вторник, 21 октября 2014 г.
As Ebola patients vanish in Liberia’s health system, survivors go on a desperate search
By Kevin Sieff
For the 29th day, Linda Wilson came to the gates of the Ebola treatment center looking for her best friend, the woman whose picture she carried in her purse, so she could show it to guards or nurses or anyone else who might be able to help.
“Have you seen her?” Wilson asked them.
For the 29th day, the answer was no. Barbara Bai’s name was not on any list, even though she was admitted to a hospital one month earlier. There was no record of her death or her survival at any hospital in Monrovia. She was one of the many people who have simply vanished as Ebola tears through the city.
Ebola ravaged this capital so quickly that some patients passed through an already broken medical system with hardly any paper trail. Others were admitted to one clinic and transferred to another without notice. Hundreds were cremated long before their families were notified that they had died.
The world has heard about the deaths. Ebola has claimed 2,500 lives in this country, most of them in Monrovia. But the epidemic has also left in its trail another form of grief and anguish for those whose friends and relatives are missing. About 30 percent of Ebola victims survive. That’s the number many here obsess over — it is just high enough to offer hope and to fuel uncertainty.
Their vigil is a reflection of a medical system so overwhelmed by the virus that it has lost track of both the living and the dead. The United States and other foreign donors are working with the Liberian government to improve its system of medical records. Some clinics and hospitals have started posting more accurate lists of the deceased on their front walls, where families now gather, collapsing into tears as soon as the names appear.
But many are left without even a hint of their loved ones’ whereabouts.
“I’m left without any knowledge,” Wilson said as she walked away from Island Clinic, a fortified Ebola treatment center.
Relatives and friends spend hours each day outside the city’s four Ebola clinics. Some come to pray. Many are not sure if they’re in the right place.
They wait for visiting hours, held in special partitioned spaces, even though the loved ones they are looking for never show up. They check patient lists, even though they’re almost always incomplete. They ask nurses for help, even though the requests usually don’t yield information.
After almost a month, Wilson, 36, knew that the chances of Bai’s survival were slim. But without any confirmation, she kept imagining her friend walking out of the gates of a treatment center, sprung back to life as if she had never been ill.
Speaking with the families of the missing has become a second job for hospital employees at Island Clinic — a product of their rare access to the isolation ward.
Last week, Prince Nyumah approached one employee after the next with a picture of his sister, one that showed her wearing a wide smile and a big turquoise necklace. She was dropped off at the clinic three days earlier. She had been sharing an apartment with a woman who died of Ebola.
“We want to know. Even if she’s dead, we want to know,” he said.
“She’s doing fine. She’s sleeping,” a tall male hygienist said confidently.
Nyumah looked reassured. He walked to a group of other family members to share the news.
But the truth was that the hygienist, who declined to give his name, wasn’t sure. When a desperate family confronts him, he sometimes feels forced to lie, to say their relatives are fine, even if they aren’t.
“I don’t want to be the one to tell them that bad news,” he said.
Wilson dropped off Bai at Redemption Hospital in mid-September, when it was overflowing with patients and littered with dead bodies. She wasn’t sure if her friend had Ebola, but Bai’s fever and vomiting had worsened, and the hospital’s doctors said she should remain there for observation.
Wilson took Bai’s daughter, a 17-year-old named Grace, to live with her.
A few days later, Wilson got a call from a friend who worked at Redemption. Many of the patients had been transferred, including Bai, but he wasn’t sure where. Wilson got in her car. It was the first day of her quest to find her friend.
A world apart
The streets are still crowded in Monrovia. The markets are still full of men hawking bootleg DVDs, and women selling fruit and bags of rice. Almost everywhere, music blasts from car radios. After sunset, joggers run along a street near the beach.
The city’s four Ebola treatment centers are a world away. Each is fenced off and tightly secured. When relatives arrive, they’re asked to wait outside with other families. They watch men and women in full-coverage “moon suits” through the fencing, sometimes shouting questions to them.
When survivors are released, looking disoriented and lethargic, the crowd outside scans for the familiar face of a loved one. When families hear that their relatives have died, the wailing is immediate and seems to come from all directions.
Wilson divided her time between the city’s clinics in her search for Bai, whose husband had abandoned her before Ebola swept through Liberia. She wore a beige cap to protect herself from the sun during the hours she spent outside waiting.
Wilson has high cheekbones, big brown eyes and a girlish voice. She met Bai in church when they were teenagers. Wilson sang alto in the choir, and Bai sang soprano. For a few years, they lived together. They started introducing each other as sisters.
Bai, 36, got sick just as Liberia’s medical system was overwhelmed with Ebola patients. Redemption Hospital was not equipped to treat the disease, so it became a holding center for those like Bai, until their test results came back. If they were positive, the patients were sent to one of the four Ebola treatment centers.
“But which one?” Wilson kept asking.
No one knew. Unless a patient is healthy enough to make a call on a borrowed phone or to wave at relatives from a partitioned visitation center, it’s almost impossible to know whether she’s alive or dead. Wilson returned home each day and cried in her closet, so Bai’s daughter wouldn’t hear.
No final answers
Nyumah got the call a few days ago from a contact at the hospital. His sister’s bed was suddenly empty.
He raced to Island Clinic and asked everyone he could find what had happened. No one knew.
He found a member of the body-collection team, responsible for handling the dead, and asked him to look for his sister among the body bags he was carrying away for cremation — a disposal practice now mandated by the state.
The team member never got back to him, but soon a pickup truck loaded with the bodies pulled up, and tears formed in Nyumah’s eyes. He took a picture of the pile of bags. Days later, he still wasn’t sure if his sister was in one of them.
Wilson’s call came late on the 34th day of her search. A nurse at Island Clinic had done some research and found out that Bai had died. He couldn’t say when, only that her body had been taken to the crematorium. The bodies are burned at night in a compound outside the city.
Wilson started crying. She was glad for the certainty after so much time spent peering through fences, looking for a woman who might have died weeks earlier. But the news was still paralyzing.
She’s heard talk about a big ceremony planned to commemorate all of Liberia’s Ebola victims. But it won’t take place until the disease fades away, a point in the future that is hard to imagine in Monrovia now.
What kind of memorial could she offer Bai in the meantime? With no body and few facts about the death, it was hard to think of anything.
“I can just say that she was my friend, she was my sister,” she said. “And I’ve got to try to move on.”