Monsignor Robert Vitillo, Geneva delegate to the United Nations for Caritas Internationalis, left last Friday for Liberia to assist with strengthening the Caritas response to the Ebola crisis.
Monsignor Vitillo has extensive experience with major health crises, having worked on the Church’s HIV and AIDS response for more than 25 years.
Now in Liberia, he is assisting those on the ground who are both caring for ebola victims and their families, and also, crucially, educating and informing the people about the virus and how to curb the epidemic.
ZENIT asked Monsignor Vitillo, a US national, to tell us about what he’s finding, and also to explain why the ebola case in Dallas would never cause the level of crisis being faced in West Africa.
ZENIT: This week, the first confirmed case of this Ebola outbreak was discovered in the United States, in Dallas, which naturally made national news. But the media emphasized there was no real need for alarm. Perhaps for many Americans, it’s difficult to imagine why Ebola wreaks such havoc in Africa if in the States, it poses relatively little threat. Could you illustrate this with your experience?
Monsignor Vitillo: The Ebola virus was first identified in the early 1970s in the former “Belgian Congo”, now the Democratic Republic of Congo (DRC). Since then, there have been several outbreaks in the DRC and in Uganda, but each outbreak affected a relatively small geographic area, which allowed public health experts and medical doctors to isolate the area and, with isolation of patients and contact tracing of those relatives and acquaintances, they were able to stop the further spread of the virus in a relatively short period of time. In fact, such outbreaks were like ”brushfires” that burn intensely, do much damage, but then rather quickly burn themselves out.
The difference with the present outbreak in Sierra Leone, Guinea, and Liberia, is that it rather quickly spread to large population centres – cities, capitals – and thus the Ebola spread has been much more extensive, has continued for many months and affected large areas, including the capital cities in each of these heavily affected countries. In fact, every county of Liberia now has people living with Ebola. On the other hand, in those countries where there were few cases of the present Ebola outbreak, such as Nigeria and Senegal, and where public health officials quickly limited contact between sick persons and healthy persons, the outbreak has ended.
Why does a virus such as Ebola not cause havoc in Northern or high-income countries such as the USA? First of all, the virus has remained more or less limited to areas in Africa that do not receive a large number of Northern visitors, and those who do come are not usually in close contact with people who have symptoms of Ebola. We must remember that transmission occurs only when the body fluids of an infected person have a port of entry into the body of a previously uninfected person. On the other hand, those caring for Ebola-sick persons, especially family members and health care workers are at greatest risk of infection through contact with infected body fluids, particularly when they do not use PPE (Personal Protection Equipment), such as masks, goggles, gloves, gowns, boots, etc.
ZENIT: The US is among countries trying to support the African nations affected by the epidemic. Is the international community offering sufficient support? Are US troops, for example, actually able to provide any effective assistance?
Monsignor Vitillo: The international community has been slow to respond. In fact, during a briefing for governmental Missions to the UN, which I attended on behalf of the Holy See, Dr. Margaret Chan, Director-General of the World Health Organization (WHO), pointed out that for other natural or human-made disasters, the international community is accustomed to respond much more quickly than it has for the Ebola outbreak. At the same time, with all due respect, I must express the opinion that the affected countries were slow in detailing their needs so that potential donors could determine their ability to support efforts in the affected countries. Another issue to consider is that the health care infrastructures in all three heavily affected countries are quite weak and lack capacity and capital to respond quickly and to do contact tracing and safe transfer of patients to specialized treatment units.
Hopefully, foreign volunteers, such as medical personnel and others, including the military being sent by USA, will strengthen the in-country responses in the affected area. It will be important, however, for foreign medical experts to work side by side with Liberian national in order to help strengthen the health care system to be prepared for future epidemics and other emergencies.
ZENIT: Caritas has the advantage of working with local aid structures already in place. Reportedly much of the problem with detaining the epidemic seems to be a lack of trust among victims’ families or would-be victims in the information being given by foreign or government health care workers and responders. Does Caritas face that same challenge?
Monsignor Vitillo: Many myths and much misinformation are circulating in the local communities; there are rumors, for example, some locals say that foreigners poisoned the water system and thus caused the Ebola outbreak. When I accompanied Sr. Barbara Brillant, FMM, to a partners’ meeting between the government, the UN agencies, and non-governmental and faith-based organizations, on Saturday, 27 September, some young people said, “Look at those two people – they’re here with all their money and are doing nothing for us.” However, for the most part, Liberians are faith-filled people and will listen to their priests, ministers, and lay leaders. That is why Sr. Tava, FMM, of the Mother Patern College of Health Sciences, in Monrovia, decided to recruit volunteers from among her HIV educators group, many of whom also may be HIV-infected, to initiate awareness-raising on Ebola. They already knew the communities, and were not too timid to deliver a strong message to people. Sr. Tava has been very successful in preparing these Ebola team members.
These teams not only bring prevention information; they also deal with issues of stigma and discrimination. They make it clear that people who have recovered from Ebola no longer are able to pass on the infection to other people and have developed a natural immunity to the virus and thus cannot be re-infected. Such people, in fact, are good candidates to serve as educators and caregivers to others who may be living with or affected by Ebola during the current or future outbreaks.
Similar social mobilization efforts have been organized by the Caritas organizations in Sierra Leone and Guinea, and Caritas Liberia is in the process of expanding such programmes in all three dioceses of the country.
Another very important contribution of the Church is that of pastoral care. Because of the “no touch” policy (no physical contact and standing at least one meter distant from those suspected to be, or already confirmed as, living with Ebola, it is difficult for priests to administer some of the sacraments, such as the Sacrament of the Sick or, in some cases, even of Holy Eucharist. However, priests are able to counsel, to guide spiritually, to pray with such persons, even from a distance. Yesterday, I met a Liberian priest, working in a very rural area (he has to walk five days to reach the mission stations at the far end of his parish). He told me how he brings food to parishioners who are quarantined for suspected infection with Ebola, how he speaks with them, even from a distance, and how appreciated this human contact is by the people who feel so isolated from others in the community.
Moreover, the burial practices have changed since people could become infected even by contact with the bodies of those who have died of Ebola; thus families no longer are able to wash a
nd prepare bodies for burial – they are not even able to participate in the actual burial – this is all handled by specialized teams of volunteers (organized mostly by the Red Cross). Also here, the Church needs to help people memorialize and pray for the souls of those who have died through prayers and Requiem Masses even if the body of the deceased person is not present during these rites.
Finally the Church is reaching out to orphans and other vulnerable people who have lost family members to Ebola. They, too, experience stigma and discrimination, and clergy, religious, and lay leaders in Christian communities must model acceptance and welcome to these people and help them satisfy their basic needs for a dignified life.
ZENIT: What should people in the West do to support Caritas in fighting this epidemic?
Monsignor Vitillo: First of all, they should pray for God’s comfort to those already infected and hope to those who are trying to remain healthy. Secondly, they could donate to our Caritas efforts in support of the work being coordinated at field level by local Caritas organizations, religious congregations, and other Catholic Church-inspired organizations (see web site, click the red “Give to Caritas” button on the right of the screen, and select “Fighting Ebola in West Africa”
To read more of Monsignor Vitillo’s experience:
http://www.caritas.org/2014/09/no-touch-rules-in-africa-after-ebola/
