Tag: Liberia

Families left haunted by Liberia’s Ebola crematorium

Bystanders watch as a suspected Ebola victim waits to be transported from Devils Hole North, west of Freetown. (Pic: Reuters)
Bystanders watch as a suspected Ebola victim waits to be transported from Devils Hole North, west of Freetown. (Pic: Reuters)

Brian Lomax (26) sleeps on a pile of bones – the remains of cremated Ebola victims whose relatives may never get the chance to collect.

He was hounded out of his community by neighbours who feared his work at the Margibi crematorium in Boys Town, Lower Margibi county, was helping to spread the disease rather than contain it. This is the only place he has left to go.

Lomax is just one of many Liberians whose lives have been altered by the cremations at Margibi, which came to an end in December after a burial site was found for new victims.

For authorities and health workers, who believe they are now beating back the virus, the cremations – an alien and unwelcome practice in Liberia – were a successful measure that helped contain the disease.

“Cremation is not our culture. It was due to necessity that we had to cremate people, but it worked very well,” said Tolbert Nyensuwah, head of the government’s Ebola task force.

However, over the past four months, waves of protests have taken place against it. Those who worked at the facility are left facing stigma, and the relatives of those who were cremated have no graves for their loved ones.

Liberia was the country hardest hit by the Ebola outbreak, which has now claimed over 8 500 lives. In the midst of the crisis, disposing of the bodies of victims quickly and safely had been, and remains, paramount, as the bodily fluids from the corpses can still transmit the virus.

By August last year, Liberia’s government was struggling to keep up with the rising death toll. Underpaid, under-equipped and overworked burial workers couldn’t cope. When teams clad in space-man like protective suits came to collect victims, terrified residents often chased them out.

‘Nights of terror’
When members of Margibi county’s Indian community, which ran the Margibi crematorium 50 miles from the capital, offered to help, it seemed like an obvious solution. A group of Liberians were quickly taught how to carry out the Indian cremation method to dispose of the bodies.

Sometimes up to a hundred bodies were burned at once. Members of the community living nearby reported huge explosions as it burned with smoke rising through the air. Disturbed by the process, they called it ‘nights of terror’.

The burial process and honouring deceased relatives is an important tradition in Liberia, and often involves touching the body of the deceased. On decoration days, crowds visit cemeteries to clean and decorate the graves of relatives. The cremations, which were often rushed and en masse, left many relatives alienated, and often unable to locate and identify the remains of their loved ones.

Lomax, a student who had never worked in a crematorium before, was one of those who volunteered to work at the crematorium. “[We] opted for it because we had to do a service to the country because no one wanted to do such a work,” Lomax said.

“When they [the government] got here, they put us together and told us that this issue was an emergency issue, so we did not discuss anything with them,” he said. “All of a sudden they started the method that the Indian people taught them. They started training us on the method to carry out the cremation.”

The process of cremation burns corpses, but the bones then have to be ground to a powder afterwards – a stage that was neglected in the Margibi crematorium.

“All these containers are filled with human bones and because we have nowhere to go, we sleep with the bones [inside this] fence,” Lomax said, pointing to a row of steel drums which he and his colleagues were placing wooden planks over to form makeshift beds every night.

In August 2014 President Ellen Johnson Sirleaf decreed that the bodies of Ebola victims be cremated: “this measure is intended to avoid tampering with the dead and contaminating water sources”, she said.

But promises that the ashes of Ebola victims would be handled respectfully and returned to family members quickly unraveled. The overwhelmed workers at Margibi didn’t know what to do. Some days, dozens of corpses arrived. Hundreds are thought to have been cremated at the site between August and December.

“This is the largest altar where we burned 145 bodies. The ashes were too much, and we had nowhere to put them. [Back] then we had no knowledge of bringing in drums,” Lomax explained, referring to the steel drums brought in by the government when they decided to preserve the ashes.

“So we just wasted [dumped] it in these holes. Later they decided that we use the drums,” he said. For those whose bones and ashes could not make it into the zinc containers, their bones are all dumped in a pit resembling a mass grave.

“This is how people who died from this deadly disease were treated here,” said Lomax.

Bones lie waiting to be claimed
The Boys Town community called for all cremations to stop, and eventually a new burial ground was found on Disco Hill, also in Margibi County, where Ebola victims will be interred from now on.

Bone fragments are seen in a barrel of the cremated remains of Ebola virus victims in Boys Town on January 9 2015. (Pic: Reuters)
Bone fragments are seen in a barrel of the cremated remains of Ebola virus victims in Boys Town on January 9 2015. (Pic: Reuters)

The bones now sit in silent rows, unmarked for any relatives who might want to claim them back. The only clue to the identity of those who remains are stored inside are the dates scrawled on the side of each container.

Lomax has been outcast for his work at Margibi, believed to be the country’s only crematorium for Ebola victims.

“My father has his house right behind here but he told the children I shouldn’t go there because I am working here and burning Ebola bodies. He said he does not want me to carry the virus to his house,” he said quietly.

Just over a month ago, their bosses stopped coming to work and he worries about money. He and his colleagues fear they may never reintegrate into society.

“For the past three weeks we have not seen our bosses. After all that we have done, at least we should have been settled [paid].”

Tibelrosa Tarponweh, a local resident, called for counselling services to “ be provided to members of the community, including a select few that were hired without proper guidance to perform such an abnormal task.” He said the lack of training for Lomax and his colleagues had led to a “sloppy and harmful” process.

He called for the government “to secure and preserve the now-defunct crematorium for use as a shrine in memory of our fallen compatriots.”

Wade Williams and Monica Mark for the Guardian Africa Network

Buckets and soap – birthday gifts for a president in an Ebola zone

It has been a vexing problem for courtesans of queens, princesses and the powerful throughout history – what do you get for the woman who has everything?

For the guests celebrating the 76th birthday of Liberia’s President Ellen Johnson Sirleaf, the answer was straightforward: a few buckets, some bars of soap and gallons of disinfectant.

A head-of-state might normally blanche at such a thrifty tribute, but Ebola-hit Liberia is living in strange times and Sirleaf was more than happy, according to an official statement on Thursday’s celebrations.

“She noted that the commemoration of her birthday should be a moment of reflection for all Liberians and partners standing up together in the difficult period to fight the Ebola,” Sirleaf’s office said, expounding at length on the austerity of the occasion.

The gift came from an association of former pupils who had travelled from an agricultural school 70 kilometres  east of the capital Monrovia to wish their leader many happy returns.

“We will join the government in fighting and driving away this pandemic that has attempted to devastate our country – but our country will not be devastated,” alumni representative Kenneth Best said in a stirring speech quoted by the presidency.

A man pushes a wheelbarrow containing a woman thought to be a victim of the Ebola virus at the Ebola treatment centre at Island hospital in Monrovia on October 2 2014. (Pic: AFP)
A man pushes a wheelbarrow containing a woman thought to be a victim of the Ebola virus at the Ebola treatment centre at Island hospital in Monrovia on October 2 2014. (Pic: AFP)

If Sirleaf didn’t feel like breaking out the champagne, it is hardly surprising. Her government is leading the fight against an Ebola epidemic that has killed almost 5 000 people in west Africa, around half of them in Liberia.

Her office was at pains to point out that the presidential birthday was a time for sombre reflection rather than wild celebration.

Sirleaf received well-wishers throughout the day in her austere office in the Foreign Ministry, including members of her cabinet, the chief justice and senior officials in the governor of the central bank.

But it wasn’t all doom and gloom, for the gathered guests, who recited poems and belted out birthday songs, according to the presidency.

One senator even brought news that he had managed to sign four financial bills into his county’s local laws, “as a present for the Liberian leader’s natal day”.

Alpha Kappa Alpha Sorority, a US-based worldwide association of African-American female students and its male equivalent, Alpha Phi Alpha Fraternity, presented Sirleaf with a cake decorated with a presidential portrait.

Ebola threatening Liberia’s existence, minister warns

Health workers at ELWA's hospital isolation camp in Liberia. (Pic: Reuters)
Health workers at ELWA’s hospital isolation camp in Liberia. (Pic: Reuters)

Ebola is threatening the very existence of Liberia as the killer virus spreads like “wild fire”, the defence minister warned Tuesday, following a grim World Health Organisation assessment that the worst is yet to come.

After predicting an “exponential increase” in infections across West Africa, the WHO warned that Liberia, which has accounted for half of all fatalities, could initially only hope to slow the contagion, not stop it.

“Liberia is facing a serious threat to its national existence,” Defence Minister Brownie Samukai told a meeting of the UN Security Council on Tuesday.

The disease is “now spreading like wild fire, devouring everything in its path,” he said.

The WHO upped the Ebola death toll on Tuesday to 2 296 out of 4 293 cases in Liberia, Sierra Leone, Guinea and Nigeria as of September 6. Nearly half of all infections had occurred in the past 21 days, it said.

The agency also evacuated its second infected medical expert, a doctor who had been working at an Ebola treatment centre in Sierra Leone.

Emory University Hospital in the United States admitted an American on Tuesday who had contracted the disease in west Africa, but declined to confirm whether the patient was the WHO employee.

The hospital has successfully treated two other infected US nationals.

Ebola, transmitted through bodily fluids, leads to haemorrhagic fever and – in over half of cases – death. There is no specific treatment regime and no licensed vaccine.

The latest WHO figures underscore Ebola’s asymmetric spread, as it rips through densely populated communities with decrepit health facilities and poor public awareness campaigns.

Speaking on Tuesday, WHO’s epidemiology chief Sylvie Briand said the goal in Senegal and Nigeria was now “to stop transmission completely”. Senegal has announced only one infection, while Nigeria has recorded 19 infections and eight deaths.

The Democratic Republic of Congo is battling a separate outbreak which has killed 32 in a remote northwestern region.

“But in other locations, like Monrovia, where we have really wide community transmission, we are aiming at two-step strategies,” Briand said in Geneva, “first, to reduce the transmission as much as possible and, when it becomes controllable, we will also try to stop it completely.

“But at this point in time we need to be pragmatic and try to reduce it in the initial steps.”

A day earlier the WHO had warned that aid organisations trying to help Liberia to respond would “need to prepare to scale up their current efforts by three- to four-fold”.

Before the current outbreak, it noted, Liberia only had one doctor for every 100 000 patients in a population of 4.4 million.

In Montserrado county, which contains Monrovia, there are no spare beds at the few Ebola treatment sites operating, the WHO said.

It described how infected people were being driven to centres only to be turned away, return home and create “flare-ups” of deadly fever in their villages.

It said 1 000 beds are needed – far more than the 240 currently operational and 260 planned.

Guinea’s President Alpha Conde described Ebola as a “war” his nation – with 555 dead so far – needed to win.

He slammed neighbouring states including Côte d’Ivoire and Senegal for shutting their borders, and airlines for suspending flights to affected countries.

“They forget that when you close borders, people just go through the bush. It’s better to have official passages of transit,” he said.

African Union commission chief Nkosazana Dlamini-Zuma also called Monday for travel bans to be lifted “to open up economic activities”.

In Gambia, customs officials said Tuesday they had closed the borders to Guineans, Liberians, Nigerians and Sierra Leoneans – though not to neighbouring Senegal.

“We are also advising Gambians intending to travel to these countries to cancel their trips, but any Gambian who fails to heed our advice, we will not allow you in the country if you return,” Ebrima Kurumah, a health officer posted at the border with Senegal, told AFP.

There were restrictions further afield, too. China, one of the region’s main investors, announced on Tuesday it was reinforcing checks on people, goods and vehicles – and even mail – arriving from affected countries.

Meanwhile, Italy announced its first possible case of Ebola – a woman recently returned from Nigeria.

Ebola taking toll on West African economy

Locals in a market in Kenema, Sierra Leone. (Pic: AFP)
Locals in a market in Kenema, Sierra Leone. (Pic: AFP)

The worst-ever outbreak of the Ebola virus is taking a heavy toll on West Africa’s economy as crops rot in the fields, mines are abandoned and goods cannot get to market.

The epidemic has ravaged the region since it erupted in the forests in the south of Guinea earlier this year, killing 1 427 people and infecting thousands more.

On Friday health officials said the fever had spread to every corner of Liberia, the worst-hit country in the grip of the epidemic where 624 people have died so far.

But beyond the mounting death toll, the disease is also undermining the region’s economic growth and threatening the long-term development of some of the world’s poorest countries.

“It is a total catastrophe. We are losing lots of money,” said Alhaji Bamogo, who sells clothes in the market in the Liberian capital Monrovia.

“All those who are coming to the market come only to buy food or products for the disinfection of Ebola,” he said.

Economic crisis
Across the resource-rich countries of Liberia, Sierra Leone, Guinea and Nigeria, companies are suspending operations due to fears of the haemorrhagic fever, which is spread through contact with bodily fluids.

Steel giant ArcelorMittal this month said the contractors at its expanding iron ore works in Liberia had suspended operations and were pulling out staff.

Several international airlines have halted their flights to west Africa in a move that Moody’s ratings agency warns “will exact an economic toll” on the region.

And in Nigeria, Africa’s top oil producer and most populous country where 15 cases have been identified and five people have died, experts warn that the impact for the regional economy could be dire if the disease takes hold.

“The Ebola epidemic is not just a public health crisis, but an economic crisis… affecting many sectors of activity,” the president of the African Development Bank, Donald Kaberuka warned this month.

Too dangerous to invest
Philippe Hugon, Africa research director at the French think-tank IRIS, said the biggest threat for west Africa is a long-term pullout of global companies that the region relies on.

“Everything depends on whether this stays limited or whether the epidemic continues to spread in a prolonged way. The heads of foreign businesses on the ground are very concerned,” he said.

The epidemic may “reinforce the idea that Guinea, Sierra Leone and Liberia are countries where it is dangerous to live — because of diseases like Ebola and AIDS — and thus to invest in,” he said.

The disease is also exacting a direct economic toll on the countries where it is spreading by sapping already stretched government budgets.

Moody’s warned it will squeeze state coffers from all sides, by forcing both “increased health expenditures, and… an Ebola-induced economic slowdown on government revenue generation”.

This month the African Development Bank pledged $60 million to support the over-stretched health systems of the four affected countries.

Critics have accused west Africa’s governments of being slow to admit the extent of the problem because of the cost of deploying resources to fight the disease.

Amadou Soumah, a trade union official in Guinea, which only last week declared a national emergency despite being at the epicentre of the outbreak earlier this year, said the government had played down the crisis “to stop investors fleeing”.

And now “Guinea is going to deploy its forces along the border to rack up even more spending,” he added, referring to the closure of its frontiers with Liberia and Sierra Leone.

Food shortages
For people on the ground, the epidemic has created an even more pressing problem: food shortages.

In the markets, supplies of staple commodities such as rice are already dwindling, with only the bravest traders willing to venture far afield to buy stocks.

In quarantined zones in Sierra Leone and Liberia, key cash crops such as cocoa and coffee have been left rotting in the fields as farmers fear to stray far from home.

“People are going to move around less and less,” said Philippe De Vreyer, a specialist in west African economics and professor at the University of Paris.

“For instance, the man who usually goes to the local market to sell his vegetables will decide to stay home. People are not going to get their supplies, with all that entails.”

In Nigeria, even though it is the least hit by the epidemic, Ebola fears are already keeping people indoors.

So far the epidemic has not threatened the economically vital oil industry, which is centred in the southern Niger Delta about 1 000 kilometres from Lagos, where the cases have been found.

The service industry is feeling the effects, however.

“Bookings to hotels have dropped by almost 30 percent so far this month, as have orders for food and drink for large social gatherings like weddings and funerals,” said Bismarck Rewane, head of the Lagos-based Financial Derivatives Company.

Zoom Dosso for AFP

Ebola epidemic sparks state of emergency across West Africa

A fast-spreading Ebola epidemic sparked a state of emergency in overwhelmed West African nations on Thursday as the death toll neared 1 000.

In Liberia, where the dead lay in the streets, lawmakers gathered to ratify a state of emergency while Sierra Leone sent troops to guard hospitals and clinics handling Ebola cases. Nigeria held out hope it could receive an experimental US-developed drug to halt the spread of the virus.

Since breaking out earlier this year, the epidemic has claimed 932 lives and infected more than 1 700 people across west Africa, according to the World Health Organisation.

Staff and volunteers at the ELWA hospital in the Liberian capital Monrovia wearing protective gear. (Pic: AFP)
Staff and volunteers at the ELWA hospital in the Liberian capital Monrovia. (Pic: AFP)

Ebola causes severe fever and, in the worst cases, unstoppable bleeding. It is transmitted through close contact with bodily fluids, and people who live with or care for patients are most at risk.

Spanish priest, nun evacuated
As African nations struggled with the sheer scale of the epidemic, Spain flew home a 75-year-old Roman Catholic priest, Miguel Pajares, who contracted the disease while helping patients at a hospital in the Liberian capital Monrovia.

The missionary was the first patient in the outbreak to be evacuated to Europe for treatment.

A specially equipped military Airbus A310 brought him to Madrid’s Torrejon air base along with a Spanish nun, Juliana Bonoha Bohe, who had worked at the same Liberian hospital but did not test positive for the deadly haemorrhagic fever, the Spanish government said.

Immediately after landing Thursday morning, ambulances took the pair to Madrid’s Carlos III Hospital, which specialises in tropical diseases.

The priest was stable and showing no sign of bleeding while the nun appeared to be well but would be re-tested for Ebola just in case, health officials said.

Two Americans who worked for Christian aid agencies in Liberia and were infected with Ebola while taking care of patients in Monrovia were taken back to the United States for treatment in recent days.

They have shown signs of improvement after being given an experimental drug known as ZMapp, which is hard to produce on a large scale.

The vast majority of those infected face a far inferior level of health care at home.

State of emergency in Liberia, Sierra Leone
There is no proven treatment or cure for Ebola and the use of the experimental drug has sparked controversy as Ebola experts call for it to be made available to African victims.

Liberia President Ellen Johnson Sirleaf declared a state of emergency of at least 90 days on Wednesday, saying extraordinary measures were needed “for the very survival of our state”.

“The scope and scale of the epidemic, the virulence and deadliness of the virus now exceed the capacity and statutory responsibility of any one government agency or ministry,” she said.

Liberia’s Parliament is to ratify the decision on Thursday.

In Sierra Leone, which has the most confirmed infections, 800 troops including 50 military nurses were sent to guard hospitals and clinics treating Ebola patients, an army spokesman said. The Parliament was to meet to ratify a state of emergency declared last week.

Nigeria
Fears are growing that the disease is also taking hold in Nigeria after the death of a nurse in Lagos, a megacity of more than 20 million. It was the second Ebola death in Nigeria, where another five people have tested positive for the disease.

Nigeria’s Health Minister Onyebuchi Chukwu told reporters he was in contact with the US Center for Disease Control on the possibility of getting drugs from them.

“I said we are getting reports that this experimental drug seems to be useful. Is it also possible that we can have access for our people presently being treated and under incubation?” he said Wednesday.

Chukwu said all seven confirmed cases in his country had “primary contact” with a Liberian finance ministry employee who brought the virus to Lagos on July 20 and died later in hospital.

US President Barack Obama said it was too soon to send experimental drugs for the treatment of Ebola to west Africa, however, urging officials instead to focus on building a “strong public infrastructure”.

“I think we have to let the science guide us. And I don’t think all the information is in on whether this drug is helpful,” Obama said on Wednesday.

WHO emergency session
The World Health Organisation is meeting in emergency session behind closed doors in Geneva to decide whether to declare an international crisis. It is not expected to make a decision until Friday.

A Saudi Arabian who had travelled to Sierra Leone and developed Ebola-like symptoms died on Wednesday of a heart attack while being treated in hospital in Jeddah, the Saudi health ministry said.

First discovered in 1976 and named after a river in what is now the Democratic Republic of Congo, Ebola spreads through contact with bodily fluids such as blood, saliva and sweat.

It has killed around two-thirds of those it has infected over the last four decades, with two outbreaks registering fatality rates approaching 90 percent. The latest outbreak has a fatality rate of around 55 percent.