TNH: How mixed messages on sexual transmission and breastfeeding may help Ebola spread

29 November, 2019

From The New Humanitarian. Extracts below and a comment from me. Full text here:


When Romelie Kawgho’s boyfriend returned from his Ebola checkup in the eastern Democratic Republic of Congo in January, he told her he was cured. The 25-year-old Ebola survivor had been discharged from a treatment centre three months earlier and insisted on having unprotected sex with her.

Although doctors urged the couple to use a condom for a year, Kawgho’s boyfriend assured her he was fine. Months later, after repeatedly having unprotected sex, 19-year-old Kawgho found herself in an Ebola isolation ward fighting for her life.

“I didn’t know many things about Ebola,” she said. “Had it been explained before about sexual transmission – if I knew everything – it would have been good, and I would have forced him to use a condom.”

When HIV swept across much of Africa in the 1980s and ‘90s, people were warned that unprotected sex, breast milk, and exposure to other bodily fluids could put them or their children at risk. In the latest Ebola outbreak, however, warnings about sexual transmission and breastfeeding have been inconsistent, while a stark reality has emerged: *most Ebola victims are women and children*...

Community outreach workers admitted being confused by guidance on sex or breastfeeding risks, sometimes omitting information...

According to UNICEF, breastfeeding information is only given to Ebola survivors and not to the general public.

“It might panic people,” said Mariama Sire Kaba, a community engagement specialist with UNICEF...

But aid groups like Mercy Corps think people have the right to be provided with all the facts... “We know that when people have accurate information – for example about the spread of cholera – we see a significant decrease in transmission,” said Schibli, of Mercy Corps.


Comment (NPW): These last sentence raise an issue that we have not previously discussed on HIFA. Is there ever a situation where people should be denied information 'for their own good', as suggested by the UNICEF community engagement specialist? I suspect this is rarely if ever the right thing to do. Apart from the immediate impact of withholding information needed to protect health, selective sharing of information could undermine the public's trust in the health system - trust that is vital to bring the outbreak under control.

Best wishes, Neil

Coordinator, HIFA Project on Information for Citizens, Parents and Children

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HIFA profile: Neil Pakenham-Walsh is coordinator of the HIFA global health campaign (Healthcare Information For All - ), a global community with more than 19,000 members in 177 countries, interacting on six global forums in four languages. Twitter: @hifa_org FB: