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Eman’s Emails from Liberia: Through September

Emmanuel Gokpolu and son Larry, from Liberia.
Eman Gokpolu and son Larry, from Liberia.

Emmanuel Gokpolu, who lives in Liberia, calls me Mom, although he has a wonderful real mother. In Africa, family isn’t only about DNA.

Eman contacted me in 2007, after using my human genetics textbook in college. My husband Larry and I had been putting him through medical school in Monrovia — until Ebola happened. Now the funds go for gloves, long sleeve shirts, detergents, food and medicine, to keep Eman and his family, including his almost-one-year-old son, little Larry, safe.

This week Eman asked me to share his emails, which began arriving before many people here had heard of Ebola, or cared much about it if they had. Then the disease seemed, and was, half a world away.

The world is a small place.

JULY 28

“Hi Mom and Dad, hope all is well with you. It’s not that good here. The Ebola virus has everyone living in fear. One of our professors, a doctor, died from the virus yesterday. Imagine? So much fear. Please keep us in your meditations. Your son

AUGUST 6
These have been some of the worst days we have witnessed.

Public facilities and gatherings have been discouraged, schools have been closed, some marketplaces and even clinics closed just to curb the incursion of this virus. Worst of all, some heartless people have been poisoning pumps and wells.

Medical students have only been used to sensitize communities on the outbreak and prevention. There was not much we could do due to lack of medical supplies. This virus mostly affects health workers and caregivers.

We could have done much better to stop this virus from killing so many people if not for denial that the virus exists. You won’t believe this: in the midst of all these deaths, people still doubt that this virus exists! In fact, people are blaming the West, while others say it’s government propaganda. Others are even claiming that health workers are deliberately killing people to extract body organs.

Family members and loved ones do not easily accept when their relatives are diagnosed. People consider the virus more a stigma than a sickness.

As a medical student Eman can't treat people, so he is a  "sensitizer," educating people on how to avoid infection.
As a medical student Eman can’t treat people, so he is a “sensitizer,” educating people on how to avoid infection.

I’ve been working with a local organization that I chair to sensitize people in my community. It’s been a huge job with little material to work with but overall, it’s been great.

The family is fine and we are all keeping safe. It’s only Larry that has not been doing that well. He got sick, been vomiting, red eyes and high temperature. We got so afraid and had to call the Ebola response unit because these are all signs and symptoms of the virus. We are relieved that he’s negative and is being treated.

Hugs, Eman

AUGUST 7

Ebola is on the rise day by day. The death toll keeps mounting. President Sirleaf has declared a 90-day state of emergency.

Fear of the virus has prompted many hospital workers to abandon clinics – many are now shut. Because of this, many diseases like typhoid and malaria that are prevalent during the rainy season are untreated and there could be preventable deaths. We are living in fear.

Public transport vehicles have been ordered to reduce the number of passengers. Also, physical contact sports have suspended all practices and games, but more awareness needs to be done. During my organization’s community awareness campaigns, we noticed that some people hardly even know of the virus. Unhealthy practices that might spread the virus are still done.

Basically, the message here is to wash our hands as often as possible. Go to public places and you will see buckets with chlorinated water to wash your hands before entering.

Mom, this situation is very serious and the outside world might not know it.

(Wikimedia Commons)
(Wikimedia Commons)

AUGUST 10 (I tried to interest editors in Eman’s story, but got resounding rejection. This is his response to news of my failure.)

Tell them that our hospitals have closed due to their inability to tackle this virus, that even our medical doctors and nurses have fallen to this virus, and that our schools are closed and we live under a state of emergency, meaning our rights are suspended. Above all, tell them that we lack the experts to conquer this virus. Make them understand that this is no fiction or fairy tale. This is reality and people are dying and desperately need help.

(I quoted a short Eman email here mid-August, because media reports were so oversimplified, mixing up RNA and DNA, genome sequences and genetic code, that I felt I had to spell out the science, in “How Ebola Kills.”)

AUGUST 11
Two of my ex high school mates have died of the Ebola virus as have nurses from St. Joseph Catholic hospital. This hospital has been hit the hardest with more than 6 health workers dead from the virus and 10 more positive. It just doesn’t get better. More needs to be done, I keep saying. Our health system is just too weak for this outbreak. It was too weak before the outbreak.

The state of emergency has made things tough. The prices of food have skyrocketed and if something is not done, it might be another emergency! The health authorities have put into place measures to curb the spread of the virus but the cases keep coming. Among these measures are:

• Every business has chlorinated water in buckets outside for washing hands for those entering. This includes banks, churches etc.
• Schools are closed indefinitely
• Taxis are only allowed three persons in the back.
• Checkpoints have been set up to control the movement of people.

Sadly, there has been no decrease in the number of cases. My family has decided to send the younger kids up country to our mom where they will be monitored. Also, due to the increase in food prices, we have to reduce the number of people. Food is in short supply. We have heard that health experts are coming from the US and Nigeria, but none yet.

Sonn and grandson (4)AUGUST 12

I am using a phone to email you. Public gatherings are not encouraged, so I don’t see an Internet cafe as safe.

I just lost my elementary health science teacher to Ebola. It hurts so much. We can’t give up though.

Today, another Ebola case made health workers abandon an entire clinic. Two patients in critical condition were taken to the Goodwill clinic. Upon finding out they had Ebola, the workers escaped. This shows how unequipped and unprepared our health workers are to tackle this outbreak. Also, families knowingly keep love ones in their homes attempting to treat them, infecting themselves.

A friend from my community went to Guinea to visit his family before the outbreak. His father got infected and died and his mother and two sisters are infected too and seriously ill. He doesn’t know if he’s infected. He called today and broke down in tears. This is so scary!

The ZMapp is here and will be given to two doctors. Other health workers’ families have to sign that they acknowledge that it is a trial drug and might have unknown side effects which, if it occurs, will not hold the company or government responsible.

eman and flagsFrom a personal perspective, I have a few doubts. Why didn’t the US government present this trial drug until two of its citizens got infected? Why hasn’t anyone tried the serums of those who survived the virus? WHO says there are only 12 doses. What happens after those 12? Lots of questions in my mind.

Seeing loved ones die with no options to save them is just so ridiculous! I wish I could do something to help. Just staying safe at the moment. Survival is cardinal right now.

AUGUST 17

I know we have got you worried but I must tell you that it is more than you see on TV. Everyone is so, so afraid! From the way this situation has been handled, I fear for the worst. Would you imagine that there is a single burial team to dispose of Ebola-related dead bodies? As a result, people are exposed day in, day out. In fact, there are only a few isolation centers, making them overcrowded. This government is joking with our lives.

With the millions coming in as aid, we should be somewhere but the situation is becoming even worse. If I had a voice, I would recommend that aid be sent through NGOs instead of the government.

An Ebola quarantine site was attacked and looted, and most of the patients have escaped. This is going to put more fear into the population. All of this is happening because people are denying the virus. Keep me in your meditations.

Ebola_virionsAUGUST 18
Need help!

(Eman developed fever and pain. Relieved that it was “just” hookworms and malaria, he was hospitalized for a week.)

AUGUST 25
There’s some not very good news. The virus has struck on the street where I live; the physician from a clinic in my area. That makes it very, very scary. In spite of that, I applied to volunteer with MSF. Still awaiting their call. I only fear for the community because this is going to be my daily routine when I’m a doctor. We all have to help now, but maybe in a safe way.

SEPTEMBER 15
Mom, You have to pray for us harder. Things are getting worse by the day; more than 1300 deaths and thousands more infected. WHO projects even more terrible times. We just don’t know what to do.

Supplies might not take us through the 90 days as prices have gone the highest. Larry is running out of food, and his medications too. We all have to take preventive malaria pills in case we encounter mosquitoes. Even worse, all quarantines are over capacity and new patients are told to go home. Quarantines are out of food and beds. It’s a nightmare!

SEPTEMBER 19
We just can’t wait to see those troops on the ground. They have to be fast before we all perish!

little LarryThe economy is crashing. Importers have stopped importing basic commodities. Milk and medicines for babies are so expensive. Basic goods prices have doubled or tripled, especially drugs. The syrups for Larry, once opened, cannot be used more than a week because we do not have the means to store them for long, so we have to spend huge sums buying the same drugs. His milk was $22; it’s now $35. If something is not done quickly, there is sure going to be a food crisis.

SEPTEMBER 24

School is closed indefinitely but I have to keep reading and researching. I have been following the Ebola virus and vaccine trial closely. I’ve read a lot of articles on the virus and mutations it is undergoing. I hope it doesn’t become airborne; just one of many possibilities. Keeping it safe. Hugs. Eman”

SEPTEMBER 30 (me again)

Ebola arrived in the US with Thomas Eric Duncan, visiting from Liberia. He showed up at Texas Presbyterian Hospital in Dallas, where some of the medical staff appeared not to know how to keep viruses out of one’s body.

ebola deathsAs the U.S. finally began to wake up and my inbox overflow with reports on Ebola, I began emailing Eman everything I received, even the embargoed news releases and papers available only to journalists. His need to know all he could was insatiable, and the ignorance here has stunned both of us. I continue to find scientific errors both in hurried reports to clinicians as well as in the top magazines. (Vanity Fair’s “Hell in the Hot Zone,” by Jeffrey E. Stern in September, is a notable exception — it’s terrific.)

STEM education, anyone?

Emmanuel Gokpolu, medical student and community organizer at the epicenter of the Ebola epidemic, who has lived with cholera and cerebral malaria and amoebiasis, can tell westerners a thing or two about this virus.

Eman’s story will continue next week, picking up at the start of October — a turning point here, but just another horrific day in Liberia.

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