Into The Ebola Triangle, As Doctors Risk All To Stop The Spread

A reporter follows international doctors into the heart of the West Africa where Ebola is spreading, from Gueckedou (Guinea), Kailahun (Sierra Leone) and Foya (Liberia).

Volunteers battling Ebola in Gueckedou, Guinea, in April 2014
Volunteers battling Ebola in Gueckedou, Guinea, in April 2014
Rémi Barroux

KAILAHUN — It's late July in the south of Kailahun in Sierra Leone, and a small convoy of white four-wheel drives from Doctors Without Borders (DWB) and the World Health Organization (WHO), along with a local ambulance, slowly rolls towards the tiny village of Mendekema.

It takes more than an hour to drive just 20 kilometers (12.4 miles) on this road weaving deep into the bush, and soaked by heavy seasonal rains.

A death believed to have been caused by the Ebola virus has been reported by telephone, and this team is on its way to carry out a saliva test on the deceased. Several dozens of village residents have gathered around the vehicles and refuse to hand over the body. Tension is rising.

"Ebola isn't here," shouts Salomon, a 20-year-old man. "We don't want to have anything to do with all that."

The body is apparently in one of the village houses. But after an hour-long debate, the team has made no progress in gaining access. The convoy turns back, leaving the community to bury its deceased and risk infection. All the medical staff can do is pass on a few recommendations for minimizing the chances of the disease spreading.

Not a word is spoken on the road back to Kailahun, where there is a DWB Ebola treatment center and a base camp for the international organizations.

The Ebola triangle

The doctors are on the front line in the war against this deadly epidemic, and we traveled with them hundreds of kilometers into the heart of the Ebola triangle, from the towns of Guéckédou (Guinea), Kailahun (Sierra Leone) and Foya (Liberia). We are in the area of the Kissi people, an ethnic group that lives on either side of the Makona River, a natural border to the south of forested Guinea that we cross in boats.

The Mendekema episode illustrates how this epidemic — which officially hit Guinea in March before moving on to Liberia and Sierra Leone — has killed so many people and, most of all, why it continues to spread. In just four months, the virus infected more than 1,300 people, and so far more than 880 people have died after suffering intense fever, diarrhea, vomiting and sometimes hemorrhages.

It is by far the most serious epidemic since the 1975 arrival of the virus to the Democratic Republic of Congo, near the Ebola River for which it is named. For 30 years, the number of victims — 1,570 deaths — had been relatively contained. But now the regional epidemic is considered out of control. The three West African capitals of Conakry, Freetown and Monrovia have all been hit. On July 26, Nigeria had its first confirmed case after an adult, who returned from Liberia via Togo, died in Lagos.

Mistrust of "white people"

The opposition we witnessed in Mendekema isn't isolated. In early July, more than 20 villages in Guinea refused intervention from medical staff. Exploiting the absence of treatment and mistrust towards "white people," opportunists are offering miracle cures based on onion potions. It is impossible to know the real health situation in these villages, and on the few occasions when medical teams gain access to them, unwelcome surprises inevitably await.

The most serious episode took place in Kolobengo, a small village to the north of Guéckédou, Guinea. In mid-July, local residents banned any access to the village. Two New York Times journalists were greeted with machetes, and young people even attacked a delegation of elderly people who came to talk with them. Police officers arrested 28 residents.

The opposition is persistent, and rumors are wreaking havoc. Many of the villagers believe "white people" are here to kill the population by spreading the poison with the sprays that are used to disinfect the homes. Denial of the illness, which is rumored to be an invention of governments and NGOs, is mixed with fear of the virus.

Clashes with medical teams

"Many think that going to a treatment center means certain death, that they do lethal injections, cut off ears and burn the bodies," says one person who was previously infected with the virus.

Marc Poncin, a DWB coordinator for Guinea, says that fear breeds fear in a vicious cycle. "People are suspicious, refuse our services, call us when it's too late," he says. "And seeing as the people in the advanced states of the illness die in the centers, they say it's our fault." Attacks against NGO vehicles are frequent. Residents throw stones and make threats with sticks.

"There is a clash between these different ways to handle the illness," explains Professor Cheikh Niang, a Senegalese anthropologist who travels around villages in Sierra Leone with a medical staff of 10 people. "When people say, ‘you’re taking our dead,’ it’s a metaphor for the absence of communication from the medical community." He says villagers reject the authority embodied by “doctors, power, the illness.”

He is working to implement processes and rituals that take community traditions into account. "In Uganda, when a person dies, the body is covered with a traditional cloth," he says. "So during a previous Ebola epidemic in this country, medical teams added a cloth around the bag that contained the body."

Avoid all contact

Funerals represent a high risk of contamination. Families gather, and neighbors come to bid farewell to the body, to kiss it and touch it — the perfect conditions for the virus to spread from one family to another, and from one village to another. Despite the apparent tranquility of these communities, which are spread out around this forest region that produces fruits, vegetables and rice in large quantities, it is now difficult to feel safe, facing this invisible enemy.

The teams are reminding the people they are able to reach that they must reconsider their habits. They should wash their hands frequently, with a chlorinated preparation and, most importantly, avoid shaking hands, using at most a fist bump instead. The learning process has been tough for the local medical staff, who are accustomed to warmer relations.

"They're not used to Ebola," explains the young doctor Keita Namory, a Guinean from Conakry who works with DWB. "It's the first time we've had to face this epidemic. We need to teach disinfection, security measures."

Like his colleagues from the other centers, he has accepted the risks, the concerns and sometimes rejection by family to fight the deadly threat.

To battle the epidemic, authorities have developed messages intended for the various populations. "Ebola is real," for example, is written on large billboards at the border between Liberia and Guinea. At the Conakry airport, travelers must pass through a sanitary control. Medical personnel take temperatures, and travelers are required to fill out a document certifying that they have not had diarrhea, vomiting, abnormal bleeding, fever or "felt unusual tiredness" in the 24 hours before departure.

In the end, the medical teams are the ones doing the heavy lifting to contain the virus. As Namory says, "In an epidemic: It's up to doctors to lead from the front."

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January 22-23

  • Navalny saga & Putin’s intentions
  • COVID’s toll on teenage girls
  • A 50-year-old book fee finally gets paid
  • … and much more!


What do you remember from the news this week?

1. Which two words did U.S. President Joe Biden use about possible scenarios in the Russia-Ukraine standoff that upset authorities in Kyiv?

2. What started to mysteriously appear on signs, statues and monuments across Adelaide, Australia?

3. What cult movie did U.S. rocker Meat Loaf, who died Friday at age 74, star in?

4. What news story have we summed up here in emoji form? 🇬🇧 👱 💬 💼 ❌ 🥳 🦠

[Answers at the bottom of this newsletter]


Toxic geopolitics: More than ever, we need more women world leaders

The world is watching the Russian-Ukrainian border. Russian President Vladimir Putin threatening an invasion finds an ally in Iran’s Ebrahim Raisi, united against their common enemy: the United States. Back in Washington, U.S. President Joe Biden — marking his first year in power with painfully low approval rates (higher only than Donald Trump’s) — sends his Secretary of State, Antony Blinken, to Kyiv to reassure President Volodymyr Zelensky who worries that France’s Emmanuel Macron might undermine Ukraine. And we haven’t even mentioned Xi Jinping!

It’s an endless theater of world leaders beating their respective chests — and they have exactly one thing in common: they’re all men. It’s by now a decades-old question, but worth asking again: What would happen if women, and not men, were running the world? Would there be less conflict, more prosperity? More humanity?

In 2018, the World Economic Forum released a study that showed that “only 4% of signatories to peace agreements between 1992 and 2011 were women, and only 9% of the negotiators.” The report shows that in several conflict zones in the world in recent decades, citing Liberia, Northern Ireland and Colombia, women have been instrumental in achieving peace.

In Colombia, where 20% of peace negotiators for the 2016 peace treaty were women, Ingrid Betancourt, herself a victim of the 50-year conflict, has announced her candidacy for the May presidential elections. Differently from previous bids, where she focused on fighting environmental abuses and corruption, Betancourt now is putting gender issues at the center of her political agenda. Bogota daily El Espectador questions whether the former hostage will be able to ride this important political wave, with feminist movements flexing their muscle around the region demanding more rights.

In Italy, next week’s elections for the head of state are monopolized by infamously misogynous former Prime Minister Silvio Berlusconi, who is hoping to be elected for the seven-year, honorary function. There is no official candidacy, but Berlusconi’s name and that of current Prime Minister Mario Draghi are the two getting the most attention. Italian feminist writer and intellectual Dacia Maraini writes in La Stampa that, yes, the very fact of electing a female president will be progress for the country — and by the way, there are plenty of women qualifed for the job.

There was also a woman politician making the news this week for actually getting elected: Maltese conservative politician Roberta Metsola, became the new European Parliament President after the death of Italy’s David Sassoli. And yet the election of the first female president of the EU’s legislature since Nicole Fontaine in 2001 has been widely criticized by female politicians — primarily for Metsola’s stance against abortion rights. "I think it is a terrible sign for women's rights everywhere in Europe," French left-wing member of the European Parliament Manon Aubry told Deutsche Welle.

The women who have risen to power in history (Margaret Thatcher, anyone?) don’t necessarily make the case that gender is the silver bullet to fix politics. Still, after watching all the toxic masculinity on the world stage this past week, we can rightfully demand fewer men.

Irene Caselli


• Record-breaking online concert of Mahler’s “Symphony of a Thousand”: More than 100 musicians from around the world will take part today in a performance of Mahler’s epic 8th symphony consisting of 1,200 elements, including a double chorus, children’s choir, a full orchestra and an organ. The event is a culmination of a year of work; all artists recorded their parts in isolation besides the children’s choir. Tickets can be purchased here.

Yearly Japanese festival will set a mountain on fire: Today, the grassy hillside of Mount Wakakusayama in Japan will go up in flames as fireworks go off in the background as part of celebrations for Wakakusa Yamayak. The origin of the festival isn’t totally clear, but might relate to border conflicts between the great temples in the region or to ward off wild boars.

• New insights into antiquities taken by the Nazis: Scholars are looking into how German forces during World War II looted artifacts such as on the Greek island of Crete. Nazi officials pillaged these valuables for their own personal gain, but many were also destroyed, which is why researchers around the world are hoping to gain greater insight into this often overlooked aspect of German occupation.

Exhibition of Beirut’s restored artwork: The Beirut Museum of Art has inaugurated the exhibition “Lift” featuring 17 paintings by Lebanese artists that had been damaged by the port explosion in 2020, and have since been restored as a result of a UNESCO initiative.

The world’s first vegan violin tunes up: Berries, pears and spring water are just some of the natural ingredients relied on for the construction of the instrument by English violin-maker Padraig O'Dubhlaoidh. Traditionally, animal parts like horsehair, hooves, horns and bones are used, especially to glue pieces together. The £8,000 instrument is sure to be music to some animal lover’s ears.


One year ago anti-corruption lawyer and politician Alexei Navalny was detained in Russia, marking the effective end of domestic opposition to Russian president Vladimir Putin. In the time since, more than half of the former coordinators of Navalny's headquarters fled Russia. Even Navalny's name is forbidden: Putin never says his name, calling him "this citizen."

At the same time, Navalny’s imprisonment and the de facto end of the opposition have changed Russia. The fear of persecution, the lack of alternatives and the total censorship and propaganda have caused Putin's ratings consistently downward.

An aging leader with no successors, no enemies and dwindling popular support is finding it increasingly difficult to explain why he must continue to rule forever. In such a situation, there’s nothing quite like an external threat to fuel the raison d’être of the authoritarian regime. In Putin’s eyes, the perfect threat right now is NATO expansion, and the perfect enemy is its neighbor Ukraine and its attempts to join the military alliance. Whether Russia's president is ready to engage in a real war is the great unknown, but its aggressive and uncompromising foreign policy — like his disposing of Alexei Navalny — is the latest legitimization of his increasingly absolutist rule now into its third decade.

Read the full story: What The Alexei Navalny Saga Tells Us About Putin’s Intentions On Ukraine


Íngrid Betancourt spent more than six years as a prisoner of the Revolutionary Armed Forces of Colombia (FARC) terror group in Colombia, an experience that is sure to play a role in her recently announced presidential campaign. Betancourt, who is 60, is running as part of the Verde Oxígeno and is the only woman in the Centro Esperanza Coalition (CCE), a centrist alliance.

Betancourt could be a boost for the coalition and embody its goals of transforming, overcoming polarization and, as its name indicates, giving hope to Colombia. In particular, the centrist candidate who in the past has been largely focused on anti-corruption and environmental protection, has said she will make women’s rights a cornerstone of her campaign.

Read the full story: Ingrid Betancourt, A Hostage Heroine Reinvented As Feminist For President


A growing number of studies around the world show that COVID-19 and lockdown restrictions have prompted a disproportionate increase in mental health illness among teen girls. These include rising suicide rates among adolescent females in the United States, Germany and Spain and a higher prevalence of anxiety and eating disorders in Israel. But why are women being disproportionately impacted?

There’s a range of reasons. In India, for example, young women had increased difficulty accessing education resources when schools went online and shared a disproportionate burden of household tasks as opposed to their male peers. Around the world, social media also played a significant role; without access to in-person socialization and hobbies, young people spent more time online, often comparing themselves to others, impacting feelings of self-worth. The situation is particularly dire given the challenges of accessing mental health support resources during the pandemic.

Read the full story: Why The COVID-19 Mental Health Crisis Is Hitting Teenage Girls The Hardest


Norwegian mobility company Podbike has announced that Frikar, its four-wheeled enclosed electric bike, will soon hit bike lanes on home turf. The futuristic-looking vehicle does require the user to pedal, which powers a generator and drive-by-wire system that keep the Frikar running — with a speed limited to 25 km/h.


“Mãe De Bolsonaro” is the top query on Twitter in Brazil, after news that Brazilian President Jair Bolsonaro’s mother Olinda Bonturi Bolsonaro had died at age 94.


Photo of the new President of the European Parliament Roberta Metsola

New President of the European Parliament Roberta Metsola

Philipp Von Ditfurth/ZUMA

London’s legendary bookshop Waterstones Gower Street tweeted a photo of a letter from an anonymous user confessing to having forgotten to pay for their books some 48 years ago. Owing approximately £100 ($136), adjusted for inflation, they had sent through £120 ($163) to make up for their tardiness. Touched by the kind gesture, the bookshop reciprocated by donating the money to the largest children’s reading charity in the United Kingdom.


Dottoré! is a weekly column on by Mariateresa Fichele, a psychiatrist and writer based in Naples, Italy. Read more about the series here.

Bucket of tears

I’ve been thinking and thinking about a patient of mine since yesterday. His name is Giovanni.

Psychiatrists, you might not know, are quite often asked the same unanswerable question: "Why does one become insane?”

When I was younger, I searched and searched for an answer, losing myself in scientific explanations about synapses, neurons and neurotransmitters.

By the end of my studies, I’d realized that the only thing that was clear was that I’d been clutching at straws to justify my work and give it a semblance of scientific dignity. In the years since, I’ve forced myself, in defiance of the authority of my position, to reply with a laconic but honest: "Sorry, but I don't know."

So when Giovanni asked me that same question, he was not happy at all with my answer. “Dottoré, how’s it possible that you don't understand why I became crazy?”

When he tried to ask me again one day, I tried a different response:

"Giová, do you cry?"

"No. Why?"

"Imagine that the tears that you don't shed, that you force yourself not to shed, because that's what you've been taught to do, all end up inside your heart. The heart is an organ that pumps blood, which brings nourishment and oxygen to the whole body. But over time those diverted tears accumulate to the point that the heart begins to pump them instead of your blood. Slowly your body becomes sick, but the part that suffers the most is your brain. Because tears don't contain oxygen and nourishment, just sadness."

I expected a reaction to this fanciful explanation, but instead Giovanni kept quiet and eventually left.

The next time I saw him, he said: "Dottoré, I've thought about it. I know you told me about the tears to make me feel better, but maybe you’re right. Because sometimes I feel that I have a lake, more than a heart. But it takes a very powerful pump to pump out all that water, and my heart alone cannot do it. And now that you've explained to me how I became crazy, can you also tell me if I'll ever get better?"

"Do you want another story or do you want the truth?”

"This time, I’d rather have the truth!”

"The answer is always the same then. I'm sorry, Giová, but I don't know this either. But I can tell you one thing for sure. I'll help you slowly, slowly with just a bucket. Because the truth is, not even I have that pump."


• Italy's parliament will convene Monday to begin the process of voting for a new president to succeed Sergio Mattarella for a seven-year term.

• Qualification games for the 2022 FIFA World Cup will be held from Jan. 27 to Feb. 2 for South, North and Central America as well as Asia. Argentina’s national team will not be able to rely on superstar Lionel Messi, still recovering from COVID-19.

• Next Thursday will mark 100 years since Nellie Bly died. The American journalist is known for her record-breaking 72-day trip around the world in 1889, inspired by Jules Vernes’ book Around the World in Eighty Days

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