Marburg workers battle to win trust of locals

Efforts to contain Angolan virus outbreak hit by violence

Deadly contagion: aid agencies in Angola are working to quarantine patients dying of Marburg fever. Credit: REUTERS/NEWSCOM

An outbreak of Marburg disease in Angola's Uíge province is spreading, despite the best efforts of several relief organizations. Western aid workers have been unable to win the trust or understanding of locals, and have even come under attack.

Marburg is a rare virus from the same family as Ebola. Few people survive the haemorrhagic fever it causes, but in general the virus is contracted only from people who are visibly sick or dead. In theory, it should be simple to contain an outbreak by keeping such people in isolation.

“There is no vaccine, there is no cure. We have to break the transmission cycle by letting people know not to have contact with the dead,” says Dave Daigle, a spokesman in Uíge for the World Health Organization. However, this causes conflict with families, who want to nurse their sick relatives and prepare bodies for burial.

Workers are trying to quarantine patients, and are sprinkling bleach on body bags in an effort to replace the strong local custom of washing dead bodies. But the paper-suited, respirator-wearing strangers who arrive at the homes of suspected cases by truck or helicopter and attempt to remove the ill or dead from their families have been met by resentment and, on several occasions, rocks.

Relief organizations are scrambling for ways to break this cultural impasse. Aid workers are now accompanied by anthropologists and health educators to help mollify families and convince them to part with their relatives. Religious leaders, including the local Catholic bishop, are being drafted to disseminate news about steering clear of the infected, and the Angolan Red Cross is going door to door.

The remaining members of a traditional band that lost its lead singer to the virus have even put out a song with lyrics about defeating the disease and cooperating with health workers. Called Marburg, it is being played on the radio and from the loudspeakers of roving trucks.

The World Health Organization and other aid agencies are working to contain the disease, but the death toll, now at more than 200, continues to rise.“I'd like to tell you that the numbers are contained, but they are not,” says Daigle.

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Marris, E. Marburg workers battle to win trust of locals. Nature 434, 946 (2005). https://doi.org/10.1038/434946a

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