Glenna Gordon has worked in West Africa for five years. Visiting Nigerian slums, she knows which streets to avoid. She expertly steers clear of Islamic extremists and kidnappers.
But the microscopic particles of Ebola baffle her. When the freelance photographer went to Liberia last week for an assignment with the Wall Street Journal, she received conflicting advice about maneuvering this uncharted epidemic.
“There is no protocol. People are grasping for information,” Gordon, 33, said by telephone from Monrovia. “Our knowledge about the disease is so limited.” A CNN crew wore plastic coveralls as protection. Other journalists rely on rubber boots and long sleeves. Everyone douses cars and hands with chlorine, but what is the right solution? And should one wear a mask?
“It’s not clear who is in the know,” Gordon said. “The hardest part has been the range of opinions on how to behave.”
Her anxiety deepened when her friend Ashoka Mukpo, a freelance cameraman, came down with the virus last week, after taking what he thought were suitable precautions. He arrived in the US on Monday for treatment.
The two things everyone knows is that Ebola is spread by droplets of blood, vomit, urine, diarrhea, and secretions, and that the outbreak in West Africa is the biggest ever, killing more than 3,400 people since it began in March.
Since halting exposure is central to preventative warnings, the Centers for Disease Control and Prevention and World Health Organization have issued no health advice for media covering the story. Without firm guidelines, reporters are improvising with tips circulating at the hotel bar or online.
“We’re talking about a vulnerable, at-risk group without the protection afforded to aid workers or the military,” said Christopher Tedeschi, an emergency physician at Columbia’s Medical Center. He has a background in global health and television documentaries. “Journalists in Ebola epidemic regions have limited medical training, often work on their own without direct supervision or protection, and are eager to get to the middle of this story.”
His concern is shared by beleaguered aid workers, who are trying to figure out their own procedures while fielding media requests. They worry about freelancers who lack insurance for medical evacuations should they fall ill.
The most detailed media-specific advisories are issued by a small NGO in London, the International News Safety Institute, which list health guidelines alongside flight restrictions. Discussion about best practices otherwise percolates in a Facebook group, Ebola Coverage, which has 199 members.
Sarah Crowe covered myriad African emergencies for television before becoming UNICEF’s chief of crisis communications. This biological war, as she calls it, is “unlike anything we’ve seen.”
“It’s all so new that you can’t say that any one organization had figured out protocols. It’s unmapped terrain, whether you’re at it from child protection to precautions for the media.”
During her five weeks in Liberia, however, some basic rules emerged. She told journalists to stand back at least six feet if interviewing someone with symptoms. Bring your own sprayer and disinfectant, in case supplies run out in the market. Wash hands with chlorine constantly. Same with rubber boots and vehicles. Don’t shake hands or touch orifices. Don’t take taxis, which are often used as ambulances. Never wear lapel mikes. Check your temperature for fever twice a day, including 21 days after leaving the zone. (That is how Mukpo discovered his infirmity.) Shoot with a long-distance lens.
After that it gets hazy. Do you report to health authorities upon returning home, or just watch for symptons? Do you pack protective suits, gloves, and goggles like Daniel Berehulak of Getty Images?
Not without expert supervision, says Sean Casey, who runs the Ebola operations of the International Medical Corps.
“If you haven’t been trained to use coveralls, masks, etc, and if you don’t have a trained sprayer working with you to remove them safely, you’ll expose yourself in the removal process,” he said. “Really, if you’re going anywhere that requires personal protective equipment, you need to be under the supervision of someone who knows what he or she is doing. Proper removal requires about 20 sequential steps, with spraying and hand washing throughout.”
Which leads us to the next topic of debate: Where to film.
Journalists are basically on their own outside the tightly regulated facilities managed by international NGOs. Doctors with Doctors Without Borders, for instance, are normally too busy hooking up IVs to help a reporter take off a plastic apron and then incinerate it. Aid workers have provided help with interviews, but in controlled circumstances with clear briefings and ground rules. It’s easier, but riskier, to go to a graveyard with an ambulance.
Many journalists head for the JFK and Island treatment centers, which are so overcrowded that would-be patients lie outside leaking vomit and blood. This provides vivid copy, but tremendous risk of exposure, warns Casey. He likened entering a patient home or following burial teams without expert supervision to walking into crossfire without basic body armor. Freelancers worry him the most.
“I see freelancers taking similar risks that they take in war zones. Pushing the line a little further to get something interesting that they can sell,” Casey said. “They often have less protection and they tend to be less considered before going out on a story.”
Mukpo may have endangered his health that way. A friend says he traces his infection to a visit to Island when it was teeming with sick people outside, or when he sprayed a car that had transported an Ebola victim. Contaminated droplets might have splashed back.
So how to stay safe? Hyper vigilance, says Adam Nossiter, of The New York Times, who has staffed the Ebola zone nearly continuously since July without succumbing. He brings common sense along with a big tank of chlorine to Sierra Leone. His protocol resembles Sarah Crowe’s. He goes low tech with boots and long sleeves. He stands nine feet from subjects. He never touches walls. He doesn’t step into areas that are completely infested. Most importantly, he never lets down his guard.
“Last week we were at the edge of these wards that were obviously infected. You could see the urine on the floor. I didn’t go in. I stood on the threshold,” he said. “The photographer wanted to go in, and I told him, ‘Don’t do it, you’re diminishing the odds.’”
They still got the story, and it ran on the front page.