For survivors of Ebola, the crisis isn't over | Soka Moses

翻译人员: Tristan Yu 校对人员: ZHANG FENG

June 13, 2014

2014年6月13日，

started as a routine Friday

一个寻常的周五，

in Redemption Hospital in Monrovia, the capital of Liberia.

利比里亚（西非国家）首都 蒙罗维亚的救赎医院。

Redemption is the largest free public health hospital in the city.

救赎医院是当地最大的免费公立医院。

We are called upon to serve hundreds of thousands of people.

在这里我们作为医生 治疗过数十万患者。

In the best of times it puts strain on our resources.

然而即便医院运行良好， 医疗资源也相当紧张。

Monthly supplies run out within weeks,

每月的医疗物资 一两周内就消耗殆尽，

and patients without beds would be seated in chairs.

没有床位的病人 只能坐在椅子上接受治疗。

That summer, we had a nurse who had been sick for a while.

那年夏天，医院有位护士 病了一段时间，

Sick enough to be admitted in our hospital.

后来严重到需要入院治疗。

But our treatment didn't seem to be helping her;

但我们的治疗似乎并没有帮助到她；

her symptoms were getting worse:

她的症状越来越严重：

diarrhea, severe abdominal pain, fever and weakness.

如腹泻、严重腹痛、发烧和虚弱等。

On that particular Friday, she developed severe respiratory distress,

就在那个周五， 她出现了重度呼吸困难，

and her eyes were menacingly red.

眼睛变成了不正常的红色。

One of my fellow doctors, a general surgeon,

我的同事，医院的一名普外科医生，

became suspicious of her condition.

对她的病情有所怀疑，

He said her symptoms were suggestive of Ebola.

认为她的症状疑似 感染了埃博拉病毒。

We kept a close watch on her, we tried to help her.

我们一直对她密切观察， 并尽力帮助她。

We were treating her for malaria, typhoid and gastroenteritis.

我们按照疟疾、伤寒 和肠胃炎对她进行治疗，

We didn't know it, but by then it was too late.

但我们不知道，那时候为时已晚。

The next morning I walked in to check on my patient.

第二天一早，我去给病人做检查，

I could tell by the look in her eyes that she was filled with fear.

从她的眼神里我可以看出， 她的内心充满了恐惧。

I gave her reassurance, but shortly after ...

我安慰了她，但不久后——

she died of Ebola.

她就死于埃博拉病毒感染。

For me, her death was very personal.

对我来说，她的死只是一个个例。

But this was just the beginning.

然而，这仅仅是个开始。

A virtual biological bomb had exploded.

虚拟的生物炸弹已经爆炸。

But the word spread faster than the virus, and panic spread across the hospital.

但流言比病毒传播得更快， 恐慌蔓延到整个医院。

All the patients ran away.

所有的病人都逃走了。

Then, all the nurses and doctors ran away.

然后，几乎所有的医生和护士也都跑了。

This was the beginning of our medical tsunami --

这就是我们的医疗海啸的开始——

the devastating Ebola virus

毁灭性的埃博拉病毒

that left an indelible scar in our country's history.

给我们国家的历史 留下了不可磨灭的伤疤。

I was not trained for this.

我从没接受过应对这种问题的培训。

I had just graduated from medical school two years before.

那时我不过刚从医学院毕业两年。

At this time,

当时，

my total knowledge about Ebola came from a one-page article

我对埃博拉病毒的全部了解 只是源于上学时读到

I had read in medical school.

的一篇一页纸的文章。

I perceived the disease as so dangerous,

而这页纸唯一的作用

this one page in essence had convinced me to run out of the hospital, too,

不过是让我觉得这种疾病太过危险，

the moment I heard of a case of Ebola.

必须要望风而逃罢了。

But when it finally happened, I stayed on and decided to help.

但当它最终发生时， 我决定留下来帮助病人。

And so did several other brave health care professionals.

其他好几位勇敢的医护人员也是如此。

But we would pay a heavy price.

然而我们为此付出了沉重的代价。

Many persons and health professionals had become high-risk contacts.

许多医护人员已经变成 有高感染风险的接触者，

This actually meant 21 days counting to potentially disease or death.

事实上这意味着，21天病毒潜伏期过后， 我们可能会患病甚至死亡。

Our health systems were fragile,

我们的医疗体系如此脆弱，

our health workers lacked skills and training.

医护人员严重缺乏技术和训练。

So in the weeks and months that followed,

所以在接下来的几个月里，

health workers were disproportionately affected by the Ebola virus disease.

医护人员受到了 埃博拉病毒的严重影响。

More than 400 nurses, doctors and other health professionals became infected.

超过 400 名护士、医生 和卫生专家被病毒感染。

Unfortunately, my friend, the general surgeon

不幸的是，我的朋友

who correctly identified the symptoms in that first case

那个准确诊断出第一例 埃博拉感染的普外科医生

became one of the casualties.

也因此丧生。

On July 27, the president of Liberia

7月27日，

利比里亚总统下令对 受影响最严重的地区实施隔离。

imposed quarantine on the worst-affected areas.

She closed all the schools and universities

当地中小学和大学全部关闭，

and shut down many public events.

许多公共活动也被迫停止。

Four days later,

4天后，

the United States Peace Corps

美国和平队

pulled out of Liberia, out of Sierra Leone and Guinea

也撤出了利比里亚、 塞拉利昂和几内亚，

due to Ebola.

因为顾忌到埃博拉的肆虐。

In August, six weeks after the nurse died,

8月，那位被感染的护士死亡6周后，

hundreds of people were dying of the disease each week.

每周都有上百人因埃博拉丧生，

People were dying in the streets.

很多人就这么横死街头。

Over the months that followed,

此后的数月里，

West Africa would lose thousands of people to Ebola virus disease.

西非地区的埃博拉 夺去了数千条人命。

In August, I joined a team to set up the Ebola treatment unit

当年8月，我在蒙罗维亚 的约翰肯尼迪（JFK）医院

at JFK hospital in Monrovia.

加入了一个团队，大家 共同建立埃博拉医疗小组。

I was charged with running the second Ebola treatment unit in the city.

我负责管理当地 第二支埃博拉医疗小组。

Our unit provided hope for thousands of patients, families and communities.

我们的治疗小组为上千名患者、 他们的家人和社区带来了希望。

I not only provided care, I came face to face with Ebola.

我们不仅提供医疗护理， 而且要和埃博拉病毒正面交锋。

Living every day as a high-risk Ebola virus disease contact

在病毒爆发最严重的时期， 作为高埃博拉感染风险

during the worst of the outbreak

的接触者生活的每一天

was one of my worst experiences.

都是我最糟糕的一段经历。

I started counting 21 days every day.

我开始每天计算21天的病毒潜伏期，

I lived every moment anticipating the onset of symptoms of the disease.

时刻做好出现感染症状的准备。

I measured my body temperature several times.

每天我都要量好几遍体温，

I showered with chlorinated water,

用高于推荐浓度

more concentrated than actually recommended.

的氯化水洗澡。

I chlorinated my phones, my pants, my hands, my car.

我用氯化水为我的手机、衣服、 车子，还有双手消毒。

My clothes became bleached.

我的衣服都被漂白了。

Those days you were alone,

那些日子里，你只能是一个人。

people were so afraid of touching anybody.

人们都害怕和别人发生肢体接触。

Everyone was counted as a potential contact.

每个人都是潜在的病毒接触者。

Touching would make them sick.

似乎一旦肢体接触，就会感染。

I was stigmatized.

我感到被羞辱。

But if that was what it was for me, who was symptom-free,

可是如果对我这个 没有出现症状的人尚且如此，

imagine what it was for someone who actually had symptoms,

设想一下那些出现症状的人， 那些真正被感染的人，

someone who had Ebola.

他们又作何感想呢？

We learned that to treat Ebola successfully,

我们意识到，要想成功治愈埃博拉，

we had to suspend some of the normal rules of society.

就不得不暂时摒弃正常的社会规则。

Our president declared a state of emergency in August

利比里亚总统在8月份 宣布国家进入紧急状态，

and suspended certain rights.

并暂停了部分公民权利。

And the national police even supported our work during the Ebola response.

国家警察甚至也来协助我们的工作。

In February 2015, gang members came in for isolation

2015年2月，一批黑帮成员 来到我们的伊波拉病毒隔离组

in our Ebola isolation unit.

接受隔离。

这些人有个别号，叫 “蒙罗维亚大佬” （VIP Boys of Monrovia）

They were also know as the VIP Boys of Monrovia,

terrifying small-time drug addicts

净是些可怕的瘾君子。

whose presence could instill a tremendous amount of fear,

虽然依照法律，这些人不能持枪，

although they could not legally carry guns.

可他们的出现还是 给人们造成了极大的恐慌。

They underwent quarantine for 21 days in our unit and were not arrested.

他们在我们的隔离组接受了 为期21天的隔离，而且没有遭到逮捕。

We told the police,

我们告诉警察，

"If you arrest them here,

“你们要是在这儿逮捕这些人，

他们就不会再来了，也无法得到治疗。

they will stop coming, they won't get treated.

And the Ebola virus will continue to spread."

埃博拉病毒将会因此继续扩散。”

The police agreed, and we were able to treat the VIP Boys,

警方同意了我们的请求， 我们得以对这些“大佬”进行了治疗，

and they did not have to worry about being arrested while in the unit.

他们也不用担心在治疗期间被逮捕。

Over the course of the outbreak, West Africa had almost 29,000 cases.

整个病毒爆发期间， 西非近29000人患病，

More than 11,000 people died.

11000多人丧生。

And that included 12 of my fine colleagues at John F. Kennedy hospital in Monrovia.

这其中就包括我在蒙罗维亚 约翰·肯尼迪医院工作期间的12位同事。

In June 2016, exactly 23 months after my first Ebola patient died,

2016年6月，恰好在 我的首例埃博拉患者死亡23个月后，

Liberia declared its Ebola outbreak ended.

利比里亚宣布埃博拉疫情结束。

We thought that once the outbreak ended,

我们本以为一旦疫情结束，

so did the problems.

其他问题也会迎刃而解。

We hoped that life would go back to normal.

我们希望生活能够重新回到正轨。

Today, there are more than 17,000 survivors in West Africa.

如今，西非有超过17000名 埃博拉病毒的幸存者。

People who actually had Ebola virus disease,

这些人作为埃博拉的患者，

lived through it and survived.

经历了这一切并幸存了下来。

We counted survival rate as a success:

我们将存活率视为成功：

the end of suffering for the patient and fulfilling joy for families.

病人结束了痛苦，他们的家庭重获喜悦。

Every discharge from the unit was a moment of jubilation.

每次患者出院，都是值得庆祝的时刻。

At least so we thought.

至少我们是这么想的。

The best description of the moment of discharge

我的好友兼同事，菲利普·爱尔兰医生

and a rare glimpse into the moment that defines our life post-Ebola

在接受《时代周刊》采访时，

was vividly expressed in the words of my best friend

用寥寥数语生动 的描述了出院时的景象，

and fellow doctor, Philip Ireland, in an interview with "The Times."

以及战胜埃博拉之后的生活。

He said at the time of his release,

他在出院时说，

"There were a lot of people there from JFK hospital:

“约翰·肯尼迪医院来了好多人：

my family, my elder brother, my wife was there.

我的家人、我的哥哥、我的妻子都在。

A lot of other doctors were there, too, and members of the media were there.

很多医生也来了，还有不少媒体也在。

And I felt like Nelson Mandela, it felt like the 'Long Walk to Freedom,'

我感觉自己就像曼德拉，出院的 那几步路就是‘通往自由的漫漫长路’，

and I walked and raised my hands to the heaven,

我一边走，一边将双手举向天空，

thanking God for saving my life."

感谢上帝的救命之恩。“

And Philip said, "Then I saw something else.

菲利普说，”然后我看到了别的东西。

There were a lot of crying people, people happy to see me.

有很多哭泣的人， 他们因为见到了我喜极而泣。

But when I got close to anybody, they backed away."

可当我走近他们的时候， 他们却向后退开了。”

For many Ebola survivors, society still seems to be backing away,

对于许多埃博拉的幸存者而言， 整个社会似乎在疏离他们，

even as they struggle to lead a normal life.

即使他们为过上正常的生活 而竭尽了全力。

For these survivors, life can be compared to another health emergency.

对于这些幸存者而言， 生活本身就是另一出健康危机。

They may suffer debilitating joint and body pain.

他们或许会饱受关节无力 和身体疼痛的折磨。

The suffering gradually decays over time for most.

对于他们中的大多数来说， 痛苦会随时间慢慢减弱。

However, many continue to bear intermittent pain.

然而，不少人要继续 忍受着间歇性疼痛，

Some survivors are blind, others have neurological disabilities.

一些幸存者失明了， 另一些出现了神经障碍。

Some survivors experience stigmatization every day, in many ways.

有的幸存者每天都在遭受各种羞辱，

A lot of children are orphans.

很多孩子都变成了孤儿，

Some survivors experience post-traumatic stress disorder.

一些幸存者患上了 创伤后应激障碍（PTSD），

And some survivors lack opportunity for education.

还有人错失了受教育的机会，

Even families can be split apart by fear of Ebola, too.

对于埃博拉的恐惧 甚至让很多家庭分崩离析。

There's no definitive cure for transmitting Ebola virus through sex.

对于埃博拉病毒的性传播， 目前还没有根治的方法，

However, there are successful interventions for prevention.

但是，通过医疗干预 可以成功进行预防。

We have worked hard on semen testing,

我们在精液检测、行为咨询、

behavioral counseling, safe sex promotion and research.

提倡安全性行为以及 相关研究方面下了很大功夫。

For the past year, there have been no cases of sexual transmission.

过去一年间都没有出现 性传播的病例。

But some male survivors have lost their spouses

但是一些男性幸存者的配偶

out of fear they will be infected with Ebola.

还是因为害怕被传染而离开了。

That's how families are torn apart.

家庭就是这样破裂的。

Another tremendous challenge for Ebola survivors

埃博拉幸存者所面临 的另一个巨大挑战，

is obtaining adequate health care.

就是获取充足的医疗保障。

In theory, Liberia's public health services are free of charge.

理论上，利比里亚 的公共医疗是免费的，

In practice, our health system lacks the funding and capacity

而实际上，我们的医疗体系 缺乏资金和能力，

to expand care to all at the point of need.

无法为所有人 在需要的时候提供保障。

Many survivors have waited many months to undergo surgery

很多幸存者都要等上好几个月

to heal their blinding cataracts.

才能接受白内障手术。

Few had to relive the traumatic experience,

少数人不得不再次体验 疾病爆发时的惨痛经历，

when their blood was retested for Ebola at the point of admission.

因为他们在入院时会重新接受 针对埃博拉病毒的血检，

Some survivors experienced delayed or deferred admission

一些幸存者在需要住院的时候 不是被推迟，就是被延期，

due to limited bed capacity.

因为医院的床位不够，

No bed available for one more patient.

没法再多容纳哪怕一位患者。

This is neither national policy nor officially condoned,

这种行为既不是国家政策， 也不是官方授意的，

but many people are still afraid of the sporadic resurgence of Ebola virus.

但是很多人还是害怕 埃博拉病毒零星复发。

The results can be tragic.

因为一旦发生，后果不堪设想。

I have seen Beatrice, an Ebola survivor, several times now.

有一位名叫碧翠斯的埃博拉幸存者， 我见过她很多次了。

She's 26 years old.

她今年26岁。

Many of her family members became infected, she luckily survived.

她家里有不少人感染了埃博拉， 而她幸运地活了下来。

But since that day in 2014 she was discharged

但是自从2014年她出院，

to cheering health workers,

与医务人员一起欢呼后，

her life has never been the same.

她的人生从此就不同了。

She became blind as the result of Ebola.

因为埃博拉，她丧失了视力。

In 2014, the baby of a dear friend of mine was only two months old,

2014年，我一个好朋友的孩子 才不过2个月大，

when both parents and child were admitted in an Ebola treatment unit in Monrovia.

那时他们一家三口都在 蒙罗维亚医疗小组接受埃博拉病毒治疗。

Luckily, they survived.

幸运的是，他们都活了下来。

My friend's baby is almost three years old now,

我朋友的孩子现在已经快3岁了，

but cannot stand, cannot walk, cannot speak.

但是他无法站立、不会走路， 甚至不能说话。

He has failure to thrive.

他没办法茁壮成长，

There are many more hidden experiences and many stories are yet untold.

许多类似的经历和故事都还不为人知。

The survivors of Ebola deserve our attention and support.

我们应该给予埃博拉病毒 的幸存者们更多的关注和支持。

The only way we can defeat this pandemic

只有当我们在这场 最后的战役中取得成功，

is when we ensure that we win this final battle.

才算是真的战胜了这场流行病。

Our best opportunity is to ensure

实现这一目标最好的方法， 就是确保

that every survivor receives adequate care at the point of need

每位幸存者在需要时 能够得到充分的照顾，

without any form of stigma and at no cost to them personally.

要让他们免遭羞辱， 不必负担个人费用。

How can a society consider itself healed

当一个人的身份

when a person's entire identity

完全被埃博拉幸存者所定义，

is defined by the fact that they recovered from Ebola?

又怎么能认为社会的创伤已经被抚平？

Should a previous disease that a person no longer has

难道已经治愈了的疾病

become the sum total of their identity,

应该成为个人身份的全部，

the identifier in their passport

成为护照里的一个标识，

that deters you from traveling to seek medical care abroad?

让这个人无法出国就医吗？

Simply the ID that denies you health care.

仅仅是埃博拉幸存者， 就得不到医疗保障，

Or prevents you from having a relationship with your spouse.

无法维系正常夫妻关系，

Or denies you of family, of friend or home.

不再拥有家人、朋友或是住所，

Or prevents you from carrying on your normal job,

无法继续正常工作，

so you can put food on the table or have a roof over your family's head.

缺衣少食，无处容身。

What is the meaning of the right to life

当我们的生活

when our life is clouded by stigma and barriers that fuel that stigma?

被羞辱和隔阂笼罩之时， 生命权的意义又是什么？

Until we have much better answers to those questions in West Africa,

在西非为这些问题 找到更好的答案之前，

our work is not over yet.

我们的工作还远没有结束。

Liberians are a resilient people.

利比里亚人民是坚韧的民族，

And we know how to rise to a challenge, even a devastating one.

我们知道如何应对挑战， 甚至是毁灭性的挑战。

My best memories of the outbreak

我对于这次疫情爆发 的最美好的回忆

center on those many people who survived the disease,

主要来自于那些幸存者，

but I cannot forget the hard-working nurses, doctors, volunteers and staff

但那些奋力工作的医生、护士、 志愿者和工作人员也都令我难忘，

who risked their own safety in service of humanity.

他们牺牲自身的安危进行人道救助，

And some even losing their lives in the process.

一些人甚至为此付出了生命。

During the worst of the contagion,

在疫情最严重的时候，

one thing kept us making those perilous daily journeys into the Ebola wards.

一股力量让我们日复一日 冒险进入埃博拉病房，

We had a passion to save lives.

那就是治病救人的热情。

Was I afraid during the Ebola outbreak?

要问我在埃博拉爆发的时候害怕吗？

Of course I was.

答案当然是肯定的，

But for me, the opportunity to protect our global health security

但对我而言，守护全球健康安全，

and keep communities safe at home and abroad was an honor.

让国内外的人免受 疾病之苦，是我的荣幸。

So as the dangers became greater, our humanity became stronger.

因此危险越巨大， 我们的人性也就越强大。

We faced our fears.

我们能直面自己的恐惧。

The global health community working together defeated Ebola,

全球健康组织团结一致对抗埃博拉，

and that ...

而这——

that is how I know

也让我明白，

that we can defeat its aftermath

我们终将荡平埃博拉的余波，

in our hearts, in our minds and in our communities.

无论是在情感、意识层面， 还是在人与人之间，都将如此。

Thank you.

谢谢。

(Applause)

（掌声）