How Doctors Convinced A Street Gang To Agree To A Quarantine In 2015, health workers in Liberia faced a challenge. They had to figure out how to quarantine a street gang that could be spreading Ebola at the height of the epidemic.

A Gang Killed A Guy With Ebola. Will They Agree To Be Quarantined?

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And I'm Steve Inskeep with the kind of true story that could be sold for a movie script. Police discover a body in a warehouse. It's a young man who's been stabbed multiple times. They swab that body, and it tests positive for a deadly infectious disease. Investigators realize that the people who killed him, members of a street gang, may now be spreading the virus without knowing it. This actually happened in the West African nation of Liberia in 2015, and the deadly disease was Ebola. NPR's social science correspondent Shankar Vedantam tells us what happened next.

SHANKAR VEDANTAM, BYLINE: As soon as public health workers realize that Ebola might be incubating in a gang in the city of Monrovia, the first thing they had to do was track down the members of the gang. That turned out to be easy. The hard part was convincing the members to quarantine themselves for 21 days. The young men, like many Liberians, were skeptical of international aid organizations, as well as their own government.

FRANK MAHONEY: The government had attempted involuntary quarantine, and they had a really bad experience in the slums of Monrovia.

VEDANTAM: Frank Mahoney is an epidemiologist with the Centers for Disease Control and Prevention.

MAHONEY: This is not something that's going to build trust in the community. It's not a way to manage the outbreak.

VEDANTAM: Many Liberians also worried that if they did go into quarantine, they would never come out. It didn't help that the nation's largest Ebola treatment unit was initially built without an exit.

ATHALIA CHRISTIE: They didn't build an exit because we weren't thinking about survivors at that time.

VEDANTAM: Ophelia Kristie is one of the CDC officials who traveled to Liberia to respond to the outbreak.

CHRISTIE: Many people, understandably so, thought that going to an Ebola treatment unit meant that you would not come home.

VEDANTAM: Adding to this epidemic of fear and mistrust was another fact - the police wanted to arrest the gang members in connection with the stabbing victim's death. Here's Liberian epidemiologist Mosoka Fallah.

MOSOKA FALLAH: The police wanted to go in. However, if we allowed the police to go in, the gangsters will escape, and we'll have pretty close to 35 young men who are all high-risk contact on the loose.

VEDANTAM: So the public health workers convinced the police to stand down. They then offered incentives for the gang members to quarantine themselves. Frank Mahoney again.

MAHONEY: You know, the CDC, I think we ended up paying their families some support costs because they were no longer able to earn money for their families.

VEDANTAM: But even this was not enough. It turned out some of the young men were addicts, and they needed drugs so they wouldn't go into a draw.

MAHONEY: They needed treatment. It wasn't a conventional treatment, that's for sure.

VEDANTAM: It was odd for public health officials to be sanctioning illegal drug use. But when you're in the middle of an unfolding catastrophe, you sometimes have to bend the rules and, in this case, build trust. To be clear, the CDC did not provide anyone illegal drugs, but the arrangement did produce a lot of double takes. One day, a Liberian government minister turned to Frank Mahoney during a discussion and joked about the backdoor drug channel.

MAHONEY: And he says, and I understand that CDC is providing them with the marijuana. And I said, excuse me, sir. I said, I'd like to correct that. I said, CDC is not providing the marijuana, but we're providing the cocaine.

VEDANTAM: Incredibly, the epidemiologists did manage to convince most of the gang members to go into quarantine. These were young men whom no one thought would listen to the authorities. But by reposing trust in them and treating the young men as partners, the public health officials had a method that seemed to work better than coercion or trickery. Still, there was one member of the gang they could not track down. During the fight, he'd held down the stabbing victim as the blades came out and the blood splattered. And now, Frank and the others found, he'd run away.

What was his name?

MAHONEY: His name, ironically, was Time Bomb.

VEDANTAM: That's right - Time Bomb.

FALLAH: Time Bomb became very elusive. We could not find Time Bomb.

VEDANTAM: At first, the gang members did not want to tell Frank Mahoney or Mosoka Fallah where Time Bomb was.

FALLAH: But as we built friendship and rapport with the other criminals, one of them took us to his house.

VEDANTAM: There, they found a young man, a young woman and a baby. The public health researchers asked the young man if he was Time Bomb.

FALLAH: He said, I'm not Time Bomb. Time Bomb has gone out. I'm his younger brother. But if he comes back, I will let you know. Then I said, OK, thank you very much.

VEDANTAM: It was at this point that Mosoka Fallah did something that led to a breakthrough in the case.

FALLAH: The wife had a young baby, and I remember giving the wife a hundred dollars and saying, go ahead and buy milk for the baby. Feed the baby, and we'll take care of you.

VEDANTAM: Something changed in the young man's demeanor.

FALLAH: After I did that, he turned to me and said to me, I am Time Bomb.

VEDANTAM: Mahoney and Fallah told Time Bomb and his wife that they would be back that night. They promised they would return with more food.

MAHONEY: I went with Mosoka, and it was like 10 o'clock at night.

FALLAH: This was, like, a slum community. It is known to have gangsters. And that's why Frank was emphasizing that we had to keep our word. They had to trust us.

VEDANTAM: This was the key.

MAHONEY: So we brought food to him and his family - I think a couple sacks of rice and things.

FALLAH: For some reason, they trusted us. And they came to the car and helped us take the rice.

VEDANTAM: Mahoney and Fallah gently asked Time Bomb whether he would be willing to come to the Ebola treatment facility to be quarantined. Time Bomb wasn't ready for that. The public health researcher said they understood and that they were willing to trust him to do the right thing.

FALLAH: If you get sick, you call us. And he said, I will do that; I trust you guys.

MAHONEY: And so I think it was a matter of building up a trust and comfort level for him to talk to us.

VEDANTAM: In the end, none of the young gang members contracted Ebola, not even Time Bomb. The cluster did not spread in this poor part of Monrovia. Building those invisible but very real bonds of trust took time, but the CDC's Athalia Christie says this was essential to stopping an outbreak.

CHRISTIE: You're asking people to leave their friends and family for 21 days, or we were asking people to change their burial customs, and it's difficult. It can sound simple, and I know that I spoke to people here who would say, I don't understand. Why can't they just change the way they care for their family members if they're sick? But as a mother, I can't imagine not touching my child if he was sick. So it's about interpersonal relationships. You have to be honest and straightforward about what you need and why and, most importantly, I think, you need to be human.

VEDANTAM: Shankar Vedantam, NPR News.

INSKEEP: Shankar is host of the podcast Hidden Brain.

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