admire opening a window into unopened questions on how the biggest big lived and how they eventually died our website is aljazeera.com. thanks for joining us, i'm joie chen. it's a welcome announcement. the world health organisation announced that west africa is officially ebola free. there may

be a false sense of security attached to that sigh of relief, even though no new cases emerged in 42 days, something else has. a debilitating set of health problems known as post-ebola syndrome. lisa fletcher with a survivor, a doctor that fought the virus at ground zero. >> it was the height of west africa's ebola outbreak. a medivac plane rushes another american healthcare worker home and into a bio-containment facility. the fate of the doctor was uncertain, as was the care he would receive. there were no proven drugs, no cures. just the grim statistic that ebola can kill up to 90% of the people it infects. three weeks later, the doctor emerged.

25 pounds lighter, physically virus. >> the c.d.c. declared me safe and free of virus. thank god, i love you all. >> reporter: after 15 years of practicing medicine in liberia, with a christian military group, saik ra found himself in the largest outbreak on record. >> reporter: was the ebola outbreak something you thought about previously, or did it take you by surprise as much as it did anyone else. >> we doesn't know we had ebola in the region, it's like having a south american disease pop up. we don't have that here. >> eventually 28,000 in west africa would get ebola. >> he's bleeding a lot. >> 11,000 would die. many of those that survived, including the doctor, would learn that while the ebola itself was gone, there would be lingering and effects.

>> they may have joint pain, muscle pay, anorexia, abdominal pain, hair loss, hearing loss. >> doctor gavin mcgregor skinner is the director of global disaster response and an expert on ebola and other diseases. >> based on history of other highly infectious diseases, we knew there were long-lasting symptoms, we knew people never got back to 100%. we are hearing store why is. >> people can't work, they feel depressed. they have joint pain or problems with my hearing, problems with my ice. >> symptoms that may seam average. when concentrated, point to something more insidious. doctors are just beginning to recognise that thousands who survived ebola may have to deal with long-term complications from an emerging condition known

as post-ebola syndrome. >> it's not until you come back to the u.s. where we have survivors we can focus on using modern medicine that we go wow, can you look at that. that patient has a problem with their eyes. they have hair loss. that lady, that nurse who survived hasn't had her period for months, what does that many. can she have babies in the future, and if she does, will they have ebola. we don't know. >> reporter: for saik ra, the onset was quick. within days of being released, he was rehospitalized with a high fever, terrible costs and loss of vision in his left eye. all the while, sacra worried that thousands in west africa were probably experiencing the same syndrome unaware and geographically beyond the reach of modern medicine. >> before i got out of the hospital in nebraska when i was

sick, i was thinking about i wander how long it will take before i'm back in liberia. >> he's been back to liberia four times. serving a region suffering the aftereffects of the ebola virus in an environment of poor uncertainty. >> it's a failure of systems, it's a weak health care system ebola. >> what system. with. >> that's right. you see the signs, stop ebola, fight ebola. we are not telling the community anything. that. >> to keep ebola at bay and win the war on post ebola syndrome in west africa, education and dispelling myth like ebola key. >> we knew there was not enough physicians, nurses, hospitals. let's use ebola, the most acute

greatest public health emergency we had in recorded history. let's use it as the string board, the platform for doing things that are right. >> and that, he says, begins with getting sick west africans to trust their doctors. >> how do you develop trusts, management skills to manage the fantastic staff that you have, and the brick and mortar hospitals you have to gain the trust of the whole community and be able to diagnose, detect, are sick. >> reporter: skinner says that is important now, because they have more to worry about than post ebola syndrome. there's evidence that in some survivors the virus can hide, avoid detection methods, and possibly be transmitted through mucus, faeces , breast milling.

. >> we found live virus 63 days after he recovered. it's gone to 75 days, and another paper came out 270 days. >> so no one knows. >> we don't know? we have papers where we found viable virus in the breast milk. >> what does that do to the baby consuming it. >> when we talk of long-lasting symptoms, we have little knowledge of what happens in children that survived with ebola. >> reporter: another component of post-ebola syndrome, post-traumatic stress disorder, nightmares, depression. skinner says the mental health component of living through a virus decimating communities cannot beunderestimated. >> these patients are going to have long-lasting symptoms for years. how do they get a job, how do they earn enough income to look after their children, their family. the challenges are not over.

this is not over by any means. >> for sacra, that is the tart. his focus when he gets to africa, help build a system including comprehensive care, and a residency braining programme to teach doctors to combat infetchous diseases and everything they leave behind like post-ebola syndrome. >> we have specialists. there's no cardiologist, no neurologist. there's no m.r.i. there's a range of support that the nigeria health system needs at this point. >> you had a brush with death, and you put yourself back into harm's way. you've been back a number of times, and are going back in a number much weeks. why? >> liberia is my second home. these are my people. i mean, i lived there a long

time and viewed this as my hospital and the place that god put on my heart to serve. they say when you are there that the dust gets in your shoes and makes it so you can't forget. that is in your shoes. >> "mork arnd mindy." is he okay now. >> he's doing well. he's back to normal. he feels 100%. he's heading back to africa. for the fifth tim since he fell ill with ebola. >> why does he want to go back. anyone would look at him and say life. >> he looked like me like i was a crazy person. it was in his heart, his being, that's where he feels he was called to be. his next chaptor is to create a residency programme for young

doctors there. that doesn't exist now. so part of the hospital where he works, they want to develop that, and dratrain up family doctors, and they are a lot different to family doctors at home. there they do prenatal care, they deliver babies, they take care of h.i.v., and they take care of ebola, it runs the gambit. it's comprehensive training, he wants to be a part of it. >> they don't have the complex technologies or equipment that makes it possible. >> how crazy is that. in the piece where he says there's no m.r.i., no working cat scan in the country. >> it's mind numbing. they have a lot of compensating to do in that area, in terms. medical equipment. he hopes when they train the nurses, doctors and spr staff, that may be -- support staff, that may be some.

way. >> without that equipment, practice, is there a way for authorities to track how many syndrome. >> it's hard. they have 17,000 survivors. of that number, there's no idea how many may have the symptoms, they can be regular, a person may not associate it with having had ebola. the hospital and the doctor are part of a three-country study where they are monitoring pregnant women who are ebola survivors. they are hoping helpful information will come out. >> what are the information from that, if you don't know you are suffering post-ebola system, you have another result? >> it's unclear. they don't know the degree to which the symptoms affect a person. it could be minor, like vision loss.

they don't know what the treatment is for various things. if you don't know you have it, you are not going to a doctor, it will not be addresseded. >> later in the programme, you'll talk about the implications of what happens when the virus is in the body. >> which is different from post-ebola syndrome and more dangerous. >> we'll see that shortly. thanks. >> at 9:30 - "america tonight" - top investigative reporting, uncovering new perspectives. >> everything that's happening here is illegal. >> then at 10:00 - it's "reports from around the world". >> let's take a closer look. >> antonio mora gives you a global view. >> this is a human rights crisis. >> and at 11:00 - "news wrap-up". clear... concise... complete.

another health scourge we have been following on "america tonight", the rise of heroin addiction. united states. it travels along a trail that begins in deep south america. adam raney followed the journey from its source. >> here in the sierra mountains of mexico, the wrong violent and deadly trade in heroin begins. we meet this farmer who leads us to the family plot. her husband tends the poppies, the key source for heroin. >> it's the smugglers who are the richest, the farmer is the poorest. it's like being a slave. >> mexican farmers seed more and more poppy fields to keep up with the scope demand for heroin in the u.s.

mexico sees five times as much poppy last year as compared for the year before that. now it rivals that of columbia. the southern state is a leading producer of raw poppy sap. once collected it's processed into high grade heroin. it's delicate, time inform consuming work, but the payoff is higher than for legal crops like avocado. the farmers face threats and communities. whether we want to or not, if we didn't grow this. more than anything else we do it out of necessity. if my parents didn't works here, we didn't have anything to eat. they say men show up three times a year to buy the sap. farmers say they have to agree whatever prices are set. suicide.

>> that would be like putting a gun to my head. >> poppy farmers can earn hundreds a day in the high season. community leaders say they'd prefer to grow fruit and vegetables. drug trafficking and poppy cultivation has grown. the government never supported poor people. >> no support, but there's punish. fumigation has been stepped up. the result, whole fields of poppies lost. sometimes neighbouring fields are damaged. the harvests are getting bigger. by the time heroin hits the streets of the united states, every one along the supply chain makes money, and the dealers know which downs to

follow. heroin. >> you can put a lot of heroin in here. inside the trophy room, veteran officers teach new recruits to spot drugs. soft drink bottles, gas tanks and fire bottles used to slash iran. just over the border of arizona, he is alerted to a drug bust. a special agent with homeland security, his job is to rings. >> 2012, we have 5 kilos. 2014, we have two numbers. his team intercepts drugs every day, like we did when we rode with them. and it doesn't stop the flow of heroin. with so much funny in play, the cartels are watching too.

>> that is mexico separated by the border fence. >> as you can see the blocks, houses, residences have a direct line of fight. running into the operations. they can see what is going on, leaving. >> smugglers told al jazeera, there are many ways to get the drugs past the wall. sometimes tunnelling under it. sometimes walking across. and heroin is so valuable even in small amounts you don't have to take it over the border in cars. more and more officials are seeing officials walk it from here and mexico over to the united states. sometimes they are seeing it strapped to old people's bodies and young children for every pound that we stop coming in to the united states, there's at least 100 pounds more that we don't stop. >> so it's a drop in the bucket. he says he's one

of the last lines of defense before drugs get on the highways. mexican drug producers are lining up to feed that appetite. this town is in the grip of an epidemic. heroin powerful and cheap is ravaging the city. >> we got out of a friend of mine's house. >> in a hotel parking lot. dale describes how he almost christmas. >> they thought i was dead. >> fellow addicts left him on the ground. a passerby recognised him, calling his mother just in time. kathy steven's daughter was not so lucky. 23, she died from an overdose in

november, leaving behind a 3-year-old daughter. >> it's like a plague. that's the only thing i can liken it too. people are just dropping left and right, dropping dead. and the sad thing is people that are already addicted to it, it's hard to help them when we don't have a treatment option here. >> for more than a decade wijnaldum suffered from a devastate -- west virginia suffered from a wave of abuse. now addicts, like all ages and classes turn to heroin, often because it's cheaper. people tell us that heroin is everywhere. in fact, the other day a man was found dead in the bathroom of this restaurant with a needle in his arm.

>> in a church outside, we met a couple addicted by heroin. they want to stop, but shoot up every day to feel normal. >> when ever you wake up, you need it to function, to move. >> john saw his girlfriend nearly die many times. she wasn't breathing. i held her, took a deep breath and blew into her mouth. she started shaking. >> i don't know how to break free from it. every day this woman faces addiction. many of the newborns she streets

are born adingts. >> there's a tidal wave coming. it's sort of here. unless something is done, yes. it could be the biggest population in the future. absolutely: and while mexico's poppy fields flourish, america's epidemic will continue to grow

earlier in the programme. "america tonight"s lisa fletcher

is introduced to post-traumatic stress disorder. conditions that range from hair lose to fatigue and joint frame, hearing and vision problems, a result of surviving ebola. now we learn doctors discover something more dangerous. people that have been cured, may carry the killer virus inside them. lisa fletcher follows up with a preview of a story and an ebola survivor, who beat the twice. >> reporter: one of the sickest ebola patients treated in the united states was dr ian coezer, an infectious disease specialist. who was treating patients from sierra leone. he was overcome within a month with symptoms he knew too well. >> if you told me on day one, that a week later i will develop multicm organ failure. brain failure,

respiratory failure. kidney. it probably would have been zero. it's very port nate to be alive. >> the viral likelihood in hits blowed was more than that. two months after being released the virus which no longer appears in the drug or urine, made an oncourt americans. a few days after that we sampled the virus. it was present at high levels.

the original load being 100 times more. it was hitching a ride quietly. unbeknownst to any of us. until i developed the inflammation in the eye. >> and your eye changed colour. >> one day i woke up and my normally blue eye was yooen. >> the virus found a hideout in part of dr coezer's body, which shouldn't have been accessible to ebola. >> my eye was a bit of a canary in a coal mine. we learnt that the virus can hi hack the privileged spaces. the eye is one of them. >> in what parts of the body would ebola be discovered among survivors. can they transmit the disease. would the community have the resources to test and treat any numbers of the survivors. >> logistically, how do the folks get the medical attention they need.

luckily you are here in the hands. >> there are a number of survivors and see if many of them are realising the fact that it's not over, even though it's supposed to be over. there is a great need to pay attention to them. some of that attention is difficult, and requires expertise. and requires facilitation of them being cared for and seen and so i think increasingly there's a number of people thinking about how best to do that. i fear that as we approach the last tenth of the last file of active transmission, e want that's "america tonight"s lisa fletcher. >> how much does the community know about in re-emergence. will solutions be discovered in

time to help those that are thousands of miles away. >> next deuce, join us as dr coezer joins us in a journey in an i.c.u. unit. details of his relapse and what is ahead. as he rightside a concern to return. that's "america tonight", tell us what you think. talk to us and come back, more >> our american story is written everyday. it's not always pretty, but it's real... and we show you like no-one else can. this is our american story. this is america tonight.