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How to touch with care

Libby Bowell describes burying Ebola's victims in Liberia and helping families to care for the sick.

Liberia was the toughest mission I've been on and I've seen 15 missions so far: from cholera outbreaks in Sierra Leone to the earthquake in Haiti. But never on mission have I seen fellow nurses die, and fairly frequently.

In three countries - Guinea, Sierra Leone and Liberia - we're looking at 17,000 Ebola cases. This is not going away.

The Ebola outbreak started in Guinea with a two-year-old child who had eaten bat meat, which is very common in that area. His mum was nursing him at home; when she got sick she went to her mother's place. They all got sick and that's how it started.

The last thing you want is for an outbreak to hit a city, and that's what happened in Liberia. We were 700 beds short, so people were returning to their communities to die.

Red Cross in Liberia is well-received and has a good name. My role as emergency health coordinator was to support the Liberian team, who were all overwhelmed and needed some new energy.

In the first week, we worked with the team undertaking safe and dignified burials. The water table in Monrovia was too high to bury infectious dead bodies, so we had to cremate them. And this amazing group of young people, mostly under 25, put their hands up. And they did it with so much dignity and respect, picking up 5-10 bodies per day.

Another task was to isolate those with the disease and then identify people they've been in contact with. In every community, we identified one person to become the contact tracer. And you ask them, why are you doing this? They would say: because I can. Because we have to make this terrible disease go away.

We had to maintain a 1-2 metre distance from people. And that was one of the hardest things to get used to. I'm a hugger; I'm a shaker of hands and there was none of that.

Another thing Red Cross does really well is key messages: Wash your hands with soap. If someone gets sick, get them out of the community and to an Ebola treatment centre. Red Cross can provide safe and dignified burials.

One key message changed. When I first arrived, it was 'Don't touch anyone'. But two weeks in, we knew we didn't have enough beds. So we listened to the Liberian people when they said: 'Our people will touch people. So you need to teach us how to touch with care.'

So when there weren't enough beds, we would ask someone in the patients' family to volunteer to be the carer. This is a huge ask, but you're saving the other nine or ten in the family by doing it.

Many people are talking about Ebola treatment, but the key to stopping this is to break the transmission at the community level.

I've been asked a lot, weren't you scared? No, not really. It gets in your head at least once. But you can't enter any building, even in the smallest of rural places now, without washing your hands with chlorine. And you get your temperature taken in every building you go into. I would say in fact, that I really felt quite safe there.

There are an awful lot of 'Ebola orphans' now. We don't know why kids seem more resilient, even when they are caring for their parents, sometimes with just plastic bags on their hands. Certainly kids are contracting the disease but nowhere near the amount the adults are. But these kids are watching their mums get taken out and wondering if they're going to die next.

The health infrastructure completely closed down, so we had women in labour in the midst of Ebola treatment centres. Everything stopped for a while. There were no public gatherings. No sport.

When people recover and come home, they get issued a certificate to show 'I'm a survivor. I'm not dangerous any more.' But many communities didn't want those people back home.

I met a mother and a daughter who both survived Ebola, but the mother lost her husband and five of her kids. So how do you celebrate if you have to deal with that?

We buried a two-year-old boy. Every person in the team put their hands up to carry him out.

People were painting murals on the streets saying 'Ebola is real'. And that's my take-home message to you: Ebola is real. It is harsh. It is wiping out generations and it will go on for many more months.

Liberia is making some headway but we can't drop the ball; we have to continue to help. My Red Cross colleagues are tired. They're doing an almighty job, but they want life to go back to normal too.

This is an edited extract of a speech delivered at the Red Cross 'Frontlines of Humanitarian Aid' panel event in Sydney on 27 November.

Photos: IFRC/Victor Lacken

Thank you

Australian Red Cross has now closed the Ebola Outbreak 2014 Appeal.

Thanks to the generosity of the Australian community, we raised $1.2 million to provide humanitarian assistance to communities affected by the spread of the Ebola virus disease.

If you have raised funds for the Ebola Outbreak 2014 Appeal that have not yet been banked, please call us on 1800 811 700.