On the ground fighting Ebola

Last week, I flew to Sierra Leone to help our team scale up our response to the Ebola outbreak, which has claimed more than 1,000 lives to date and affected hundreds of thousands more.

As a senior manager for GOAL, I’ve traveled a lot in Africa. Like anyone who has done so, I have spent at least some of that time journeying on heaving roads laden with long lines of trucks and other vehicles, all blowing up huge clouds of smoke and dust. It can be quite a shock to the system.

In Sierra Leone, the contrast couldn’t have been any starker. We drove from the capital, Freetown, to Kenema in the east of the country — a six-hour trip — and the road was almost deserted. This is because Kenema, one of the areas most affected by the Ebola epidemic, is currently a restricted zone due to a state of emergency. The only people being allowed in or out are officials and humanitarian workers.

The movement restrictions are necessary, but inevitably there is a knock-on effect. For instance, trade is being severely affected. As well as dealing with the spread of the disease, the town is suffering badly from depleted supplies and crippling inflation. Livelihoods are being destroyed, and so the most vulnerable suffer even more.

At first glance, life in Kenema itself seemed to be normal, but you don’t have to scratch too far under the surface to see there’s more than meets the eye.

We met with one of our local partners. At first, it looked like they were sharing their offices with a school. It was only later that I learned that some of the children in the classroom were Ebola orphans. Tragically, these kids had lost one or both of their parents to the virus. Some of the children had survived the disease themselves and had been released from the isolation wards.

People on the front lines at extreme risk

GOAL is currently caring for more than 50 of these boys and girls in the Kenema area whose guardians (be they parents, older siblings or other relations) have died from Ebola. Apart from the obvious trauma caused by losing a loved one, these children need to be cared for and ultimately united with adoptive families.

I spoke to a brother and sister named Junioro and Martina. They had lost their dad while their mother was being kept in isolation in the Ebola unit. The case of the father, a local police inspector, showed how people on the front line are at extreme risk of infection. We have already heard about Dr. Ummar Khan, the doctor who had been leading the fight against Ebola in Sierra Leone until he contracted the disease himself and died.

Dr. Khan’s name came up in conversation later when I met a survivor of Ebola called Kadiatu Nyarkoh. Kadiatu’s husband was an ambulance driver in Kenema’s hospital when he caught the virus. He was one of the first hospital staff members to die from Ebola. Kadiatu’s eldest son also perished after becoming infected through close contact with his dad, and another five members of her extended family are likewise now dead.

While I was speaking with Kadiatu, I noticed she was tightly holding a crumpled sheet of paper. When I enquired what it was, she told me that it was the certificate that proved she was given the all-clear from the virus. Despite being released from hospital a few weeks ago, she has held this letter close to her chest every day since. It is not difficult to understand why, as it represents, in effect, the lifting of a death sentence. To Kadiatu, however, it means so much more than that.

"It meant I could embrace my children again. At least those that are left to me,” she told me. And as if to emphasize how fortunate Kadiatu has been, her letter was signed by Dr. Khan, apparently just days before he succumbed to the disease.

Long-term response needed

The response to tackling Ebola continues to focus on treatment, prevention and education. This is appropriate and it should remain that way until the virus is eradicated — but there is a slow realization building that the disease will leave a devastating legacy in countries like Sierra Leone.

For example, the country’s health system has almost completely broken down and will likely take years to recover. Health services in Sierra Leone — one of the poorest countries in the world — were already fragile to begin with. The deaths of key medical staff and the breakdown in trust between poor communities and health services will take a huge toll on the country.

The crisis is already having a hugely negative impact on the national economy. The declared state of emergency means that markets are not working and goods are not flowing as they normally would, not just in Kenema, but in many others parts of the country, and so inflation is having a crippling effect.

GOAL is working hard to provide support to people affected by Ebola in the form of food, clothing, sanitary materials and some cash. We are educating communities and people working on the front lines, such as the police force, and we are training heath educators and providing material to support their work. We will do everything we can, but the international community must not take their focus off this virus for a second.

We all need to work together to stop further transmission of Ebola and eradicate the disease in the region. This will take time, perhaps months, but it must be done, and even then we must stay with the people of West Africa.

The biggest task will be to help the country recover, long after the outbreak is over. To achieve this, we will need to strengthen the countries’ failing health institutions; care for the most vulnerable who have lost parents, breadwinners or guardians; protect survivors who face being stigmatized; and finally, ensure that all affected countries are better prepared in the event of a future epidemic.

There is a lot of good work done, but there is a lot more to do.

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