Tag: Sierra Leone

Ebola: Yes, it is real

A sign warning of the dangers of Ebola outside a government hospital in Freetown on August 13 2014. (Pic: AFP)
A sign warning of the dangers of Ebola outside a government hospital in Freetown. (Pic: AFP)

We twist and turn on the dirt road, the tyres kicking up clods of mud. It has rained intermittently the whole afternoon and the road becomes increasingly difficult to negotiate, requiring the full 4-wheel drive.

The other landcruiser gets stuck briefly, stubbornly revving to keep up behind us. We toss and tumble around on the back seats as the land cruiser dives into another rut. “Welcome to ‘Kah-llun’” the driver announces.

This stretch of the day-long journey to the base at Kailahun started with wishes of “Bon voyage” hailed across the two-way radio in Bo at lunchtime. To get to Bo, we’d left Freetown at sunrise in a minibus, packed to the brim with luggage and mission staff.

There were half a dozen police check points between Freetown and Bo: each stop requiring some unpacking of the car in order to disembark, and then lining up to have our temperature taken, and occasionally having to wash our hands in chlorinated water.

Staff in white coats pointed the thermometer at our foreheads, and read the result out loud, while camouflage-clad troops looked on. “I’m from West Africa, you from South Africa”, one of them laughed, “Yes, we are all Africans!” we agreed, me thinking that a World Cup would have been more likely to bring us together than an epidemic tearing through the country.

But we had it easy. With special passes around our necks, and a Ministry of Health placard on the front window of the bus, proclaiming “ALLOW TO PASS – EBOLA RESPONSE”, we sped to the front of the one kilometre queue, while a line of trucks, cars and motor bikes, with Sierra Leoneans –- mothers, children and men of all ages –- sitting in the heat on the road, waited to be allowed through.

The government has implemented quarantined zones, to be adhered to for 21 days after the last reported case in each zone. It was evident that while usefully restricting movement, these measures were causing havoc in people’s lives, and the transport of supplies across the country. For me, this was the first indication that the posters on houses and trees might be true, that “EBOLA IS REAL”.

We stopped on the outskirts of Bo to take a tour of the treatment centre. Built in only five weeks, the centre can take in 100 patients, and even has a helipad. In the next phase an onsite laboratory will be installed to speed up the time between a blood sample being taken and the result being available.

Few sites have onsite laboratories, and specimens are taken by road for testing, often leading to people who test positive for Ebola mixing with those who test negative for several hours in the waiting area of the centre.

Walking up to the centre, one is filled with awe: the white tent-like structures look like an impressive utopian city. But at the same time, they invoke the fear and intrigue felt by anyone who is drawn to the television news broadcasts of the yellow hazmat suits, masks and goggles. From a distance and for the first time, we catch a glimpse of these suits for real: people unloading a stretcher from the back of a vehicle … “Was that a body?”

Inside, the centre is carefully organised into high and low risk zones. Hand washing points, consisting of elevated plastic vats of chlorinated water, with a bucket underneath, are strategically placed throughout, and the paths through the zones are cordoned off with orange barrier fences and a carefully planned open water drainage system.

We see national staff putting on their Personal Protective Equipment, one layer after the next, as we stand sweating in our single layer of scrubs and gumboots.

Where are the sick and dying? One patient emerges from the high risk zone and takes a seat behind the orange barrier fencing. A few metres away, behind another orange fence, a health promoter shouts across to him, “Hello, Mr X. Since you no longer have symptoms, you are getting better. We now need to wait to see what your viral load result is, and maybe you can go home.”

We crane our necks to get a glimpse of the sick in the high risk tent. While the staff in the hazmat suits move slowly and carefully around the ward, partitions allow the patients their privacy, screening off our inquisitive eyes and those who may well be dying next to them.

We hit the road to Kenema, enroute to Kailahun. In Kenema, the market place teams with people in close proximity, buying and selling goods and food. Where is the Ebola? Where is the fear? I wonder why the fear of infection is not keeping more people away from the town centre.

But I wonder no more as we approach a busy traffic circle: a man lies prostrate in the road, emaciated and his face contorted in pain. With one arm he tries to shade his eyes. Far gone, too far gone. We shake our heads and drive on. We look back. No one will approach him: he will most likely die alone. Yes, Ebola, it’s real.

Kathryn Stinson has a PhD in Public Health and works as an epidemiologist at the University of Cape Town. She has three children, two Great Danes and one very supportive husband. She is volunteering in Sierra Leone for an NGO and writes in her personal capacity.

This article was first published on GroundUp.

Travelling with the extra baggage of Ebola stigma

A woman passes a sign posted in an awareness campaign against the spread of Ebola in Freetown, Sierra Leone. (Pic: Reuters)
A woman passes a sign posted in an awareness campaign against the spread of Ebola in Freetown, Sierra Leone. (Pic: Reuters)

Upon landing at Kigali International Airport last month, I peered out the window and my eyes caught sight of an official clad in protective gear standing just under a sign that read ‘Arrivals: Ebola testing’. If I had ever been removed from what has been going on in my beloved Sierra Leone, it ended in this moment. Before my flight from Washington, I was informed that we would be screened upon arrival. And there it was. Even from the window of seat 16K, I could see the measures that had been put in place to protect the citizens of the country.

After disembarking the plane and entering the airport, we stood in a queue for about 10 minutes. I noticed a form that other passengers were filling out. I asked the young lady behind me if it was for everyone. She responded “Yes,” so I moved to the counter to complete mine. It asked: “In the past three weeks have you been in the following countries: Sierra Leone, Guinea, Liberia, Nigeria, Senegal?” At that moment I felt a sense of solidarity first with Sierra Leoneans near and far, because sadly this too has become one of our realities. I also felt isolation because my entry, identity and existence were being sanctioned and questioned by a customs form. A customs form at which other travellers would not cringe; they don’t have blood from Sierra Leone, Liberia and Guinea. Even if I don’t explain to you what happened next, you would still be able to surmise what would occur naturally as a Sierra Leonean-American woman with Sierra Leonean entry and departure stamps in her US passport. As I continued filling out the form, I checked “No” on the form because the truth was I hadn’t been to Sierra Leone in the past three weeks.

I calculated: three weeks equals 21 days. Twenty one is the magic number that many African countries and people all over the world will use to promote the stigmatisation of people from Ebola-hit countries, or with any relations to them. It’s the number that would decide your fate when attempting to enter another country. It takes up to 21 days for the deadly Ebola virus to manifest itself in symptoms after one has been exposed. The incubation period, they call it.

No, I haven’t been in Sierra Leone in the past 21 days. Not physically. But in the past 21 days, my thoughts have been there. My mind has raced incessantly and my heart has jumped at the numbers. My soul has cringed at flaws that have been illustrated by this epidemic in Sierra Leone. For more than 21 days, I have certainly felt helpless.

But this customs officer didn’t exactly know how I or other Sierra Leoneans have felt for the past few months. As he attempted to look for a clear page to add the Rwanda entry stamp, he came across my Sierra Leonean visa page. He glanced at my passport and the stamps for my entries to Sierra Leone, the most recent being December 2013 to January 2014. I watched his eyes widen slightly as he turned the pages and I anticipated the questioning. It took a while for him to gather his thoughts and ask the question. “Are you coming from the United States?” Obviously, I thought to myself. “When last have you traveled to Sierra Leone?” Didn’t you already see the stamps? “What was the last date you left Sierra Leone?” I responded “January 10, 2014. And when I left, this wasn’t a problem”.

Some countries have banned the entry of citizens and passengers arriving from Sierra Leone, Guinea and Liberia – nations that have been hit the hardest by the latest Ebola outbreak. I understand caution but paranoia and, consequently, stigmatisation, are not the cures to this disease. To see a Sierra Leonean visa in my passport evidently put the official on high alert. The realisation that I could somehow be considered a ‘risk’ – not just to this man but to his country – despite the evidence before him made me feel small.

He stared at me a bit longer, as if trying to gauge whether the words I uttered were the truth. Then he asked me for my point of contact. I gave him that information. He made the decision not to call or do whatever he had considering doing. I smiled because even in the face of this ugly stigma and the horror that we know as Ebola in Sierra Leone, I am still proudly a “Salone Titi.” I thanked him, retrieved my passport, and rolled my hand luggage to begin my experience as a Sierra Leonean-American woman in Rwanda.

 Bintu Musa is a globetrotting educator and writer. She is currently lecturing at Rwanda Tourism University College as a Fulbright Scholar. She blogs at Bee’s Backseat

Sierra Leone quarantines more than 1-million people

A woman passes a sign posted in an awareness campaign against the spread of Ebola in Freetown, Sierra Leone. (Pic: Reuters)
A woman passes a sign posted in an awareness campaign against the spread of Ebola in Freetown, Sierra Leone. (Pic: Reuters)

Sierra Leone has ordered the quarantine “with immediate effect” of three districts and 12 tribal chiefdoms – affecting more than one million people – in the largest lockdown in west Africa’s deadly Ebola outbreak.

President Ernest Bai Koroma, in a national televised address late on Wednesday, announced that the northern districts of Port Loko and Bombali were to be closed off along with the southern district of Moyamba – effectively sealing off around 1.2-million people.

With the eastern districts of Kenema and Kailahun already under quarantine, more than a third of the population of six million, in five of the nation’s 14 districts, now finds itself unable to move freely.

“The isolation of districts and chiefdoms will definitely pose great difficulty but the lives of everyone and the survival of our country takes precedence over these difficulties,” Koroma said.

“These are trying moments for everyone in the country.”

The deadliest Ebola epidemic on record has infected almost 6 000 people in west Africa and killed nearly half of them, according to the World Health Organisation’s latest figures.

The virus can fell its victims within days, causing rampant fever, severe muscle pain, vomiting, diarrhoea and — in many cases — unstoppable internal and external bleeding.

In Sierra Leone, Ebola has infected 1 813 people, killing 593, by the WHO count.

Koroma said that 12 of the county’s 149 tribal chiefdoms – much smaller administrative areas than districts – were also to be placed in quarantine. The total population in these areas was not immediately clear.

The president said corridors for travel to and from non-quarantined areas had been established but would only operate between 9:00 am and 5pm.

“The Ministry of Health and Sanitation and the emergency operation centre will establish additional holding centres in the quarantined chiefdoms,” Koroma said.

Death toll
Sierra Leone announced on Wednesday that around 100 bodies and 200 patients had been collected from homes during a nationwide three-day lockdown and house-to-house information campaign which ended on Sunday.

“To sustain our efforts in overcoming the challenges that were further revealed during the house-to-house campaign and in consultation with our partners – and in line with our people’s avowed commitment to support extra measures to end the Ebola outbreak – the government decided to institute these further measures,” Koroma added.

The WHO said earlier this week 5 864 people had been infected since the virus first emerged in southern Guinea in December, and that 2 811 had died.

In Liberia, which has been hit hardest by the outbreak, 3 022 people have been infected and 1 578 have died while in Guinea, Ebola has infected 1 008 people, killing 632.

Nigeria has recorded 20 cases, including eight deaths, since the virus first arrived in the country with a Liberian finance ministry official, who died in Lagos on July 25.

Guinea’s President Alpha Conde and cabinet ministers from Liberia and Sierra Leone were due to attend a meeting in New York on Ebola convened by United Nations Secretary-General Ban Ki-moon later Thursday.

The meeting – part of the United Nations General Assembly – will hear from US President Barack Obama and world leaders are expected to pledge help for efforts to try to contain the spread of the virus.

Nigerian President Goodluck Jonathan appeared to jump the gun on medical advice at home on Wednesday to tell an applauding UN that Nigeria was free of Ebola.

“We can confidently say that today Nigeria is Ebola free,” Jonathan told the largest diplomatic gathering in the world to a ripple of applause in New York.

“Nigeria is Ebola free,” he said a second time to further applause.

Doctors said earlier they would have to wait to declare the outbreak over despite the Nigerian federal health ministry saying all patients being monitored for the virus had been cleared.

Rod Mac Johnson for AFP

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

Survivors enlisted in Sierra Leone’s Ebola battle

An MSF medical worker feeds a child at an MSF facility in Kailahun on August 15 2014. Kailahun along with Kenama district is at the epicentre of the world's worst Ebola outbreak. (Pic: AFP)
An MSF medical worker feeds a child at an MSF facility in Kailahun on August 15 2014. Kailahun along with Kenama district is at the epicentre of the world’s worst Ebola outbreak. (Pic: AFP)

Hawa Idrisa was visiting her father-in-law in an Ebola ward in eastern Sierra Leone when his drip snapped out and his atrophying veins spurted thin, uncoagulated blood into her eyes and mouth.

She had been carrying her infant daughter Helen but luckily she had laid the child down, otherwise the baby would almost certainly be dead by now.

A single droplet of blood smaller than a full stop can carry up to 100 million particles of the deadly Ebola virus, yet one is enough to end a human life.

“The blood got all over me, and people were running away. So I took a bucket of chlorine and poured it over myself,” Hawa said.

She returned home to forget her ordeal, but a week later she began experiencing fever and headaches, the early symptoms of the Ebola.

Her 12-month-old mercifully tested negative, but her husband Nallo was infected and he and Hawa checked into the Doctors Without Borders’ (MSF) treatment facility in the eastern district of Kailahun.

Hawa spent four weeks drifting between life and death at the centre, in the district capital Kailahan city, a trading post of 30 000 in the Kissi triangle linking to Liberia and Sierra Leone.

“I didn’t know what was happening to me. I didn’t even know where I was. I don’t remember anything from that time,” she told AFP of the ordeal she survived.

Ebola kills more than half of the people it infects, putrifying their insides in the worst cases until their vital organs seep from their bodies.

It is highly infectious but not particularly contagious, meaning that once you are exposed, your chances of escaping the fever are extremely low, although it can only be passed on through bodily fluids.

The good news is that when patients are caught early enough, given paracetamol for their fevers, kept rehydrated and nourished, their chances of survival increase dramatically.

Hawa proudly shows off a certificate saying she has recovered fully, and she is preparing to return home.

“I know there is nothing wrong with my daughter, but my mind and heart will be at the centre with my husband,” she says.

Hardest-hit districts
Already more than 2 100 people have been infected across four west African countries, and 1 145 people have died, dwarfing previous Ebola outbreaks.

The epidemic is perhaps worst of all in Sierra Leone, which has registered 810 cases, more than any other country.

A sign warning of the dangers of Ebola outside a government hospital in Freetown on August 13 2014. (Pic: AFP)
A sign warning of the dangers of Ebola outside a government hospital in Freetown on August 13 2014. (Pic: AFP)

The hardest-hit districts, Kailahun and the diamond trading hub of Kenema next door, have been sealed off to ordinary members of the public.

Around a million people in the two districts are in effective lockdown, and locals say soaring food prices are pushing the region towards a crisis.

Local doctors and nurses are fighting not just the disease, but also the distrust of locals who fear modern medical practices.

Relatives have been known to snatch infected loved-ones from clinics to die in their own villages, exacerbating the spread of the virus.

They have even attacked treatment centres – as armed men did in neighbouring Liberia at the weekend – convinced that Ebola is a Western conspiracy against traditional African communities and that foreign healthworkers are in on the secret.

Some 1 500 police and soldiers have been deployed to prevent raids, but they are powerless faced with the suspicion and fear of poorly educated traditional communities.

Many tribespeople at the epicentre of the outbreak either don’t know how to prevent and treat Ebola or do not believe it exists at all.

This, says MSF, is where the survivors come in.

Survivors returning home
Ella Watson-Stryker (34), a health promoter with the aid agency, is part of a team taking Hawa and other survivors home to their villages.

She will gather their neighbours and family members around, answer their questions about the virus and try to reassure them that Hawa poses no danger.

“This is very exciting for us. It’s also really beneficial to the overall response to the outbreak because when survivors go home, they can explain about their stay at the centre.

“They give people hope that it is possible to survive and it really builds trust between the community and MSF,” she says.

Watson-Stryker also says that when survivors go back to their communities, people begin to understand that treatment centres are not just “a place where people go to die”.

They are surprised to learn that patients are fed, given unlimited soft drinks, access to toilets, showers and medicine, and that their families are encouraged to visit.

“We try to assuage the fears of the community, because there are a lot of rumours out there, that as soon as you come to the treatment centre you will just be left to die.”

Back at the MSF centre, Nallo enthuses about his future with Hawa and their baby girl, despite remaining in grave danger in the high risk area.

“At first people thought that when they got here, they were going to have all their blood removed and they would die,” he says.

“They have been giving me drugs and I am much better, so when I get back to my community I will tell people that if it ever happens that they get Ebola we advise them to come here.”