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During Ebola Mission

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1. Follow the 'No touch' policy 

(non‑contact policy)

What does this mean?

In an epidemic area, all direct and indirect physical contact with other people is avoided (no handshakes, kissing, sharing food, drinks, or utensils, no sexual relations, even when using condoms, etc.). 

Why such a policy?

  • It helps avoid any risk-taking, which is essential given that Ebola remains a severe and difficult-to-treat disease.
  • Other diseases transmitted through physical contact will also be avoided (some of which can be contagious before the person is visibly ill). This not only prevents work incapacity due to illness but also avoids the stress of experiencing symptoms that may mimic Ebola (and therefore being potentially identified as a suspected Ebola patient).
  • The no‑touch policy helps establish a habit and behavior among staff to avoid physical contact, which in turn supports correct attitudes when facing an Ebola patient or when in contact with patient "contacts" (known or unknown).
Reminder: The 'no‑touch' policy has been a constant rule throughout decades of viral haemorrhagic fever (VHF) outbreaks.

2. Follow Prevention Measures to prevent illness

Any illness among staff increases the stress level of the team, especially if you develop a fever. Therefore, follow these prevention measures: 

Take Malaria prophylaxis

  • Malaria prophylaxis is MANDATORY; no exceptions will be allowed.

Use Mosquito repellent

  • Use mosquito repellent every day to protect yourself against mosquito‑borne diseases (dengue, etc.) and sleep under a mosquito net for the same reason.

Ensure proper food handling

  • Ensure proper food handling (food well washed, well cooked, and properly stored) to prevent gastrointestinal problems (diarrhea and vomiting are also potential symptoms of Ebola).

Do not share food or drinks

  • Do not share food (eat from the same plate), drinks (drink from the same glass), or utensils.

    • 3. Take care of your mental health and well-being

    Fatigue and stress can increase risk-taking behaviours.
    Taking care of yourself is therefore an essential part of staying safe.

    How to recognise stress?

    Know the main Sources of stress

    • Specific to the Epidemic: Dealing with a large-scale outbreak alongside limited resources that make it impossible to meet all medical needs.

    • The Disease: Coping with a high mortality rate (~50%), witnessing frequent deaths (including children), shocking advanced-stage symptoms, and the lack of curative treatments.

    • Contagiosity: Managing the constant vigilance required for compliance with biosecurity measures, the physical strain of wearing PPE (heat, fatigue, dehydration), and the ongoing risk of contamination.

    • Social Consequences: Facing stigma from staff and communities, feelings of fear, rejection, and mistrust, as well as broader negative impacts on families, schools, and the economy.

    • Expatriation: Handling the worries and concerns of loved ones back home, alongside the lack of guarantee of a sanitary medical evacuations, with possible delays.

    Lookout for Signs of stress

    • Intense fear of being infected or infecting others
    • hypervigilance
    • feelings of isolation linked to compliance with biosecurity measures 
    • feelings of powerlessness and guilt
    • extreme fatigue, sleep problems
    • sadness, anxiety, discouragement
    • feeling of injustice
    • feeling paranoid or excessively suspicious

    How to manage stress?

    Take care of your basic needs

    • Take care of your basic needs: eat well, stay hydrated, get enough sleep, and allow yourself time to rest. Whenever possible, maintain regular working hours.

    Take 'Ebola breaks' daily

    • Whenever possible, take an "Ebola break" each day by engaging in activities you enjoy, such as reading, exercising, listening to music, or relaxing.

    Take days off

    • Try to take one day off per week to recover, maintain your alertness, and reduce the impact of fatigue and stress.

    Mindset matters

    • Accept that not everything is under your control and focus your energy on what you can influence and improve.

    Meaning

    • Stay connected to the reason you are here and the value of your contribution, especially when facing challenges or frustrations.

    Stay connected to loved ones

    • Stay in touch with family and friends, who can provide important emotional support.

    Stay informed

    • Stay informed about the disease, associated risks, and preventive measures. 

    • Ask questions whenever needed.

    Remember you're part of a team

    • Take care of yourselves as a team: share concerns, listen to one another, and support your colleagues. Trust, solidarity, and mutual care are especially important in an Ebola response. 

    Ask for support, don't wait for crisis 

    If you need psychosocial support, you may contact the TF21 staff health psychologists at:
    taskforce21-mentalhealth@geneva.msf.org  

    If you're feeling unwell or develop symptoms: 

    1: Self-isolate and immediately report any symptoms or health problems to the staff health focal point in the field

    A staff health focal point is clearly identified. Make sure you know who this person is as soon as you arrive on the project. During your stay on the Ebola project, report any unusual symptoms to this person, for your own safety and that of your colleagues.

    2. Do NOT take any medications without medical advice

    In other words, do not treat yourself with medications that have not been prescribed by a doctor.

    Paracetamol, aspirin, and anti‑inflammatory drugs such as ibuprofen are antipyretics and may mask the presence of fever.

    3. If you develop symptoms, you will be assessed

    If you develop symptoms compatible with Ebola (for example, fever), a test will be carried out as soon as possible to clarify the diagnosis.

    • If the test is negative, you will be treated according to your symptoms.

    • If the test is positive, every effort will be made to provide you with the best possible care. Please note that no treatment has proven efficacy for this Ebola strain, although treatment trials are likely to be implemented during this outbreak. It may be decided to keep you in the DRC initially, for example because certain treatments are only available there. The possibility and benefit of medical evacuation will be assessed immediately. Be aware that this type of medical evacuation is very complex to organise. MSF cannot guarantee 100% that you will be evacuated from the DRC and cannot predict the evacuation destination. However, you can be assured that the best possible care will be provided and that all decisions will be made in your best interest.

                                  In case of Accidental exposure

    If you experience an exposure accident such as a cut or contact with infected material, you will be considered "at risk." Post‑exposure treatment may be offered if available and validated by our experts. The procedure to follow will be explained to you. In all cases, follow‑up must be organized as quickly as possible, so if this happens, immediately inform the staff health focal point within the team.