Coping with Ebola Virus in West Africa

It’s an unexpected end to the summer. I’m on an airplane now, starting what would’ve been a homeward journey back to Dakar, where I run a technology for development consulting company with my husband. Instead, because of Ebola virus, we’ve decided to postpone going home.

We’re not sure when we’ll be back, but it will be after the Ebola outbreak subsides and I feel safe again. We deliberated our decision for weeks, over the summer in the U.S. where my husband and I were teaching at a summer graduate program.

For me, this is the right choice. It respects my boundaries and my need to be and feel safe, as much as possible, where I am. It is based on my training in public health and my understanding of epidemiology and epidemics. Others of us will chose differently, and I am grateful for that. I honor and respect it, and I am here to support you however I can.

I want to share here about why I decided what I did, and how I’m coping with the strangeness of being far away as my communities in Senegal and Liberia undergo this challenge. My intention is not to tell you what to do. It is up to each of us to weigh the risks and to make our own choices and decisions.

I want to share the journey I’ve been on for the last few weeks because I know, especially for those of my readers who are based in West Africa and the affected countries in particular, that this is an issue very much on our minds. For those of us with families, for those of us wanting to go home, for those of us feeling worried as Ebola virus frays at the edges of our minds, making us wonder, “Is it safe to be here?”

I choose to live in a world far from the virus, but I acknowledge fully that my position within race and class privilege enables me to leave in the first place. For my friends and colleagues working on the frontlines, and for my friends and community members in Monrovia and Liberia who are struggling to cope, the options and decisions have been different. I honor that, and am going to do what I can to help from where I am, honoring my own needs and process.

Here’s how I went through the decision-making, weighing the risks and costs of whether or not to go home. Here’s my process. I hope that by sharing it, it benefits you in some small way.

For those in our tribe who are dealing with Ebola virus in West Africa, may this contribute to the discussion and dialogue within your own process of decision-making. For those of you in non-affected areas, may this give you a window into a process that I hope you never have to face.

I have waited a long time to write and publish this, because I know that keeping calm and avoiding panic are of paramount importance in a public health response to an epidemic. But we’re at the point with this where what I share is quite obvious to all, so I feel like I’m well within the bounds of my professional responsibility.

So, here is…

How I Decided Not to Go Home Because of Ebola

1. Information Gathering

Since March, when news of Ebola virus first started making international headlines, my husband and I have monitored the media for information. Actually, he’s been the one combing Google news feeds for a mention of the virus, tabulating the numbers, watching what looks to us like the slow burn beginning of an exponential curve.

One of the hard things has been knowing that, in an outbreak, controlling information is essential to avoiding panic. Because panic must be avoided at all costs, we haven’t always trusted the accuracy of the numbers released by governments and other organizations. Back in March, we wondered if we’d feel the need to leave Dakar because of Ebola on our borders.

We looked at the numbers coming from Guinea from WHO and the government, and we trusted them, for the most part…until June, when the Government of Guinea said that it had purposefully delayed releasing real numbers to avoid panic. At that point, we realized that while the official story gave us a decent picture, it did not give us accurate data for decision-making. That, it seemed, would need to come from somewhere else.

At a time like this, it’s also important to avoid rumors — which can get carried away and spread like bush fire, and panic just makes things worse. Through the summer, I’ve been careful about how I speak about Ebola virus and the stories I tell, trying to avoid sensationalism and fear as much as I can. Of course, with viral hemorrhagic fever, that’s quite hard to do, but I’ve tried.

I also recommend limiting the information you take in to what is essential and necessary for where you are. Make a time every day to get current on what you need to know, and then defend yourself from endlessly checking Google for new headlines. It will only add to your stress.

2. Pick Your People

It’s been hard to find trusted friends who can support me around the emotional aspects of dealing with this. My U.S. friends don’t have the context, most of the time. One friend exclaimed, after I expressed how it felt to see my old neighbors in West Point quarantined, “I’m dealing with the same stuff too,” almost like a taunt, resentful that I could claim some kind of attention-getting high ground. It was surreal, to be suddenly faced with needing to cope with her feelings in that moment, instead of getting to acknowledge and process mine. I left the conversation feeling confused, more upset than when I’d started.

Pick people around you who are loyal, available and ready to bring you love and light. “Love and light,” you might be saying to yourself, “what does that mean?” I mean people who, when you bring them your darkness and your fear, hold space for you to be exactly where you are without telling you you’re wrong to feel how you do. People who, while you share your stories, listen openly and at the same time take a stand for hope, for empathy and for compassion. People who are willing to listen and support you without asking for much in return right now — those are the people you need around you at a time like this.

3. Create Good Boundaries

Please forgive the friends who can’t understand and don’t have the emotional bandwidth to help, but make some distance for now. You need all your resources to support yourself and make good decisions, and that means keeping a strong perimeter from people or things that will distract you.

If you’re on the frontlines of the response, this is especially important. You need positive, practical people around you, supporting you from the sidelines. You need people who will show up for a late-night Skype call, listen and love you while you cry, and then tell you how good you’re doing and how amazing you are. Find these people in your networks and your life, and forgive everyone who doesn’t measure up to what you need right now. It’s okay.

Good boundaries are also essential for dealing with the stress of what is happening right now, because it is unprecedented and scary in our modern day time. Cordon off time and make space for yourself — lots of space. You need breathing room, and room to process and feel. This can be done alone and with others — but preferably both.

Keep a group around you who understands what you’re going through. Other aid workers, colleagues and friends on the ground are excellent for this. Try to find ways to release stress and tension that are helpful and healthy — at least, most of the time. Talk to each other, share and cry — tears are the body’s best way to release the stress hormone, cortisol, which can cause long-term health damage when it accumulates. Meditate, exercise, get as much sleep as you can, and go easy on yourself. Self-love and compassion make it less likely that the endless drive of work in the response will build to panic and burn-out. Deep breaths and lots of positive self-talk reminding you how well you’re doing are helpful too.

4. Establish Criteria and Stick to Them

What about if you’re not on the frontlines of the response and don’t want to be a hero? Good for you, for knowing where you are and where you don’t want to be. Nobody “has” to do this work. It’s a choice, and for everyone who says “yes,” I equally honor those who say “no.”

For me, it was really helpful to create quantitative criteria for how to decide not to go home. We decided there needed to be a two-month period of no new cases in any bordering country for us to safely return — that was our criteria. Everyone’s choices will be different, but it’s important to set a threshold, so you know.

Otherwise, it’s way too easy to let denial push this to the edges of your awareness, and then panic can set in because you don’t have a plan. With solid, pre-agreed upon criteria, you also know when to spring into action and when it’s not time to act yet.

The trick here is to try to stay rational, as much as possible, although this is much easier said than done.

5. Make a Back-Up Plan Before You Need One

After we made our criteria, we started reaching out and looking into options. Options are another way of making space around yourself, and honoring your needs and your process. It’s a good idea to have a back-up plan in place so that, if and when you need it, it’s there. Plan for your future self to be supported, with your needs met. You deserve that.

Honestly, in our case, I let denial happen for way too long. We had our criteria, but when I saw that they weren’t happening, I made half-hearted plans that would only work for the very short-term. I didn’t fully acknowledge the emotional stress of needing to uproot and move. I pushed it away, as if it wasn’t real just because it was far away and hard to get my head around.

Seeing our community in Liberia reeling from the stress, with families evacuated and all hands on deck trying to cope with the crisis started to bring things home. I know, it’s not like that in Senegal yet — but it could be. Pushing myself into reality made me astonished at how long I’d let things go without a back-up plan.

It caused us so much unnecessary stress to deal with things in a short time-frame and to make decisions at the last minute. We’ve made a good one, but it would’ve been much easier and better for myself if I’d stepped out of denial and put my back-up plan into action a few weeks before.

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I hope that in sharing my experience with you, it’s helped in some small way to cope with what you’re dealing with around Ebola virus. And if you’re not in the region, I hope that this provides a reflection of how to process emergencies and move through them.

In our line of work, it’s always possible to be evacuated because of disasters, conflicts and other events outside of our control. But it is possible to move through the process of coping with them in a way that minimizes stress and acknowledges your needs. My way is just one way, and there are a multiplicity of others.

I hope that sharing my path has been helpful in finding yours.

Please feel free to share this with those aid workers you know who are dealing with this. It’s a good way to show that you’re thinking of them, and that you care.

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