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HEALTH
Mékambo villagers defy the WHO team
The Ebola virus and the people of Mékambo, in the north-east of Gabon, continue to defy WHO‘s health policies, in spite of the sitting up of quarantine areas by WHO‘s medical teams. The villagers have forced the epi-demiologists to pack up and withdraw towards the provincial capital, Makokou. This happened when they were trying to call a halt to such local customs as the ritual washing of the dead, which helps the spreading of the uncontrolled epidemic.
Ever since its appearance last December, the haemorrhagic fever caused by the Ebola virus has already killed more than thirty people in Mékambo and in villages situated on the frontier with Congo-Brazzaville. Starting in Ekata village, 80 kms from the border, the outbreak has continued to spread. This acute infection was first identified in Gabon in 1994, and outbreaks of fever ware noticed in February and July 1996, causing the deaths of 86 people.
A very dangerous virus.
Ebola virus, named after a river in Congo RDC, was discovered in that country in 1976 at Yambuku; in the same year, it was also identified in Nzrara, in Sudan’s Western Equatorial Province, across the border from that region. Ebola is an extremely dangerous virus, on account of its easy transmission, its high mortality rate and its distressing symptoms, No vaccine has yet been found. The disease starts with a sudden fever accompanied with muscular pain, severe headache and sore throat followed by vomiting, diarrhoea, skin rashes, renal and liver insufficiency, internal and external haemorrhaging. The incubation period is from 3-21 days and the mortality rate is 50%-90%.
According to scientists and WHO experts, the African and Asian tropical forests are natural repositories for the Ebola virus, and several presuppositions have been put forward to explain the sporadic outbreaks. In Africa, several areas of Ebola virus infection have been spotted. From June to November 1976, 284 people were infected in Sudan, causing 117 deaths. In Congo RDC, from September-October 1976 there were 280 deaths and in 1995, there were 315 cases in Kikwit, of which 244 were fatal.
Exhausted population
Mr. Victor Ngoubou is a school teacher. He explains that «the inhabitants are very worried, and they feel harassed by the specialists coming from Geneva, imposing on them sanitary constraints. Moreover, all their movements are constantly monitored.»
Areas at risk are Mékambo, Makokou and Booué in the Ogooué-Ivindo region. The relative isolation of the region has prevented the rapid spread of the infection. For economic reasons, the railway terminus at Booué was never extended to Mékambo, as foreseen thirty years ago. «This would have increased the outbreak through population movements towards the more populated big towns», says Mr. Fabien Ndong, a male nurse from Makokou Hospital.
Dr. Prosper Abessolo Mengue is a regional Health Director. He states that «the population and the local authorities must be made aware and fully informed about the danger of the Ebola virus infection, and follow all preventative procedures. They should take charge of the psychological and social help of the patients and their families. In spite of these measures, the virus has already reached neighbouring Congo-Brazza. Dr Mengue explains: «At least an infected woman has crossed the border with Congo-Brazza». In December, four villages were quarantined, but not fast enough to stop one infected woman from crossing the border. Mr Firmin Tcheka is a health service officer. He says: «This is a shifting border. People go quite freely from one village to the other».
Mr. Allaranga Yokouidé, a WHO epidemiologist, has ordered the population not to touch animals found dead in the forests; not to kill animals which seem to be acting in a strange manner, i.e. which are not running away from the hunters. Yet, in those remote villages, people live from hunting, fishing, gathering wild fruit and plants. Also, medical teams have forbidden the people to evacuate their sick, and have advised them not to touch them with their bare hands; and certainly not to handle the vomit, faeces, blood, sweat or urine from corpses with unprotected hands.
Villagers from Zadié region in north-east Gabon have reacted against the WHO regulations, which prevents them from honouring their dead, eating the meat of monkeys or other primates. When the Health Minister, Mr. Faustin Boukoubi, was asked whether he would be ready to forbid the consumption and sale of bush meat, he answered: «The health authorities are reflecting on this matter. The problem might provoke total panic among the population. Already, there are quarantine regulations set up around Ogooué-Ivindo and it’s almost certain that no animal can get out of this region».
The chief of the little village of Ekata, near Mékambo, complains bitterly: «Not only are our movements restricted, we are even forbidden to eat meat from wild animals. It’s a real punishment and we certainly don’t need that».
Virus under close watch
In Central Africa, Ebola is one of those viruses kept under close watch, and particularly in Gabon where a team of specialists from WHO has been sent. Little is known about Ebola. Since its first appearance in 1976, it has returned mysteriously and regularly to Central Africa. Its origin is unknown — human beings are not the main carriers; this could rather be the monkey which transmits the virus in a way which still has to be determined. Some people think it’s a plant virus which infects vertebrates.
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