Q: So, when did you first hear about Ebola? That Liberia was affected by the Ebola virus disease?

RYK: Fortunately, when I heard about Ebola, I was home one morning. I was listening to the radio, and somebody said there was an Ebola case in Lofa, one of our counties in Liberia here. That was 2014. So, I was like Ebola? Because I actually did not know much. We knew about Ebola, that it was deadly, and XYZ, but in the real in depth, I did not know. I decided to do fuller research, and it became serious. Everybody started talking about Ebola. I found out how Ebola affected Congo. But then people started having myths.

Q: What are those myths?

RYK: People believed that Ebola was not real. That the government wants to get money from the outside world, so they just brought a disease. Some people said it was because of foods like bats or rats. Some people actually believed it was witchcraft. Then it became more serious when there was a family that went to a party and all the food was poisoned. Everyday, one person would get sick, every day the next person would get sick, and people started dying. So, they attributed it to poison.

From my knowledge as a nurse, I started to tell my staff that we have to be careful. Prior to Ebola, when we are doing your blood pressure, or we’re doing your temperature, we’re doing a lot of touching. When Ebola became present in the country, the belief was still that it was not Ebola. People were poisoned, or they’re witched, and all that. So, I told my staff that we have to start changing our way of practice. We started wearing gloves for everything we do, we started washing our hands more frequently, and we actually minimized the amount of touching we do. If I had to touch a patient, I would make sure I have gloves on.

Q: Following on the outbreak of Ebola, what do you think has changed for the Liberian healthcare system?

RYK: Ebola actually boosted our healthcare system. Before Ebola, as I said, even in my little practice where I worked, we cared, we just did anything. I would easily see somebody’s blood and just use cotton to try to stop it from coming, but not since Ebola. We found that a lot of people - we practice hand washing a lot. Before Ebola, handwashing was something that maybe, if I played with something, and it spilled on my hands, then I know I would have to wash my hands. But Ebola really opened our eyes as health workers, as nurses. A lot of nurses and midwives died. People who had those patients, they died, and it was not easy. When you hear “oh, this person died, oh, this person died from Ebola,” everybody was afraid.

So, Ebola taught the health system a lesson.

Q: In the community, what were some of the beliefs that affected the epidemic?

RYK: There was a stigma as nurses. Yes, there was stigma. My brother told me not to go to work, even though I was not working in a big hospital. Even though I was only dealing with employees, my husband was afraid of me. When I would come from work because I have my own car to drive, and I would go straight into the bathroom and go and shower before I even go and touch my own children. Before I even go and find food to eat.

It really brought a lot of people down. Some people even had issues in their marriages, or in their relationships. Children and their parents, when your parent, or your child was sick. There was a time when one of my daughters was sick, and they called me and said Jackie vomited and said her head was hurting. The first thing I said was that nobody should touch her. So, when we came back home. We came in the evening, the fever had broken down, and we took her to the hospital, the nursery. It was malaria she had. But everybody was just afraid of everybody during Ebola.

Q: What do you say you are proud of from this whole experience?

I’m proud because, where I worked, the education, educational messages that we sent out, I believe that people listened. In the corridors, you would hear, “Ramatta, thank you. What you told me, it saved me today. Somebody was sick, and I was able to do this. What you told me, you see my hand? That is my washing hand, or this small thing I touched, I had to wash my hands.” So, I thought I was doing something little, but that education that I gave to people, it helped them to manage their lives, during Ebola.

Q: Any other lessons you drew from Ebola that you can share?

RYK: One of the best practices that we have now is that ambulance service. Initially, we never had ambulances. As a result, most of the time, a lot of people died in their homes. When you call somebody and tell them that you have a patient, the first thought that goes through somebody’s mind is maybe they’re Ebola, so I’m not coming there. Because of Ebola, everybody stayed by themselves, and a lot of people died in their homes, because we never had ambulances to take them from their homes. But since Ebola came we have almost all the health facilities have ambulances. Private or government, at least an ambulance is assigned there, and people have a service where you can call and the ambulance will come and take you to the hospital.

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Ramatta Y. Kogar was interviewed for Frontline Nurses by Annette Mwansa Nkowane on August 15, 2019 in Monrovia, Liberia.

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