the city that doesn't touch transcript

8/18/2019 The City That Doesn't Touch Transcript

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THE CITY THAT DOESN’T TOUCH –

PART ONE - OUTBREAK

When journalist Rachel Maher was working in West Africa during the recent outbreak of

the Ebola virus she was struck by the frightening parallels with Albert Camus’ novel The

Plague.

The city in Camus’ novel was under siege, just like the capitals of Sierra Leone and Liberia;

its citizens were coping with a long state of emergency, the deaths of national figures and

loved ones and isolation from the rest of the world.

Mixing oral history interviews with archives and the insights of Camus Rachel Maher tells

the story of this modern plague.

Australian nurse Brett Adamson, who treated victims of the virus in Liberia, reads from

The Plague. You hear an archival interview with him towards the end of the program.

Producer: Rachel Maher

Sound Engineer: Russell Stapleton

Executive Producer: Claudia Taranto

Earshot

Australian Broadcasting Corporation


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Music

The Plague: There have been as many plagues in the world as there have been wars, yetplagues and wars always find people equally unprepared.

[FX – background chatter, child crying]

Interview: When Ebola struck our country it didn’t mean anything to us at that initial stage.

No one understood even what Ebola was or how indeed it would transfer from person to

person.

Archives: ...nearly forty years after first striking fear with a painful and grotesque set of

symptoms, the Ebola virus is back ...

Archives: ...in this courtyard tents have been set up to house victims of the Ebola epidemic.

Janice Cooper: And I remember being very confused about what exactly it was, how

contagious is it, how was this spread?

Rachel Maher: Ebola first appeared in the West African country of Guinea in the final days

of 2013. In the following months the virus spread, as people crossed jungle borders into

neighbouring Liberia and Sierra Leone. Many unknowingly infected others before dying. By

April a chain reaction had been sparked. By June Ebola had spread quickly. In the district of

Kenema 300 kilometres east of the capital Freetown patients soon filled an ageing isolation

ward built to treat far less contagious diseases. Health services collapsed. A respected

doctor, Sheik Umar Kahn led the response in Kenema.

Archives: In Sierra Leone the death of the country’s campaigning Ebola doctor was

especially hard to take ...

Rachel Maher: With Dr Kahn’s death everything changed.

Archives: ... Umar Kahn before testing positive and dying of a lethal virus.

Abdul Samba Brima: The entire district was like in a sombre mood. It was as if sometimes

strange is coming down from heaven, everybody was like anxiously glued to the radio and


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when we entered Freetown everywhere people were clustered in twos or threes around

their radio sets just hearing the news about Dr Kahn’s death. It communicated this kind of

fear directly. You can imagine the shock, it gripped the entire country. Everybody was like,

wow this is a war.

The Plague: In barely a few days the number of fatal cases multiplied and it was clear to

those who were concerned with this curious illness that they were dealing with a real

epidemic. The authorities had not considered or planned anything at all but started by

holding a council meeting to discuss it.

Rachel Maher: Concern about Ebola in neighbouring Liberia was growing. Top health

officials, the government and existing international humanitarian agencies met to plan the

response but no one had any idea of the scale of the outbreak they’d soon be dealing with.

Liberian doctor Janice Cooper was at the meeting.

Janice Cooper: Even when we realised that we had an epidemic on our hands, there was still

not panic. I remember the first days of us meeting in a conference room at the Ministry of

Health and the panic really started growing when we realised that we had something that

was out of control and that there were not people here that were adequately prepared to

address it.

The Plague: Yes it’s almost impossible to believe but it appears that it must be the plague.

The word plague had just been spoken for the first time.

Archives: ...as the situation with Ebola grows more disconcerting. We now have some

economic ...

The Plague: No one yet had really accepted the idea of the disease. Most were chiefly

affected by whatever upset their habits or touched on their interests.

Archives: ... deteriorating public health situation ...

The Plague: These are not feelings with which to fight the plague.


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Rachel Maher: Abdul Samba Brima is a journalist based in Freetown, Sierra Leone’s capital.

The city has better health facilities and access to information than the provinces. Still Sierra

Leone is one of the world’s poorest countries.

Abdul Samba Brima: For me I had a relative in Kenema. I actually come from that part of

the country. This cousin had actually contracted the virus. The family wanted me to host

this person. I had to resist, much to my own dissatisfaction. You know how it is when you

have a relative sick and the family depends on you for help. You cannot help because if you

help you are putting your life and your children and your family’s life in danger as well.

Archives: Since February 2014 an outbreak of Ebola spread across West Africa from Guinea

to Sierra Leone ...

Archives: ... the worst Ebola outbreak in history but according to a doctor with a leading

medical organization in Liberia ...

Archives: ... this Ebola treatment centre paid for by rich tax payers ...

The Plague: It was obligatory for families to declare any case diagnosed by the doctor and

agree to isolation of their patients in special wards in the hospital.

Archives: It’s hard to believe that just eight weeks ago this seven acre site was scrubland.

Now it’s a fully functioning treatment centre ...

The Plague: Sure enough in three days the two buildings were full.

Archives: ... potential Ebola victims will be taken through here ...

Archives: This means that many infected people are being left to die in their villages without

any medical care.

Archives: It’s vital to separate out those people who are suspected of having the virus and

those who actually have it. Remember the symptoms of ...

Archives: A 60 bed capacity treatment unit is now being constructed but the health

department says it is not enough ...


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The Plague: But for most of them it would be hospital and he knew what hospital meant for

the poor.

Archives: ... is that people won’t report Ebola cases believing that an isolation ward is in

effect a death centre ...

Archives: Then their chances of recovery are improved dramatically.

Abdul Samba Brima: I wasn’t only afraid but I saw death in reality because as my cousin

who contracted the virus in Kenema actually died in just a couple of days. And most of

those who attended to him actually contracted the virus and a few of them died. This was

the period when even when people were taken to treatment centres there was no

knowledge within and among medical people on how to attend to people who had

contracted the virus. As such most of those who visited the health centres as victims never

returned, they all died.

Rachel Maher: When Ebola reached Liberia’s capital Monrovia there were no facilities to

treat the virus. Medical staff and the public were unprepared. They had less than 100

doctors in a country of four million.

Archives: I was praying ...

Janice Cooper: As I came out I saw the clinician I talked about before standing there. It did

not occur to me for a minute that he might be there to be tested. And so we embraced and

he told me that he was feeling kind of tired and it felt like typhoid or it felt like malaria.

These are all symptoms that mimic EVD and so he had come to get tested. And I embraced

him and then he walked in and I sat where he was sitting and at that point the head of case

management came out and said, “You’re sitting in a place where an Ebola suspect was just

sitting.” I didn’t panic at first. In fact I was more scared for him at the time, but I went

home and as I lay in bed, I thought about all the things that could happen to him and then

potentially could happen to me. The next day his wife called to tell me that he was indeed

EVD positive and I called to talk with him and we talked on the phone several times over the

next couple of days. And then the third day his wife called to tell me that he had expired.


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The Plague: Houses of sick people were to be closed and disinfected, their relatives put in

preventative quarantine and burials organized by the authorities. It remains compulsory to

declare the disease and isolate patients.

Janice Cooper: It was another five days before the wife could get the house sprayed. The

next time the burial team went out there the community wouldn’t let them in because they

believed that the formaldehyde and the disinfectants were causing the deaths. So there

was a lack of community knowledge and awareness. And as this played out for this

particular clinician, I started to get more and more calls like this.

Archives: In the war to control the Ebola outbreak in West Africa ...

Archives: So deadly is the virus that it’s being compared to war.

Archives: Doctors and health workers man the front lines.

The Plague: When war breaks out people say, “It won’t last, it’s too stupid,” and war is

certainly too stupid, but that doesn’t prevent it from lasting.

Rachel Maher: Both Sierra Leone and Liberia experienced civil wars in recent decades.

Adults in both countries have vivid memories of fleeing brutal violence and fear.

Abdul Samba Brima: It makes me remember of when I was a child and we had a war and

when we were inside a particular town or village, they started killing people and you’d see

dead bodies all around. Everybody would be running helter skelter, running for safety. Now

that is a similar kind of thing that was happening when the disease spread out in Kenema.

People were dying, their bodies were all over the streets. The remaining that saw these

realities actually had to run. Most of them were crossing borders. They were carrying theirchildren, some of whom had contracted the virus so you could see very easily these people

who were running for safety were the very ones who started spreading the disease.

Archives: Some borders in the region have been closed ... road blocks used to restrict

people ...

Archives: A quarantine ...


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The Plague: Someone had the idea of quarantining certain districts and only allowing people

whose services were indispensible to leave them.

Archives: ... had been placed on red alert.

Archives: The death toll in the Ebola outbreak for West African nations rose today to at least

932.

Archives: Some fear the actual number of people killed is more than what’s being reported

...

Rachel Maher: It was difficult to know just how many victims of Ebola there were. While

bodies were piling up at Ebola treatment units, authorities knew that many people were not

declaring the sick and the dead.

Archives: In a city of a million, almost 50 new cases are reported every day.

Rachel Maher: Tolbert Nyenswah, a tropical disease expert was tasked by the President to

lead the Ebola response in Liberia. He became known as the man Ebola was scared of.

Tolbert Nyenswah: Seeing bodies in the streets, seeing sick people wanting to enter a

treatment unit and there was no space, seeing the only space available to take live patients

were being occupied by dead people, seeing the community agitating and afraid, panicking

about the disease and you personally had to move people from the treatment unit who was

dead to a burial site and so getting people from the street was a very challenging moment,

very challenging moment and when I say people, it’s living and dead people in their

hundreds.

Archives: The ambulance team are taking as many precautions as they can. They’re getting

into these white suits, plastic aprons ...

The Plague: People heard with increased frequency at night the throbbing of ambulances,

sounding the dreary, passionless call of the plague beneath their windows.

Archives: These extraction workers are on yet another run. They’ve been called to the

sprawling slum of Westpoint where a spike in Ebola deaths this past ...


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Janice Cooper: I would get calls where people would have dead bodies in their house for

two or three days. The burial teams and the pickup teams could not keep up. Sometimes

they didn’t go home till two o’clock in the morning and we’d be calling them and making

more demands on them. We had talked about this pickup that was supposed to happen the

night before and the night before and the night before and one of the ministers took money

out of her pocket. She said, “This money, this is the school fees for my children.” And this is

how short sighted we were. We thought our kids were going to school the next month right.

“This is the school fees for my children I’m giving to you, just to make sure you take that

body out because it’s been in that home for too long.” There were people who were

sleeping in their cars because there were bodies in their living rooms and they couldn’t get

pickups. So we were totally overwhelmed.

Rachel Maher: Arwen Kidd is a Canadian journalist. She was at home in Liberia when the

virus reached the capital but she left for the UK soon afterwards. She was in constant

contact with her partner who stayed in Monrovia.

Arwen Kidd: I remember speaking with him about whether or not I should come back and

his immediate response was always, “No”. And he would say, “No there’s been a body in

the street outside our gate for three days and this person is not being picked up. He is still

alive, you can see that he is suffering in pain.” It’s rainy season, there are puddles. I live

right on the river so there’s a lot of water, standing water in rainy season. And there was no

one coming to get him. People were dumping bodies here, either not taking them to the

ETU or not wanting people to come to their homes. They were afraid you know they would

taken to the ETU whether or not they were sick or they would have their belongings burned

or for whatever reason they were putting their people out into the street.

Archives: On the front line of the battle, many health workers have died. Officials say it’s

because they don’t have proper protective gear or adequate training.

The Plague: The most surprising thing was that there was never a shortage of men to do the

job for as long as the epidemic lasted.

Archives: ... these men perform one of the most dangerous jobs ...

Archives: ... has proven to be extremely conplicated...


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Rachel Maher: Knowledge about the virus was growing but rumours persisted.

Janice Cooper: And there was a lot of denial, denial even within our own healthcare

workforce and healthcare community and it’s hard because these are people you love and

at the same time these are people that in some ways I feel are accountable for other people

getting sick. So we could see that the situation was out of control as we understood how

many healthcare workers were practicing outside of their homes and not in safe conditions,

as we saw how many religious leader after religious leader were burying people using either

traditional rites or religious rites that were not safe, that spread the virus, as we saw imam

after imam, priest after priest, healthcare worker after healthcare worker get infected and

yet those before them did not seem to see the message. You know whole sections of choirs

and churches got EVD.

Arwen Kidd: I remember hearing from people that worked in our compound that they had

gone to churches and you know their pastors were bringing up people who were ill to the

front of the congregation and saying, “Everyone must lay your hands on this person and this

is the way to heal them,” and we would lay our hands on this person and obviously if that

person is sick with Ebola in that case, that is a sur- fire way, you know direct contact with an

acutely ill person, to become potentially infected.

The Plague: And of course contagion is never absolute because if it were we should have

endless exponential growth and devastating loss of population.

Archives: And so (it) was scary because the place that Liberians normally turn to, religion,

for solace, also did not understand the virus initially. We didn’t always see the light at the

end of the tunnel because we were just fighting the next fire, we were fighting the next

battle, we were just moving to the next place.

Archives: Contagious and potentially deadly, over the past few months the Ebola virus has

spread rapidly in West Africa ...

The Plague: The prefect told me, let’s act quickly if you like, but keep quiet about it. Then

he looked benevolently over the rest of the company and announced that he knew very well

it was plague but that of course if they were to acknowledge the fact officially, they would

have to take stern measures.


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Rachel Maher: Urgent efforts to contain the virus were taking shape on the ground but

reluctance to declare a state of emergency prevailed. Authorities were following World

Health Organization advice to be cautious. Naming the virus as a cause of emergency would

mean risking public panic and admitting that they were unable to cope with the outbreak.

Archives: It is a disease proving difficult for healthcare workers and governments to handle.

Archives: ... and trying to contain this virus in a densely packed city centre ...

The Plague: Public opinion is sacred, no panic, above all, no panic. It’s not a matter of

painting a black picture, it’s a matter of taking precautions. He thought he could sum up the

situation by saying that if they were to halt the disease they had to apply the serious

preventative health measures provided for in law. That to do so they would have to

acknowledge officially that there was an outbreak of plague.

Rachel Maher: Finally three months after the first case of Ebola appeared in Sierra Leone

President Ernest Bai Koroma declared a national state of emergency.

President Ernest Bai Koroma: Since our country registered its first case of Ebola, my

government has been working tirelessly to bring an end to this outbreak. I have given my

approval to the National Ebola Response Centre to ...

Rachel Maher: Epicentres of the outbreak were to be quarantined, schools and markets

closed and all public gatherings restricted. The military was deployed to enforce order.

President Ernest Bai Koroma: All citizens are requested to abide by these measures as

violators will be subjected to the penalties stipulated by the laws of the country on the state

of public health emergency.

Rachel Maher: Liberia followed Sierra Leone declaring a state of emergency shortly after.

Archives: There is new concern this morning about the worst case scenario for the Ebola

outbreak. The CDC estimates up to 1.4 million cases in Africa by January. That could

happen if efforts to stop the disease aren’t stepped up ...

The Plague: Spring was slowly crushed beneath the double weight of the plague and the

heat.


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Archives: Reported cases in Liberia are doubling every 15 to 20 days and every 30 to 40

days...

Rachel Maher: Medical charity, Médecines Sans Frontiéres had been urging the World

Health Organization to intensify its response and declare an international public health

emergency. Australian nurse Brett Adamson was in Liberia working for MSF at the time.

The Plague: The whole town had a high temperature, at least that was the feeling that

haunted him.

Archives: I feel completely overwhelmed, I feel quite emotional because there’s some really

horrible situations ...

The Plague: They were gambling on chance and chance is on nobody’s side.

Archives: I found a dead mother and a baby lying on the floor and I have no idea how we are

going to manage to help that baby at all.

The Plague: This whole thing is not about heroism, it’s about decency.

Archives: I’m almost horrified by the scale of the centre that we are constructing.

The Plague: Was it truly an abstraction, spending his days in the hospital where the plague

was working overtime, bringing the number of victims up to 500 on average per week. Yes

there was an element of abstraction and unreality in misfortune.

Archives: To think that we’re going to double or triple this size, triple this size.

The Plague: But when an abstraction starts to kill you, you have to get to work on it.

Archives: So I’ve just come out, I feel like vomiting right now.

The Plague: His only defence was to resort to hardening himself and tightening the knot

which had formed in him. His role was no longer that of a healer, it was that of a

diagnostician; discovering, seeing, describing, noting and then condemning. That was his

task.

Archives: But it’s brutal, it’s really, really brutal. We’re struggling to get rid of the bodies as

they die. There’s a patient waiting area to my right and someone while they’re waiting to


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be seen has died, two people died in the other waiting area before they even get into the

centre, died. So we’re struggling to hire staff, train staff and adapt to this situation.

The Plague: This human form which had been so close to him was now pierced with spears,

burnt up with the super human fire and twisted by all the malevolent wings of disguise. It

was sinking before his eyes into the waters of the plague and he could do nothing to

prevent its wreck. He had to stay on the shore, his hands empty and his heart wrenched

with no means once more to prevent this disaster.

Archives: With concern that this health crisis is spinning out of control the World Health

Organization is holding an emergency meeting. It could declare a global health emergency,

imposing travel bans and border controls on affected countries. But some say more should

have been done earlier.

Archives: Ebola has no proven cure and there’s no vaccine to prevent infection but declaring

it an international emergency could have the effect of raising the level of vigilance. The

WHO believes that heightened global awareness, with the death toll approaching 1000

across West Africa ...

The Plague: He looked at the official telegram which the prefect had held out to him saying,

“they’re scared”.

Archives: The committee’s position was unanimous. ...

The Plague: The telegram read ...

Archives: ... acknowledges the serious and unusual nature of the outbreak.

The Plague: Declare a state of plague, stop.

Archives: ... the further international spread.

The Plague: Close the town.

Archives: Some economic effects that we’re looking at, British Airways announcing that they

have temporarily suspended their flights to and from Liberia and Sierra Leone until August

31

st

...


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Archives: At Lagos airport Nigerian health workers are stepping up efforts to stop Ebola

entering the country.

Tolbert Nyenswah: You felt left in the wilderness with nobody. You felt that...I thought this

is the time the world should be coming to our help when I’m in a devastating situation.

The Plague: Once the gates were closed they all noticed that they were in the same boat.

Tolbert Nyenswah: You felt that big countries with the resources that have seen this would

come in and help the Liberian people. It took time to even mobilise foreign medical teams

to come in because they were fear that they will get infected when they were in Liberia.

Medivac to evacuate people from out of the country was an issue. And this is one of the

lessons that the world should learn, that’s not a way to do it. It’s against the international

health regulation. Instead of isolating the people that have the infection or infectious

disease in their country, we should isolate the disease and fight the disease. And so we had

to do it ourselves.

Music – Ebola is here

Abdul Samba Brima: And it felt like the entire outside community was turning its back on

us. It really felt like we were left to tackle our own situation for ourselves, even if it meant

dying here alone.

Music

Janice Cooper: There are a couple of things that I reflect on most. My own personal

experience of course about going out and coming in but also about how the world looked on

our country. There was a lot of sympathy and there was a lot of empathy and a lot of desireto help but there was also this pariah state feeling, not very unsimilar to what happened

during the civil war. So these analogies keep coming back and back.

Music

Archives -Barack Obama: I want to take a few moments to speak directly to you, the people

of West Africa. On behalf of the American people I want you to know that our prayers are

with those of you who have lost loved ones during this terrible outbreak of Ebola.


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Archives – Queen Elizabeth: ... these differences will take time ...

The Plague: He read in the newspapers and heard on the radio the appeals and

encouragement that the outside world got through to the stricken town.

Archives – Queen Elizabeth: ... bringing reconciliation to war or emergency zones is an even

harder task.

Archives -Barack Obama: First Ebola is not spread through the air like ...

The Plague: Every evening on the airwaves or in the press pitying or admiring comments

rained down on this now solitary town.

Archives -Barack Obama: ... casual contact like sitting next to someone on the bus. ... You

are not alone.

Archives – Queen Elizabeth: And I have been deeply touched this year by the selflessness of

aid workers and medical volunteers who have gone abroad to help victims of ...

The Plague: The doctor was irritated by the epic note or the tone of a prize giving address.

Archives – Queen Elizabeth: ... or of diseases like Ebola often at great personal risk.

Archives -Barack Obama: ... this kind of outbreak doesn’t happen again.

The Plague: It may serve to make some people great, however when you see the suffering

and pain that it brings, you have to be mad, blind or a coward to resign yourself to the

plague.

Music

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