Monrovia — In Liberia, the efforts to Combat COVID-19 largely revolves around people's physical health whilst little or no attention is placed on mental health, in spite of the new challenges and realities the outbreak brings.
In March, the World Health Organization acknowledged that the coronavirus is causing stress in the global population and published mental health tips that include specific advice for health-care workers, caretakers of children or older adults, and people in isolation.
Due to the traumatic effects of the decade long civil war, the recent Ebola outbreak and the current corona virus outbreak, one would think that mental health should now be more relevant to Liberia than ever before.
Liberians like the rest of the world have to adopt to the new normal, by staying home and keeping the social distancing and those measures added to people level of stress and worry. But those at treatment center mental health conditions increase.
Sadie Marwolo a nurse and COVID-19 survivor held her baby wrap up in blanket with an attempt to shed tears while explaining her ordeal.
Marwolo went into the Coronavirus Treatment Unit (CTU) as the only pregnant woman adding that no special treatment was available for pregnant women.
"At the treatment center, I wasn't monitor properly, I was afraid and couldn't feel my baby moving, I had no appetite to eat, no attention was given to me, there was no doctor, I was left alone in the hands of God," Marwolo said.
Marwolo was certain that either she or the baby wouldn't survive or the both of them owing to the trauma of being COVID-19 patient and a pregnant woman.
"Being pregnant is stressful and coming down with COVD-19 is even more stressful," She added.
Marwolo Continues: "I requested for check-up there was nothing done, I was afraid and thought I was going to die because the hospital wasn't prepared for me in my condition yet and still they took me there, it was latter when I was complaining, when the UNFPA people provided ultra-science, a doctor that was also positive help me."
Like Marwolo, Josephine Kawa an Ebola survivor and a nurse was also pregnant when she came down with the virus.
Unfortunately, Kawa baby didn't survive. "When I was in the Ebola Treatment Center (ETU) I forgot that I was pregnant," Kawa said.
Upon hearing the outbreak of COVID-19 and seeing health workers in space suit (Personal Protective Equipment) and hearing ambulance plying streets, Kawa got quickly reminded of her days at the ETU and what she went through.
"When I heard about COVID-19, I was very sad owing to my Ebola experience, I thought on the same things that happened during Ebola, I reflected on my experience at the ETU, when I heard the ambulance sound in my community it brings back my memory, during that time you heard a lot of ambulance sound in the country, they will be carrying patients, my day was very bad," Kawa said.
Narrating her story, Kawa added, that in the ETU a baby whose mother died, was left unattended and the child suddenly died a memory that lives on.
Kawa continues: "The baby was left unattended and the child cried the whole night until that baby died, so when I heard ambulance and people in space suit (PPEs) coming for people, I could hear the baby crying."
As the number of COVID-19 cases increase, regulations tighten, as a means to combat the corona virus, President George Weah declared a state of emergency, putting security apparatus in charge of ensuring the lockdown is achieved.
The display by the military, police and other members of the joint security taskforce, reminded some Liberians of the fourteen years civil unrest.
Men in arms patrol communities and checkpoints were set at every major intersection in Monrovia.
This displayed creates a flash back for some about their terrible experience of the civil war.
Marie Kollie 58 years, a mother of four is having terrible flashback by the military display in her community.
"For me, on the first day of State of Emergency (SOE), I saw people with arms and rattans in their hands, this took me back to our senseless civil war,"
"This is like a war, streets are quiet and those in arms determines our rights after the deadline,"
For Madam Kollie sight of men in at the back of pickups with arms reminded her of the deaths of friends and family adding for days it wasn't about the virus rather pictures of the war days.
Madam Kollie argued that government could've kept people indoor without having men in arms parading the streets.
"Those people have no idea what we went through and how we're fighting to move ahead and forget about the past," Kollie said.
The Carter Center Mental Health Program Lead Benedict Dossen said considering that Liberia has a history of violence and Ebola that led to the loss of many lives, adding that the current outbreak has the propensity to exacerbate the condition of people with a history of mental illness, as well as causing other people to experience mental instability.
Dossen avers that due to Covid-19 that lead the government to put the military out in the streets can invoke trauma.
"I can't speak to the number of Liberians this might be affecting or going through such experiences, but certainly, I can say that such emergency crisis and military presence can invoke trauma, clearly because we have a history of war and Ebola crisis," He added.
Dossen said the outbreak has serious social and economic impact as businesses have slowed down dramatically.
"Many people have lost their jobs and have no means of making a living to keep up their families. Other families have to go on with their breadwinners in isolation, or dead. People cannot go to church to worship or demonstrate for reverence for their spirituality the way they are used to," Dossen said.
Dossen Continue: "We cannot shake hands or get close to people anymore, at least not until this is completely over. These are very serious situations and they can take a toll on our mental health."
Dossen said there is a pillar for Mental Health and Psychosocial Support (MPHSS) under the Incident Management Service (IMS).
The Carter Center Mental Health Program Lead adds that the MHPSS Pillar is responsible to address the mental health needs of people infected and affected, and that includes responders such as doctors, nurses, mental health clinicians, social workers, burial team and ambulance team.
"However, the pillar is supposed to be properly funded and supported by the national response mechanism (IMS). Without support from the IMS response, it is difficult for the pillar to effectively function and address the mental health needs of frontline responders," Dossen said.
People like Marwolo after been discharge from the Corona Virus treatment continue to face stigmatization.
Marwolo said, people in her community are afraid to interact with her adding that she can understand that they too have been stigmatize for just living in the same community.
"When people even leave my community to go and buy food, when the marketeers know that they are from my community, they will be running away from them because I live in the community and was diagnose of COVID-19," Marwolo said.
They ( residents) too start been afraid of me and up till now, I can't see nobody welcoming me, I really feel like I want to leave, if me and my children living in such community with stigma it very bad I'm a young mother now, I have a baby, I had this baby by caesarean session, right now don't even have the strengthen to care for my baby like a mother should do," Marwolo added.
She added, upon returning to her community the government is yet to provide any psychosocial support.
"I don't have any psychosocial support from anywhere. Since I came home nobody have even follow-up on me." Marwolo added that government should paid attention to pregnant women with COVID-19.
All attempts to get the mental health division of the Ministry of Health to respond after weeks of email exchanges failed.
But the Carter Center Mental Health Lead Benedict Dossen stressed that getting coronavirus should not be a sentence of guilt or punishment.
Dossen urged Liberians against stigmatizing people affected by the virus adding that living in isolation is already traumatizing and it can lead to more stress, anxiety and depression.
"We the community, need to stop stigmatizing them and begin showing them love and compassion. We need to demonstrate that they are still members of the community and we are there to help them," Dossen asserts.
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