Liberia

AP reports that a Liberian analysis of bed space at Ebola treatment units concludes that of 742 spaces, 351 were occupied and 391 were vacant. It cites Assistant Health Minister Tolbert Nyenswah, who heads the government’s Ebola response. The main problem is the traditional practice of honoring the dead with burial ceremonies. Nyenswah:

For fear of cremation, do not stay home to die… We know cremation is not our culture in our country. But now we have disease, so we have to change the way we used to do business.

The slum, which is Liberia’s biggest and is home to 50,000 people, introduces measures like avoiding contact with the sick and hand-washing using a bleach solution, and avoiding eating ‘bush meat,’ meat from monkeys and rodents. Aid worker Mechie Seih tells charcoal seller Mamie Kollie how to lower infection risk if a family member falls ill:

You put clean plastic bags on your hands. You wear a thick jacket with long trousers. You put shoes and socks on your feet.

Pharmacist Doris Nyenkan says she now tells customers complaining of fever to get tested for Ebola. She also sells hand sanitizer, and uses it herself:

People clean their homes every day now. Now they are washing their hands, buying this gel. Before Ebola you didn’t see people doing such things.

Friends and relatives of Ebola patients say many people have vanished after being admitted to Liberia’s hospital system. Some people passed through the health system without a paper trail, others were transferred between clinics without notice, and hundreds have been cremated before their families are informed that they have died. A hygienist who says he has reassured people that patients are okay, although he wasn’t sure himself:

I don’t want to be the one to tell them that bad news

Liberian families are reported to be paying for birth certificates stating that people who have died of Ebola did not have the virus, in order to allow traditional burial rites that include touching and kissing the dead. Prof. Columbia University epidemiology expert:

Unfortunately, the bodily fluid of recently passed victims continues to carry Ebola virus for up to three days following death. The body’s immune system stops fighting the disease, allowing virus to replicate unabated.

Liberia bans journalists from Ebola treatment units due to concerns over privacy. Deputy information minister Isaac Jackson:

Journalists are no longer allowed to enter ETUs. These journalists enter the ETUs and cross red lines. They violate people’s privacy, take pictures that they will sell to international institutions. We are putting an end to that.

Liberia requires journalists to obtain official permission to cover many aspects of the outbreak under new rules aimed at protecting patient privacy. Journalists can be arrested and prosecuted if they fail to get written permission from the health ministry before contacting Ebola patients, conducting interviews or filming or photographing healthcare facilities. Tolbert Nyenswah, assistant minister of health and head of Liberia’s Ebola Incident Management System:

We have noted with great concern that photographs have been taken in treatment centers while patients are going in to be attended by doctors. That is invasion of the dignity, privacy and respect of patients. Ebola patients are no different from any other patients. We should do that (report) under permission so that we don’t just take pictures or send out stories of naked people (in a way) that does not respect their privacy.