Dr. John Wright is back in Sierra Leone and has fired up his old Sierra Leone - Ebola Emergency blog. He's an observant and articulate writer, and I'm glad he's back in West Africa, if only for a while. Here's an excerpt from his latest, posted today:
Following the strange case of Pauline Cafferky I am keen to find out what is happening with the ETCs Ebola survivors. Ebola appears to linger in our bodies after infection. Just as herpes virus lies dormant in our spinal cord after childhood chickenpox, and returns years later as a cold sore. There are ‘immune privileged’ sites in our body such as our eyes, spinal cord and in males, testes, that remain remote from our immune system.
The American doctor Ian Crozier recovered from Ebola to find one of his eyes changing colour from blue to green - active Ebola virus replicating in the aqueous humour of this eyeball. What a scary thought when he looked in the mirror - something out of a horror film. Pauline Cafferkey had a post-Ebola meningitis and fortunately has recovered. A paper in the New England Medical Journal found that Ebola could remain in semen for up to 9 months following infection and there has been one case at least of Ebola being sexually transmitted.
So what about our Ebola survivors? I met up with two of them. Philip and his family had all been infected with the virus. His father and two brothers had died, he and his two sisters had survived after successful care in the ETC. He had recovered fully and was now training as a community health worker so he can care for future patients, which was a wonderful completion of the circle. Mohammed had also lost members of his family and was suffering from on-going health problems and struggling to find work.
Clara is a psychologist from Madrid and runs the psychosocial team looking after around 100 local survivors. She tells me that they face two hurdles after they walk out of the happy shower at the ETC. First is the fear that they still have the virus. Some of the wives of the men have refused to have sex with them for fear of contagion of Ebola STD.
The other hurdle is acceptance back into their communities. When I was here last year the survivors I spoke to faced real stigmatisation and rejection. Their friends and neighbours were scared of catching Ebola from them. This has changed dramatically over recent months. The end of Ebola has helped of course, but education and awareness and contact have overcome the prejudice. A powerful example of overcoming discrimination in society.
While you're on his site, scroll down to Friday's "While you were gone..." post. It describes the worrying contrast between a well-stocked Ebola treatment centre, with no real business except to shut itself down, and a nearby hospital that doesn't even electricity. If West Africa's healthcare system reverts to its pre-Ebola squalor, Ebola will assuredly be back again and again.