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

譯者: Lilian Chiu 審譯者: YU TING HUANG

June 13, 2014

2014 年 6 月 13 日，

started as a routine Friday

救贖醫院就像平常的星期五 一樣開始一天，

in Redemption Hospital in Monrovia, the capital of Liberia.

這間醫院為於賴比瑞亞 首都蒙羅維亞。

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

救贖醫院是該市中 最大的免費公共衛生醫院。

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

我們要服務數十萬人民。

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

在最好的情況下， 我們的資源也很吃緊。

Monthly supplies run out within weeks,

月補給會在幾週內就用盡，

and patients without beds would be seated in chairs.

沒有病床的病人就要坐在椅子上。

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

那年夏天，有位護士 已經生病一陣子了。

Sick enough to be admitted in our hospital.

病到需要住進我們的醫院。

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

但我們的治療似乎對她沒幫助；

her symptoms were getting worse:

她的症狀越來越糟：

diarrhea, severe abdominal pain, fever and weakness.

腹瀉、嚴重腹痛、發燒，以及虛弱。

On that particular Friday, she developed severe respiratory distress,

在那個星期五，她開始 有嚴重的呼吸窘迫，

and her eyes were menacingly red.

她的眼睛紅得嚇人。

One of my fellow doctors, a general surgeon,

我的一位醫生同事，一般外科醫生，

became suspicious of her condition.

對她的症狀開始產生懷疑。

He said her symptoms were suggestive of Ebola.

他說她的症狀會讓人 聯想到伊波拉病毒。

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

我們密切觀察她，我們試著協助她。

We were treating her for malaria, typhoid and gastroenteritis.

我們針對瘧疾、傷寒， 及胃腸炎來治療她。

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

我們知道的時候已經太遲了。

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

隔天早晨，我去檢查我的病人。

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

我從她的眼神中看出她充滿了恐懼。

I gave her reassurance, but shortly after ...

我給她保證，但沒多久……

she died of Ebola.

她死於伊波拉病毒。

For me, her death was very personal.

她的死亡對我是很個人的。

But this was just the beginning.

但這只是開端。

A virtual biological bomb had exploded.

一個虛擬的生物炸彈爆炸了。

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

但傳言散佈得比病毒還快， 整間醫院滿是慌恐。

All the patients ran away.

所有的病人都跑走了。

Then, all the nurses and doctors ran away.

接著，所有的醫生 和護士也都跑走了。

This was the beginning of our medical tsunami --

我們的醫療海嘯就此展開──

the devastating Ebola virus

毀滅性的伊波拉病毒

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

在我們國家的歷史上 留下了無法抹滅的傷疤。

I was not trained for this.

我沒受過這種訓練。

I had just graduated from medical school two years before.

我才剛從醫學院畢業兩年。

At this time,

在這個時候，

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

我對伊波拉的所有知識 都來自我在醫學院

I had read in medical school.

讀過的一頁文章。

I perceived the disease as so dangerous,

我感覺這疾病非常危險，

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

在我一聽到這個伊波拉案例時， 這一頁文章說服我

the moment I heard of a case of Ebola.

也要馬上逃離醫院。

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

但當真正發生的時候， 我決定留下來協助。

And so did several other brave health care professionals.

還有其他數位勇敢的 健康照護專業人士也留下了。

But we would pay a heavy price.

但我們會要付出很大的代價。

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

很多人和很多健康專業人士 都有高風險接觸。

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

那表示 21 天後， 可能就會發病或死亡。

Our health systems were fragile,

我們的健康體制很脆弱，

our health workers lacked skills and training.

我們的健康工作者缺乏技能和訓練。

So in the weeks and months that followed,

所以，在之後的數週、數月，

health workers were disproportionately affected by the Ebola virus disease.

健康工作者很不成比例地 被伊波拉病毒影響。

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

超過 400 位護士、醫生， 及其他健康專業人士被感染。

Unfortunately, my friend, the general surgeon

不幸的是，我的朋友， 那位一般外科醫生，

who correctly identified the symptoms in that first case

他正確地辨識出了 第一個個案的症狀，

became one of the casualties.

自己卻成了受害者之一。

On July 27, the president of Liberia

7 月 27 日，賴比瑞亞總統

imposed quarantine on the worst-affected areas.

針對狀況最糟的區域實施隔離。

She closed all the schools and universities

她把所有的學校和大學關閉，

and shut down many public events.

終止了許多公開活動。

Four days later,

四天後，

the United States Peace Corps

美國和平工作團

pulled out of Liberia, out of Sierra Leone and Guinea

因為伊波拉而退出 賴比瑞亞、獅子山共和國，

due to Ebola.

和幾內亞。

In August, six weeks after the nurse died,

8 月，在護士死後 6 週，

hundreds of people were dying of the disease each week.

每週都有數百人因為伊波拉而死。

People were dying in the streets.

人民死在街頭。

Over the months that followed,

之後的數個月，

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

西非有數千人因為伊波拉喪命。

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

8 月，我加入了一個團隊， 設立伊波拉治療單位，

at JFK hospital in Monrovia.

位在蒙羅維亞的甘迺迪醫院。

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

我被委託經營該市中的 第二個伊波拉治療單位。

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

我們的單位把希望帶給 數以千計的病人、家庭，及社區。

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

我不只提供照護， 我還和伊波拉面對面。

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

每天活在接觸伊波拉 病毒的高風險中，

during the worst of the outbreak

那是疾病爆發最嚴重時，

was one of my worst experiences.

這段經驗是我最糟的經驗。

I started counting 21 days every day.

我每天都在計算那 21 天。

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

我每天都預期可能會 出現該疾病的症狀。

I measured my body temperature several times.

我數次測量我的體溫。

I showered with chlorinated water,

我用加氯消過毒的水來淋浴，

more concentrated than actually recommended.

用的氯濃度比實際建議的更濃。

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

我用氯消毒我的手機、 我的褲子、我的手、我的車。

My clothes became bleached.

我的衣物都被漂白了。

Those days you were alone,

在那些日子，你是孤獨的，

people were so afraid of touching anybody.

大家都好害怕接觸任何人。

Everyone was counted as a potential contact.

每個人都可能讓你接觸到病毒。

Touching would make them sick.

觸碰就會讓人生病。

I was stigmatized.

我被污名化了。

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

但如果對於我這個沒有症狀的人 都已經是這種情況了，

imagine what it was for someone who actually had symptoms,

想像一下對於有症狀的人， 得了伊波拉的人，

someone who had Ebola.

情況會是如何的。

We learned that to treat Ebola successfully,

我們學到，如果要成功治療伊波拉，

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

我們得要暫停一些社會的正常規則。

Our president declared a state of emergency in August

8 月時我們的總統宣佈緊急狀態，

and suspended certain rights.

並將某些權利暫停。

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

在伊波拉應變中，國家警察 甚至來支援我們的工作。

In February 2015, gang members came in for isolation

2015 年 2 月，幫派成員來我們的

in our Ebola isolation unit.

伊波拉隔離單位做隔離。

They were also know as the VIP Boys of Monrovia,

他們是所謂的「蒙羅維亞貴賓男孩」，

terrifying small-time drug addicts

都是嚇壞了的三流毒癮者，

whose presence could instill a tremendous amount of fear,

他們的出現，會帶來更大量的恐懼，

although they could not legally carry guns.

雖然他們無法合法攜帶槍枝。

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

他們在我們的單位接受 21 天隔離，且並沒有被逮捕。

We told the police,

我們告訴警方：

"If you arrest them here,

「如果你在這裡逮捕他們，

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

他們就不會來這裡了， 就不會被治療。

And the Ebola virus will continue to spread."

而伊波拉病毒就會持續擴散。」

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

警方同意，所以我們才能 治療這些貴賓男孩，

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

在單位中時他們不用擔心會被逮捕。

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

在疾病爆發的過程中， 西非出現近 29,000 個案例。

More than 11,000 people died.

超過 11,000 人死亡。

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

那包括我在蒙羅維亞甘迺迪醫院中 12 位很棒的同事。

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

2016 年 6 月，我的第一個 伊波拉病人死後 23 個月，

Liberia declared its Ebola outbreak ended.

賴比瑞亞宣佈，該國的 伊波拉爆發已經終止。

We thought that once the outbreak ended,

我們以為，一旦爆發終止，

so did the problems.

問題就會終止。

We hoped that life would go back to normal.

我們希望生活會回到正常。

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

現今，在西非有 至少 17,000 名存活者。

People who actually had Ebola virus disease,

他們是真的得到伊波拉病毒病，

lived through it and survived.

撐過去並活下來的人。

We counted survival rate as a success:

我們把存活率視為是成功：

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

病人的痛苦結束，家庭充滿喜悅。

Every discharge from the unit was a moment of jubilation.

被單位釋放的每一個人， 都是個歡慶的時刻。

At least so we thought.

至少我們這麼認為。

The best description of the moment of discharge

出院時刻的最佳寫照，

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

以及定義了「後伊波拉」 生活的難得一瞥，

was vividly expressed in the words of my best friend

都被我最好的醫生朋友 生動描述出來，

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

菲利普艾爾蘭，那是他在 接受《時代》訪問時說的。

He said at the time of his release,

在他出院的時候，他說：

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

「有很多人是來自甘迺迪醫院，

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

我的家人、我的哥哥、 我的妻子都在那裡。

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

也有很多其他醫生在那裡， 還有媒體人員。

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

我感覺就像曼德拉， 這像是他的《漫漫自由路》，

and I walked and raised my hands to the heaven,

我邊走邊向著天堂舉起雙手，

thanking God for saving my life."

感謝上帝拯救了我的命。」

And Philip said, "Then I saw something else.

菲利普說：「接著我看到了別的。

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

有很多人在哭泣，很開心見到我。

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

但當我靠近任何人時， 他們都退開了。」

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

對許多伊波拉存活者而言， 社會仍然在退開，

even as they struggle to lead a normal life.

即使他們努力在過正常的生活。

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

對這些存活者而言， 人生就像是另一場健康緊急情況。

They may suffer debilitating joint and body pain.

他們可能會因為關節衰弱 及身體疼痛而受苦。

The suffering gradually decays over time for most.

大部分人的受苦會隨時間減少。

However, many continue to bear intermittent pain.

然而，許多人要持續承受 時斷時續的痛苦。

Some survivors are blind, others have neurological disabilities.

有些存活者失明了， 其他人則有神經性殘疾。

Some survivors experience stigmatization every day, in many ways.

有些存活者每天都會體驗到 以各種方式被汙名化。

A lot of children are orphans.

許多孩童成為孤兒。

Some survivors experience post-traumatic stress disorder.

有些存活者還有創傷後的壓力失調。

And some survivors lack opportunity for education.

有些存活者缺乏受教育的機會。

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

對伊波拉的恐懼， 也可能分裂一個家庭。

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

對於透過性行為傳染的伊波拉， 還沒有可靠的治療。

However, there are successful interventions for prevention.

然而，有些預防性的 干預方式是成功的。

We have worked hard on semen testing,

我們很努力做精液測試、

behavioral counseling, safe sex promotion and research.

行為諮詢、推動安全性交，及研究。

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

去年，已經沒有發生 性交傳染的案例。

But some male survivors have lost their spouses

但有些男性存活者 失去了他們的伴侶，

out of fear they will be infected with Ebola.

因為他們害怕會被伊波拉感染。

That's how families are torn apart.

家庭就這樣破裂了。

Another tremendous challenge for Ebola survivors

對伊波拉存活者，還有一個大挑戰，

is obtaining adequate health care.

就是取得適當的健康照護。

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

理論上，賴比瑞亞的 公共衛生服務是免費的。

In practice, our health system lacks the funding and capacity

實際上，我們的健康體制 缺乏資金和容納量，

to expand care to all at the point of need.

無法將照護帶到所有有需要的地方。

Many survivors have waited many months to undergo surgery

許多存活者等了數個月 才能進行手術，

to heal their blinding cataracts.

治療讓他們失明的白內障。

Few had to relive the traumatic experience,

有些人得要再走過一次創傷經歷，

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

因為當他們住院時 要重新針對伊波拉驗血。

Some survivors experienced delayed or deferred admission

有些存活者的住院被延後或延期，

due to limited bed capacity.

因為床位有限。

No bed available for one more patient.

沒有空床位再容納病人了。

This is neither national policy nor officially condoned,

這不是國家政策也不是正式赦免，

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

但許多人仍然害怕 伊波拉病毒會再復活。

The results can be tragic.

結果可能是很悲劇性的。

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

我已經見過伊波拉存活者 碧艾崔絲很多次了。

She's 26 years old.

她 26 歲。

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

她的許多家人受到感染，

她幸運存活。

But since that day in 2014 she was discharged

但自從 2014 年她出院的那天，

to cheering health workers,

健康工作者為她歡呼，

her life has never been the same.

但她的人生不再相同了。

She became blind as the result of Ebola.

她因為伊波拉而失明。

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

2014 年，我摯友的 寶寶才兩個月大，

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

雙親和孩子都住進蒙羅維亞的 一個伊波拉治療單位，

Luckily, they survived.

他們幸運存活。

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

我朋友的寶寶現在快要 3 歲了，

but cannot stand, cannot walk, cannot speak.

但無法站立，無法走路，無法說話。

He has failure to thrive.

他有成長不良症。

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

有許多不在檯面上的經驗 和沒被說出來的故事。

The survivors of Ebola deserve our attention and support.

伊波拉的存活者應該要得到 我們的注意和支持。

The only way we can defeat this pandemic

只有一種方式能打敗這種流行病，

is when we ensure that we win this final battle.

就是我們要確保贏得最終之戰。

Our best opportunity is to ensure

我們最好的機會是要確保

that every survivor receives adequate care at the point of need

每一位存活者在需要時 都能受到適當的照護，

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

沒有任何汙名化， 也不用他們個人出錢。

How can a society consider itself healed

一個社會怎麼能認為它已經治癒，

when a person's entire identity

當一個人的整個身份定義

is defined by the fact that they recovered from Ebola?

是他是否已從伊波拉康復？

Should a previous disease that a person no longer has

一個人曾得過但已經沒有的疾病，

become the sum total of their identity,

應該變成他們身份的全部嗎？

the identifier in their passport

成為他們護照上的識別記號，

that deters you from traveling to seek medical care abroad?

讓你不能立即到國外 去尋求醫療照護？

Simply the ID that denies you health care.

身份否定了你的健康照護。

Or prevents you from having a relationship with your spouse.

或是讓你無法和你的伴侶性交，

Or denies you of family, of friend or home.

或讓你失去家人、朋友、家。

Or prevents you from carrying on your normal job,

或讓你無法繼續你正常的工作，

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

無法再讓你繼續供養你的 家人、維持你的家。

What is the meaning of the right to life

生存權利的意義是什麼，

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

當我們的生命是活在汙名 及助長汙名之阻礙的陰霾之下？

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

在西非，在我們對這些問題 有更好的答案之前，

our work is not over yet.

我們的工作都尚未結束。

Liberians are a resilient people.

賴比瑞亞人是恢復力很強的民族。

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

我們知道如何迎接挑戰， 即使是毀滅性的挑戰。

My best memories of the outbreak

我對於這場爆發，

center on those many people who survived the disease,

最好記憶都以疾病存活者為中心，

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

但我無法忘懷努力工作的護士、 醫生、志工，及工作人員，

who risked their own safety in service of humanity.

他們拿自己的生命安全 當賭注來為人服務。

And some even losing their lives in the process.

有些人甚至在過程中喪命。

During the worst of the contagion,

在傳染狀況最糟的時期，

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

有一樣東西讓我們願意持續每日 巡視那些危險的伊波拉病房。

We had a passion to save lives.

我們有拯救生命的熱忱。

Was I afraid during the Ebola outbreak?

在伊波拉爆發時，我害怕嗎？

Of course I was.

當然害怕。

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

但對我來說，有機會能保護 我們的全球健康安全

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

以及確保國內外社區的 安全，是一種榮幸。

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

隨著危險變得更大， 我們的人性也變得更強。

We faced our fears.

我們面對我們的恐懼。

The global health community working together defeated Ebola,

全球的健康社區同心協力 打敗了伊波拉，

and that ...

而那……

that is how I know

那就是我如何能知道

that we can defeat its aftermath

我們能打敗它的餘波，

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

在我們的心中，在我們的腦中， 在我們的社區中。

Thank you.

謝謝。

(Applause)

（掌聲）