Hi Jarret, Your writing gives a beautiful insight of stigma that has developed towards Ebola, that is natural given its contagious and lethal nature. A similar type of stigma has historically developed for Leprosy where even those who are curd of the disease are still discriminated by the society, sometimes to an extent that they are forced to live in the fringes of the society and have limited marriage choices. 

Public Health workers have a strong role to play in combating and removing such stigma from the society and it should be a part of health education in Ebola affected areas. Photovoice is a strong tool where photographs of Ebola treated people freely  mingling with their families and people's stories can be showcased in the community to obtain desired result.

Government policies in this regards also play an important role. Correct policies, especially in the use of media like TV and Radio in spreading anti stigma message may be important in developing people's attitudes toward Ebola treated people.

Good day. Recovery from social stigma can be a balance between traditional and non-traditional systems. An inclusion environment may be acheived through stewardship of survivors as Community Health Workers (CHWs) to educate and build community engagement.  Seeking out the community gatekeepers (ie. faith-based leaders, politicians, business leaders) to initialize and support education process.

thanks for your responses Ankur and Starleen!

This is an excellent question, I think. People are scared of this disease, for it kills quickly. There is a joke in circulation in my city, Addis Ababa ( we do not have the disease). A pastor was teaching  on what Christ does to save ill people. He called a number of patients of different diseases that were cured by Christ who testified. Then , he called an 'ebola survivor' to testify how he was cured by Christ. On hearing that the audience that was curiously attending to all the miracles testified, started rushing out from the hall and some through the door and others through the windows; in effect a number of individuals were hurt.The joke  demonstrates  the fear associated with ebola and even the believers in Christ could not feel safe under the protection of the Lord.

I was involved in  a study of HIV/AIDS stigma and discrimination by making a longitudinal study of individuals who live with the virus..The study revealed why stigma and discrimination, how it is manifested and what is done to cope with the situation  The first problem is ignorance about the causes and modes of transmission of the disease; the second is perceived stigma and discrimination of people living with HIV/AIDS and the third reveled the key places and events for stigma and discrimination--home, religious sites, markets and social gatherings.

I believe that before engaging survivors of ebola in what they could do to mitigate  transmission of ebola,  for they are the right people to use their experience of ebola in social mobilization and public awareness raising activities, it s important that ebola clubs, as we have in HIV/AIDS, are formed to raise public awareness of the disease and how it is transmitted and prevented. The ebola survivors could  use their experience to teach  people. Experience is the best teacher.

Dear Jarret,

I know this sounds simple but first and foremost keep living. Secondly, as Ankur has mentioned the stigma is so powerful that the fact of continued living will in its self help. Third, it is almost impossible to break the fear of Ebola in the older generation, to many real lived experiences have been seen, felt, and loved ones lost to make any real difference.

With all the above the survivors could be used in public awareness campaigns which are focused on youth. The generation growing up should be the focus of a focused and widespread educational campaign. The survivors could be brought into schools, clubs, and after school programs and share there experience, strength, and hope with them.

Last, science can begin to understand how these particular people lived. It will be important for the survivors to agree to a mass media campaign in which hope and faith that they can survive and Ebola will eventually through science research and medical practices will become like the Black Plague a distant memory.  

Douglas      

How can survive person help to the others who are suffering from the same kind of disease? We have a little bit experience regarding the patients who are suffering from HIV/AIDS are involved under the AIDS control programme as a peer educator , At the start, their is inhibition regarding the openness to talk about the disease and diseased person , but after few year , in most of the Targetted Intervention Centre , people come openly for treatment and support where they discuss their problem with the other people having such disease also in the ART centre. With time this type of disease related stigma can be reduced, no doubt , we could not remove it completely , so the people those are involved in the disease like Ebola survival should come forward as a organization and try to discuss with the patients to boost their morale to fight against this disease , ultimately people will succeed to fight this problem also.

Haliom, Douglas and Mohan, thanks for your responses!

I believe that health educators have a strong role here as well to not only educate about the disease and its transmission, but also to utilize survivor advocacy as is done in other areas such as injury prevention.  Survivors can advocate for more research, funding and education.  Their presence sends a strong message to the population and communities  that not only did they survive but now they are working to help others do so as well.  

While there is stigma, survivors themselves are also an example of how the disease can be fought and won. Apart from health workers and doctors, agencies like MSF have managed to prevent patients from getting stigmatised by working in the field and engaging with the community. Awareness about prevention and treatment can reduce stigma. This is evident in many communicable diseases like HIV and tuberculosis. Earlier those affected by HIV and TB faced severe forms of stigma in society but with the health system ensuring care and treatment and social workers along with the media  building awareness about these diseases has helped reduce stigma in the community in a significant way.  Once communities understand how the disease is caused and how treatment can cure Ebola, patients will face less stigma and more support.

Hi Karen and Mohuya, thank your for your thoughtful responses.