Marie-Roseline Bélizaire is a doctor and epidemiologist with the World Health Organization (WHO). She was on the frontlines of Ebola and is now turning her expertise to help fight the spread of COVID-19 in the Central African Republic (CAR). She was motivated to study medicine after both her parents died from unexamined causes in their community in Haiti. Now, she goes door to door in CAR implementing COVID-19 strategies for the most vulnerable. She was able to test the resilience of her own strategies first hand when she contracted COVID-19 herself. “I go visit in the communities too. We work with community leaders. So sometimes they go also with us from door to door.”
Marie speaks about her upbringing in Haiti and how the lack of scientific and medical rigour motivated her to study medicine. She recounts her experiences on the frontlines of Ebola in the Democratic Republic of Congo, riding motorcycles into the bushes trying to contact trace that pandemic. Now, fighting COVID, she’s able to apply that expertise to the Central African Republic.
Melissa Fleming 00:00
From the United Nations This is awake at night. I'm Melissa Fleming. My guest today is Dr. Marie Roseline Belizaire, an epidemiologist with the World Health Organisation. Marie Roseline, you have fought many outbreaks of disease including Ebola. But these days you are working to combat Corona virus in the Central African Republic. And this is obviously a country that is unstable. There are many security issues and there are many problems with the health system. So what is it that you're facing that you're worried about the most in this situation?
Marie Roseline Belizaire 00:43
Thank you, Melissa for inviting me to the Awake at Night. Actually, as I said, I am in Central African Republic of fighting COVID-19 I am embedded in the Ministry of Health in the cabinet of the minister supporting his team into be all strategies to make global testing to see where there is the epidemic is where are the cluster so we can address them quickly.
Melissa Fleming 01:11
Do you yourself go visit people in the communities?
Marie Roseline Belizaire 01:14
Yes, I go visit in the communities too. We work on with community leaders. So sometimes they go also with us from door to door, but sometimes no going out to the house to inform them what COVID is how to protect themselves against COVID and also to protect their family. And also we make a very big focus on washing hands and not sleeping together, not going out to the mass gathering, all those preventive measures that they should take, we make sure there is nobody with COVID, symptoms, we asked them if they have somebody with cough with difficulty to breath with sneezing. So if we find someone that is in that situation, we offer them to do the testing for them. So with this activity, we offer services to the most vulnerable in our community, because in the places that we are putting in place is one of the poorest country where people are living, but we bring these services to their home.
Melissa Fleming 02:26
And I understand that the health infrastructure in the country is, is not great. So what's keeping you awake at night these days, in relation to the pandemic?
Marie Roseline Belizaire 02:38
Well, a lot of things. Every time we have to focus on new strategies, because we don't want people to die. So for now, the strategy we found is testing symptomatic of cases and also vulnerable people. And I was COVID positive too. And so I say oh my word
Melissa Fleming 03:01
that's an interesting aside that you've said. So you've actually yourself gone through the virus. Did you have any of the symptoms? Did you feel sick? Or were you one of those asymptomatic lucky cases?
Marie Roseline Belizaire 03:15
I was not lucky, unfortunately. I was at home for three weeks. Well, I begin with a very bad headache and I decided to take the test. So when they give me the result, I was not surprised that I had COVID, but I was afraid for my health, because this is I know how the situation is in the country. And normally...
Melissa Fleming 03:41
Well, you're a doctor as well
Marie Roseline Belizaire 03:43
But doctors are afraid too, for their health. So I follow the same protocol of the country. So this is, it was the time for me to see if the system I helped to put in place is working. So I received the team at home they came to decontaminate my house. They programme me in the same way that they programme all other positive COVID cases, I received the psychological support too and I receive also social support they bring me water and soap to wash my hand so I stay home waiting for the test, but I have very mild symptoms, I have loss of taste. I have very bad headache, I have a little bit of shortness of breath, and I stay in bed. But I continue working. I was participating in all the teleconference because I didn't want to be cut off from what was doing in the country, because this time, it was very high number of cases. So we had to adapt everyday our strategy and the President was asking for information so I couldn't stay in bed. I continue working on with my COVID when I finish my quarantine, so the first thing I did is a meeting with the coordination to tell them, this is my experience with the system. This is what we should improve and this is what we should change.
Melissa Fleming 05:17
It must have been quite frightening. You just had arrived in Central African Republic, all of a sudden, you are facing your own illness with this frightening disease. So how did you feel?
Marie Roseline Belizaire 05:32
Well, I didn't feel that I was dying with COVID, I feel lonely, because I don't like to stay at home. I'm not somebody staying alone at home. So I think the most difficult part for me was I have to stay at home, not the symptoms, not to think that I will be dying because I'm a very optimistic person too, I know that I will go over that. But staying at home for more than 22 days. So it was very difficult for me and my test five days, we're not coming out and I say, I didn't want to call to tell them to one up my tests.
Melissa Fleming 06:19
You were testing the system.
Marie Roseline Belizaire 06:21
Exactly. So I suffer. So this is also something I put in place because I know there are people that did that test and never, never received a response. So I put myself in their place and I tell the team that we should do it better.
Melissa Fleming 06:36
But let me just take you back to that situation. The day you were diagnosed, I presume that you called your family who did you call?
Marie Roseline Belizaire 06:46
I call my son to tell him you know, but he knew that I was with headache. And I was at home and I call him to tell you know that mommy is testing positive to COVID and He said oh my god mommy, how are you? What do you need? What can I do? And I said nothing I just keep hoping we receive my instruction and stay at home. So every day there was calling there was asking me how I am, what they should do, they put the video they see my face and they say okay, you are good. So so it was a good time for me too I have to say, during my quarantine, I have time for family. I have time for friends.
Melissa Fleming 07:32
You have two sons who are who are in Spain and in Spain was it was a place that was ravaged by the spread of COVID-19, how did your sons cope and then they must have been very frightened for their their mother.
Marie Roseline Belizaire 07:47
Yes, they were they were very scared for me. And I was too and I was very scared for them too because they are alone at home. I have two children. The other one is 20 years old. These are children I have adopted in 2010, after the earthquake in Haiti, but he was living before with me since he was seven years old. And I have my biological son, he's 16. So they are both living at home now, alone, and they are taking care of themselves. But what I'm very proud of - they obey instruction when I give instructions, so I am sure when I tell them not going to the street, they're not going to the street. But I was afraid because I knew them. If they have something they will not tell me because they don't want me to be worried about their health. So I call colleagues friends that I have in Spain in order to inquiry about their health. I also have the coordinator of the responding Spain calling for me at home with all the work he has to do. And when they call me to tell me they're good, there's no disease at home, everyone is fine. So I believe that they are fine.
Melissa Fleming 09:05
So that you can sleep.
Marie Roseline Belizaire 09:08
Yes, I can sleep because this is also something that keeps me awake at night, my children.
Melissa Fleming 09:14
I know that all of us around the world parents like me, I was lucky to be reunited with my my children who are 22 and 20 and kind of go through this, this very difficult, uncertain time with them, but I could see every day that they were they were safe. So I can imagine this this separation must have been very frightening both for you and also for them.
Marie Roseline Belizaire 09:42
Yes, it is. I didn't see them since 14th of February. So they spent all these bad time in Spain without me and alone dealing with it alone at home.
Melissa Fleming 09:59
So I'm sure they're very relieved now to know that you're healthy and in a good place and very proud of their their mom who is trying to suppress the spread of COVID-19 and in a very fragile country.
Marie Roseline Belizaire 10:18
And they are Thank you.
Melissa Fleming 10:21
What do you think that they tell their friends about their mom?
Marie Roseline Belizaire 10:26
Oh, I know for the youngest one, because he was talking a lot about me in his court. And the last time I went on to spend, they invite me to go to a meeting to the school and the tutor was introducing me to everyone. This is Olivier's mother. She's working on fighting Ebola to keep us safe here. He was very proud it but he's also shy about telling me Oh, I'm very proud of you mommy, and I'm telling what you are doing because at the beginning, when I first worked in Africa in 2000.. in 2015, my son was very depressed. And I was thinking about oh my god, what I'm doing to my son because it's very tied to me. And he didn't support a lot my absence, because I think I leave home in June 2015. And I go back in December 2015. So this period was very devastating for him. And I begin with a psychologist to make him understand to go forward, and he recovered. And now he is my big supporter. One of the biggest supporter I have. He understand I have loved my work, I have to do it. And he supports me a lot. This is the first person I call when I have a problem. This is the first person I call when I have a minute for me, and this is the first person to come in my head when I'm I am in a bad situation too. So we are very close. And we have a very good relation son to mother and mother to son now.
Melissa Fleming 12:10
You gave a very good segue to the next question I was going to ask which is you arrived in Central African Republic from another very difficult duty station in the Democratic Republic of the Congo, where you were battling one of the most deadly diseases, frightening diseases, Ebola. I remember seeing seeing a film of you travelling into a very remote area. Could you describe how you travelled into the villages and how do you reach people in order to really address the spread of Ebola that was reaching into very remote areas?
Marie Roseline Belizaire 12:49
Well, we use helicopter cars, mortorcycle, bicycle and also we walk too so I cannot imagine now how many times we have cut trees to have places for a helicopter to land. Because we were in the forest and the population were living inside the forest, every time they are going deeper to the forest. And sometimes we have also to work three hours sometimes to which a village and three hours out to come back. And sometimes we go with cars and the road were very very in bad situation.
Melissa Fleming 13:30
I remember in the film seeing you on a motorcycle,
Marie Roseline Belizaire 13:34
That was in euqator. So in this place, we had to use motorcycles. So motorcycles for 160 kilometres a day that we are driving because the the road were very near war, and we have to go through inside the community have this habit of living in the deepest side of the forest and tomorrow, we come back the village it doesn't exist anymore. They go deeper in the forest and we have to go after them.
Melissa Fleming 14:06
So why were they moving like that where they were trying to get away from you?
Marie Roseline Belizaire 14:11
Yes, but and this is also the way of living we learned from them because we have some anthropology studies that help us understand what they are doing. Every time they see a foreigners discover where they are living, they have to leave the camp and build another camp. They are living in very, very small, not houses, small tent that they built with the tree and they go and build another. And we have some cases and between them so knowing we have to vaccinate them, and we have to go to that places to find them to see if they are okay if they are not going to die in the camp if they're not going to be to spread the disease by dying in other village and we have that a lot. In the Ebola outbreak,
Melissa Fleming 15:02
and what happened when you found somebody who actually had the disease, who had Ebola, what did you do?
Marie Roseline Belizaire 15:08
So we call the team and now we bring them quickly to the treatment centre. So in the treatment centre, we do the test if the test is is positive, so we begin of quickly in less than 24 hour with the experimental treatment, we make our contact on tracing again. So we make deepest investigation to find all the contact, we want his person and programme the vaccination in less than 24 hours.
Melissa Fleming 15:38
So you're really in hot pursuit, with a vaccine on behalf of a crusade to stop the spread of Ebola, but it must have been I mean, I understand that you were performing these operations in very unstable regions. So I mean there was a danger to your life from a security perspective, but also this disease is highly I mean, you could have caught it. Were you afraid?
Marie Roseline Belizaire 16:05
I was not afraid to contract Ebola because I knew that I was taking a lot of prevention measure, I always have my, my alcohol solution, my alcoholic solution in my pocket, always washing my hands, not touching people not touching anything one, and I also take the vaccination, and I make sure that my team are taking on the same prevention measure.
Melissa Fleming 16:35
I can imagine that it meant that it must have been quite quite harrowing, though at times. And I know that health workers did come under attack. In fact, one health worker who was very close to you also not just in proximity but a friend. Can you tell? Tell us about what happened
Marie Roseline Belizaire 16:58
well It was one of the saddest things that we had in this Ebola outbreak. So this team was working in one of the biggest Hospital of Butembo. And people were coming all over the area to be assisted in that hospital. Our colleague, Richard Mouzoko was the head of team there in this hospital. And he was having a meeting on this Friday afternoon, when two men entered and shot him to death. So in this this day, I was in one of the worst places the resistance we have where we hide. It is the first day that we will begin vaccination in these places, and I receive a call to tell me that, oh, you should come we have, we have an incident. I don't know. I say we are vaccinating and I was very happy because it was a very good achievement for us. to vaccinate in these places this day, and they tell me no, no, no, you should come, you should come. So I left the vaccination team in I went, and they tell me, one of our colleague was dead. And I say who is let's go to the hospital. And when I go to the hospital, I they didn't tell me the name, or the tell me the name, but I didn't put the name on the face. And when I arrived to the hospital, and I asked to see the body, and I saw that was, was Richard that the day before I was with him in the same hospital, and they show me where the bullet entered and tell me was he's dead and I couldn't say anything. So it was what it was. But the most difficult thing for me after that is to tell the team that we should keep going, that the work was not done yet, that we still have have high number of Ebola cases in the community, and to tell them that we are fighters but fighters, scientific fighters, we are not fighting with bullets. We don't have arms, but our own arms is our knowledge. But at the same times, I had to understand that they need also time for them. So I was giving to the team, a very big, I mean, psychological support. But after the funeral, we managed to have a very big security system in place. We continue engaging with the community. After that, I see the community was compassionate with me. They came to to present their sympathy to present their condolences to me and to tell me that they were sorry about that. And somehow they have protected me it this this go in my car was never broken, even though we have some days 5, 10 cars broken, but mine never. In, in somehow I think there were protecting me also, in that way.
Melissa Fleming 20:14
You've chosen a career in medicine that isn't a comfortable career at all. You've chosen to go to very unstable countries with very weak health infrastructures. Probably the most challenging assignments that one could imagine for a WHO field medical colleague, this must come from somewhere. I know that you grew up in Haiti, what was the environment like when you were a child in Haiti?
Marie Roseline Belizaire 20:44
I was born in Jérémie and but my family is from a very rural and poor area near Malaya. In my early age. My mother took me to Port au Prince when I grew up, and I went I went to a congregational school. And I always have access to information that not all the population has access to it. I was very close to the community and also close to the people of my age. I set up some community groups to share information and also I have a community for cleaners and at the age of 16, I built an organisation for what we call business community, it was for women in order to have autonomy in the nuclear family. I remember because of that, I I met under President Aristide and everyone in my family think that I will become a politician but this changed two years after, after the death of my father. I have to say also that I grew up in Haiti at in a very difficult period after the dictatorial ending in 86. And we begin with this violence in the community. I saw so many violence that death becomes something common. When I was I mean little girl, when someone died in my community, it was a big effort and we have to protect the body and we have to convert, it becomes something sacramental. But in this period, I was going up death because something very common. You see people die. I was going to school with my father, and we see a lot of bodies in the street. We feel in nobody's caring about that. So I think I took my strenth to be in those places. Also from that,
Melissa Fleming 22:45
Probably just not as much of a shock to you, but but you mentioned just, uh, you know, what, you were a young kind of activist, kind of community activist. But you said you lost your father at a very young age.
Marie Roseline Belizaire 22:59
Melissa Fleming 23:00
How old were you and what happened?
Marie Roseline Belizaire 23:02
I was 17 when my father died. Well, I don't know what happened. I'm still looking for what happened. And I think it is the reason why I became doctor. Because in Haiti, nobody is dying by dying with a disease it because of Voodoo, it because someone doesn't like you, it because you do good and we have to eliminate you because you are good people. So I understand with the death of my father, that he was sick. We were there and nobody pay attention to that. The doctor was trying to explain me, but I didn't understand at that time what it is.
Melissa Fleming 23:42
So you didn't you the idea that there must be a scientific reason a medical reason that already struck you and not these...
Marie Roseline Belizaire 23:51
Melissa Fleming 23:51
these ideas that Voodoo was responsible or that the person themselves must have taken yet something that they caused The death yeah even though it was of a disease but there's still a mystery surrounding his death. Tell me what happened afterwards after after his death and what did you do and
Marie Roseline Belizaire 24:11
I stay with my mother and my little sister and brother and my mother was working but it was not enough to support me because our school we are very high prices. And I was very good at school and I went to see the nuns and tell them that I couldn't afford it yet and I need a scholarship and they were very happy to give me the scholarship. So after that, I decided to become a doctor. But in my country is not giving to anyone who wants to become a doctor even though you are good at school. So I didn't enter the National University of Medicine in my country because you need
Melissa Fleming 24:51
you need connections
Marie Roseline Belizaire 24:53
You need connections, exactly, you need linkage but I didn't accept to have a linkage for that. I was doing engineering before becoming med doctor and there was some scholarship to go to Cuba to do medicine.
Melissa Fleming 25:10
And Cuba was known for its medical prowess and expertise and also the export of, of doctors who help people around the world. So you're excited to go there?
Marie Roseline Belizaire 25:22
Yes, I was. I was really very excited to go to Cuba. And it was a very big experience for me. And for my mother, too. She was really happy. And I went to Cuba in 99. And I entered medicine medical school the same year and graduated in 2005.
Melissa Fleming 25:44
But I believe during that time that you had more family tragedy. Tell me about what happened
Marie Roseline Belizaire 25:52
when I was in medical school in the first year in March of 2000. So I receive a Call it was a Tuesday after school to tell me that my mother was dying, had died. And two days ago I was talking to her. She didn't refer to me that she was sick. I know that she was complaining about headache, but everyone has headache. And I was asking what I couldn't. I couldn't return myself. I was crying, crying and crying. And I was the, I Am the elder of the family. So I have to prepare myself on to go back to my country and to arrange everything. In Haiti death is something very, I mean, not the party, but it's something where all the family come even though you have 10 years we didn't see the person when he died who have to come to the funeral. So I have people coming from United State because we have some a family in the United States. And I also have people coming from the Capitol going out to the province. But they didn't help me. I have to do everything by my own. I have to do to go to the morgue, because I have to see to see her because I didn't believe first that she had died. And after that, I have to take care of my of my brother of my sister. Make sure that they have everything set up for the funeral, going to the church, go doing everything.
Melissa Fleming 27:31
What a big responsibility at such a young age. And did you know did they tell you? What was the cause of her death?
Marie Roseline Belizaire 27:39
I never knew. I never knew I never knew what happened to my mother. Actually, this is something I really want to investigate this year for the 20th anniversary of her death. I was planning to go to Haiti to see what's going on there and take advantage of going to my little village and talking to people, talking to those we have close to my mother and ask them what happened if she was sick, what what are the sickness because she didn't go to the hospital. She died at home.
Melissa Fleming 28:13
So you have two mysteries. You don't know how your father died. You don't know how your mother died. And I believe there was another. Another tragedy.
Marie Roseline Belizaire 28:21
And I also have my little sister died the same year that my mother, four months after she was 12 when she died, and I didn't see her, because I went back quickly to Cuba, because in Cuba, they don't have the system of credit. And I heard that my sister was being sick. But she went to the doctor. She told me that she had cancer, but I never see her. She died in July. And when I went to Haiti, the funeral was done.
Melissa Fleming 28:55
It must have been terribly sad for you How did you how did you pick up the pieces and move on? How did you find the strength to? Well keep going?
Marie Roseline Belizaire 29:07
I think I always I always have a vision, since my father died, I said that I should save people around me. And with my model, I think you'd become stronger with my sister is stronger, stronger again to say so, they make me convinced more that something is happening that that should help that my place should be in the community. Why are you dying without knowing going to have structure what what is happening? And my little brother is actually also a doctor. And I'm very proud of that. Because this is one of things I think, I I have to give that for the memory of my mother of my father and all of them. And I also wanted to To make some Memorial Hospital in the name of my model, this is one of the things also I have in mind and I will do at the end of my life at the end of humanitarian life. So I think all those keep me going because it's impossible that people are dying like that. And I'm maybe sometimes when I'm thinking, maybe it is an infectious disease that they have. And they died like that.
Melissa Fleming 30:26
I think you have a lot of lives to save and the many countries that need you around this world and especially during this COVID-19 pandemic, that is just so devastating. Thank you. Thank you, thank you for what you do. And please take care.
Marie Roseline Belizaire 30:46
Thank you. And thank you to you too, for giving me this opportunity. I'm really grateful for that.
Melissa Fleming 30:52
Thank you for listening to Awake At Night. We'll be back soon with more incredible and inspiring stories from people working to do some good in this world at a time of this terrible pandemic. To find out more about the series and the extraordinary people featured, do visit un.org/awake-at-night. On Twitter. We're @UN. I'm @melissafleming. Marie Rosaline is @mrbelasaire. Subscribe to Awake At Night please wherever you get your podcasts and do take the time to review us It does make a difference. Thanks to my colleagues at the UN and to my producers Bethany Bell and the team at chalk and blade. Laura sheeter Fatuma Khaireh and Alex Portfelix. Thanks also to the UN Office for Humanitarian Affairs for its support. The original music for this podcast was written and performed by Nadine Shah, and produced by Ben Hillier. The sound design and additional music was by Pascal Wyse