights.

  • And the national police even supported our work during the Ebola response.

  • In February 2015, gang members came in for isolation

  • in our Ebola isolation unit.

  • They were also know as the VIP Boys of Monrovia,

  • terrifying small-time drug addicts

  • whose presence could instill a tremendous amount of fear,

  • although they could not legally carry guns.

  • They underwent quarantine for 21 days in our unit and were not arrested.

  • We told the police,

  • "If you arrest them here,

  • they will stop coming, they won't get treated.

  • And the Ebola virus will continue to spread."

  • The police agreed, and we were able to treat the VIP Boys,

  • and they did not have to worry about being arrested while in the unit.

  • Over the course of the outbreak, West Africa had almost 29,000 cases.

  • More than 11,000 people died.

  • And that included 12 of my fine colleagues at John F. Kennedy hospital in Monrovia.

  • In June 2016, exactly 23 months after my first Ebola patient died,

  • Liberia declared its Ebola outbreak ended.

  • We thought that once the outbreak ended,

  • so did the problems.

  • We hoped that life would go back to normal.

  • Today, there are more than 17,000 survivors in West Africa.

  • People who actually had Ebola virus disease,

  • lived through it and survived.

  • We counted survival rate as a success:

  • the end of suffering for the patient and fulfilling joy for families.

  • Every discharge from the unit was a moment of jubilation.

  • At least so we thought.

  • The best description of the moment of discharge

  • and a rare glimpse into the moment that defines our life post-Ebola

  • was vividly expressed in the words of my best friend

  • and fellow doctor, Philip Ireland, in an interview with "The Times."

  • He said at the time of his release,

  • "There were a lot of people there from JFK hospital:

  • my family, my elder brother, my wife was there.

  • A lot of other doctors were there, too, and members of the media were there.

  • And I felt like Nelson Mandela, it felt like the 'Long Walk to Freedom,'

  • and I walked and raised my hands to the heaven,

  • thanking God for saving my life."

  • And Philip said, "Then I saw something else.

  • There were a lot of crying people, people happy to see me.

  • But when I got close to anybody, they backed away."

  • For many Ebola survivors, society still seems to be backing away,

  • even as they struggle to lead a normal life.

  • For these survivors, life can be compared to another health emergency.

  • They may suffer debilitating joint and body pain.

  • The suffering gradually decays over time for most.

  • However, many continue to bear intermittent pain.

  • Some survivors are blind, others have neurological disabilities.

  • Some survivors experience stigmatization every day, in many ways.

  • A lot of children are orphans.

  • Some survivors experience post-traumatic stress disorder.

  • And some survivors lack opportunity for education.

  • Even families can be split apart by fear of Ebola, too.

  • There's no definitive cure for transmitting Ebola virus through sex.

  • However, there are successful interventions for prevention.

  • We have worked hard on semen testing,

  • behavioral counseling, safe sex promotion and research.

  • For the past year, there have been no cases of sexual transmission.

  • But some male survivors have lost their spouses

  • out of fear they will be infected with Ebola.

  • That's how families are torn apart.

  • Another tremendous challenge for Ebola survivors

  • is obtaining adequate health care.

  • In theory, Liberia's public health services are free of charge.

  • In practice, our health system lacks the funding and capacity

  • to expand care to all at the point of need.

  • Many survivors have waited many months to undergo surgery

  • to heal their blinding cataracts.

  • Few had to relive the traumatic experience,

  • when their blood was retested for Ebola at the point of admission.

  • Some survivors experienced delayed or deferred admission

  • due to limited bed capacity.

  • No bed available for one more patient.

  • This is neither national policy nor officially condoned,

  • but many people are still afraid of the sporadic resurgence of Ebola virus.

  • The results can be tragic.

  • I have seen Beatrice, an Ebola survivor, several times now.

  • She's 26 years old.

  • Many of her family members became infected, she luckily survived.

  • But since that day in 2014 she was discharged

  • to cheering health workers,

  • her life has never been the same.

  • She became blind as the result of Ebola.

  • In 2014, the baby of a dear friend of mine was only two months old,

  • when both parents and child were admitted in an Ebola treatment unit in Monrovia.

  • Luckily, they survived.

  • My friend's baby is almost three years old now,

  • but cannot stand, cannot walk, cannot speak.

  • He has failure to thrive.

  • There are many more hidden experiences and many stories are yet untold.

  • The survivors of Ebola deserve our attention and support.

  • The only way we can defeat this pandemic

  • is when we ensure that we win this final battle.

  • Our best opportunity is to ensure

  • that every survivor receives adequate care at the point of need

  • without any form of stigma and at no cost to them personally.

  • How can a society consider itself healed

  • when a person's entire identity

  • is defined by the fact that they recovered from Ebola?

  • Should a previous disease that a person no longer has

  • become the sum total of their identity,

  • the identifier in their passport

  • that deters you from traveling to seek medical care abroad?

  • Simply the ID that denies you health care.

  • Or prevents you from having a relationship with your spouse.

  • Or denies you of family, of friend or home.

  • Or prevents you from carrying on your normal job,

  • so you can put food on the table or have a roof over your family's head.

  • What is the meaning of the right to life

  • when our life is clouded by stigma and barriers that fuel that stigma?

  • Until we have much better answers to those questions in West Africa,

  • our work is not over yet.

  • Liberians are a resilient people.

  • And we know how to rise to a challenge, even a devastating one.

  • My best memories of the outbreak

  • center on those many people who survived the disease,

  • but I cannot forget the hard-working nurses, doctors, volunteers and staff

  • who risked their own safety in service of humanity.

  • And some even losing their lives in the process.

  • During the worst of the contagion,

  • one thing kept us making those perilous daily journeys into the Ebola wards.

  • We had a passion to save lives.

  • Was I afraid during the Ebola outbreak?

  • Of course I was.

  • But for me, the opportunity to protect our global health security

  • and keep communities safe at home and abroad was an honor.

  • So as the dangers became greater, our humanity became stronger.

  • We faced our fears.

  • The global health community working together defeated Ebola,

  • and that ...

  • that is how I know

  • that we can defeat its aftermath

  • in our hearts, in our minds and in our communities.

  • Thank you.

  • (Applause)

June 13, 2014

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【TED】For survivors of Ebola, the crisis isn't over | Soka Moses

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    Zenn   に公開 2018 年 05 月 01 日
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