Fear of Ebola Breeds a Terror of Physicians

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KOLO BENGOU, Guinea — Eight youths, some armed with slingshots and machetes, stood warily alongside a rutted dirt road at an opening in the high reeds, the path to the village of Kolo Bengou. The deadly Ebola virus is believed to have infected several people in the village, and the youths were blocking the path to prevent health workers from entering.

“We don’t want any visitors,” said their leader, Faya Iroundouno, 17, president of Kolo Bengou’s youth league. “We don’t want any contact with anyone.” The others nodded in agreement and fiddled with their slingshots.

Singling out the international aid group Doctors Without Borders, Mr. Iroundouno continued, “Wherever those people have passed, the communities have been hit by illness.”

Health workers here say they are now battling two enemies: the unprecedented Ebola epidemic, which has killed more than 660 people in four countries since it was first detected in March, and fear, which has produced growing hostility toward outside help. On Friday alone, health authorities in Guinea confirmed 14 new cases of the disease.

Workers and officials, blamed by panicked populations for spreading the virus, have been threatened with knives, stones and machetes, their vehicles sometimes surrounded by hostile mobs. Log barriers across narrow dirt roads block medical teams from reaching villages where the virus is suspected. Sick and dead villagers, cut off from help, are infecting others.

“This is very unusual, that we are not trusted,” said Marc Poncin, the emergency coordinator in Guinea for Doctors Without Borders, the main group fighting the disease here. “We’re not stopping the epidemic.”

Efforts to monitor it are grinding to a halt because of “intimidation,” he said. People appear to have more confidence in witch doctors.

Health officials say the epidemic is out of control, moving back and forth across the porous borders of Guinea and neighboring Sierra Leone and Liberia — often on the backs of the cheap motorcycles that ply the roads of this region of green hills and dense forest — infiltrating the lively open-air markets, overwhelming weak health facilities and decimating villages.

It was in this rural area, 400 miles over bad roads from Guinea’s capital, Conakry, where the outbreak was first spotted, and where it has hit hardest. More than 80 percent of those infected have died in this region, and Guinea has recorded more than twice as many deaths as the other countries.

In Koundony, more than one-eighth of the population, including the headman, are dead; many others have fled.

There is no known cure for the virus, which causes raging fever, vomiting, diarrhea and uncontrolled bleeding in about half the cases and up to 90 percent of the time, rapid death. Merely touching an infected person, or the body of a victim, is dangerous; coming into contact with blood, vomit or feces can be deadly.

Now the fear of aid workers, principally from Doctors Without Borders and the Red Cross, is helping to spread the disease, health officials say, creating a secondary crisis.

Villagers flee at the sight of a Red Cross truck. When a Westerner passes, villagers cry out, “Ebola, Ebola!” and run away.

This month, Doctors Without Borders classified 12 villages in Guinea as “red,” meaning they might harbor Ebola but were inaccessible for safety reasons.

As recently as April, the epidemic seemed to be under control. But in the past two weeks, its center appeared to have shifted across the border to Sierra Leone, where most of the new dead were being recorded. The sick are being hidden and the dead buried, without any protection.

Last week, the Sierra Leone Health Ministry reported that its lead doctor fighting Ebola had contracted the disease, and the virus had spread to a fourth country, with a confirmed fatality in Nigeria. Over the weekend, an aid organization working in Liberia, Samaritan’s Purse, said that two Americans, a doctor who was treating Ebola patients and an aid worker on a case management team, had tested positive for the virus. And the Liberian government said Sunday that one of its most high-profile doctors had died of Ebola, according to The Associated Press.

Back in Guinea, in the village of Wabengou, residents placed a tree in the road to block outsiders. They also attacked an official delegation from Conakry, rushing its cars, banging on the vehicles and brandishing machetes, according to Doctors Without Borders.

“We don’t want them in there at all,” said Wabengou’s chief, Marcel Dambadounou. “We don’t accept their presence at all. They are the transporters of the virus in these communities.”

He was surrounded by grim-looking men from Wabengou, standing at a crossroads on the way to his village; none of them demurred.

“We are absolutely afraid, and that’s why we are avoiding contact with everybody,” he said, “the whole world.”

Doctors Without Borders has set up an emergency treatment center in the regional capital, Guéckédou, but a nurse there said the center had diminishing appeal.

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“Here, if the people come in, they don’t leave alive,” said the nurse, Fadima Diawara.

It may not help win confidence that the medical teams wear top-to-toe suits and masks, burning much of the outfit after helping a patient.

The wariness against outside intervention has deep roots. This part of Guinea, known as the Forest Region, where more than 200 people have already died of the disease, is known for its strong belief in traditional religion. The dictator who ruled Guinea with an iron fist for decades, Ahmed Sékou Touré, was only partly successful in a 1960s campaign to stamp out these beliefs, despite mass burnings of fetishes.

Addressing villagers this month in Bawa, where a woman had just died, the regional prefect from Guéckédou, Mohammed Cinq Keita, warned: “There is no root, no leaf, no animal that can cure you. Don’t be fooled.”

Near the border with Sierra Leone this month, Doctors Without Borders discovered an Ebola patient who had been privately “treated” in the village of Teldou and then returned to his relatives in another village, possibly infecting untold others.

“Extremely, extremely concerning,” said Sylvie Jonckheere, the charity’s doctor on the scene. A colleague in full gear lectured the villagers of Teldou as the rain started, but was met with indifference or hostile stares; some turned their backs on him.

As the aid workers drove off, the private nurse who administered a shot to the Ebola patient defended his treatment. “I couldn’t say that he had the illness,” said the nurse, Eduard Leno. “His body was hot, that’s all.”

Asked why the patient had not been sent to the clinic in Guéckédou, he said angrily: “We are in the bush here. You can’t just send someone away. How will society view you?”

Local officials have begun a campaign to open the closed villages — there have even been some recent arrests in Kolo Bengou — but in tiny Koundony, fear is palpable.

On a recent day, a Red Cross truck drove up to the cemetery to deliver the body of Marie Condé, 14, wrapped in plastic sheeting.

As the body was carried off the truck, a high-pitched wail pierced the country stillness. “There is no cure!” a woman cried. “There is no cure!”

The gravedigger, Marie’s half brother Famhan Condé, 26, was sweating as he heaved shovels of dirt. The grave, he said, would be the 26th he had dug since the epidemic began.

“We’re all scared here,” he said. “There’s no solution. We can do nothing. Only God can save us.”