The drive from Kenema to Kailahun in Sierra Leone’s Eastern Province is a magnificent stretch of road that reminds you why the ‘Lion Mountain’ was given its name. Sent on assignment by UNICEF to write about the worsening Ebola outbreak, I was preparing myself for the horrors of the remote Ebola epicenter that continue to be reported since the outbreak started in May. Corpses abandoned on the street, exploding new case numbers and endless deaths are the stories that have defined this Ebola hotspot. As someone who is not treating patients and afforded the privilege of a relatively protected existence in Freetown, the presence of Ebola is less overt than the gruesome stories and alarming speculation we are surrounded by. It is a fear that you carry with you, an itchy eye that you can’t scratch or a hot flush that makes you reach for a thermometer. In the picturesque town of Kailahun, the fear felt no different and the disease is everywhere.
We approached the town late, the night was crackling with fire flies, an unexpected treat that made me forget for a moment where our road was leading. We passed a gang of armed soldiers hauled up outside a home that had been quarantined. I learned later that three people from the house had been taken the same day to the MSF run treatment hospital in Kailahun, the remaining family members were unable to leave the house while the virus’ 21 day incubation period is played out.
A Child Protection Officer from Save the Children – Fattu Fomba, who has been working on family tracing and reunification to support children affected by Ebola was my guide in Kailahun. She gave up her weekend to show me around and to help explain how this terrible disease is affecting those most vulnerable – children. She had an exhaustive bank of anecdotes about infants who had lost their entire families, who had been rejected by their communities after being infected and whose lives were in limbo because their relatives were scared to take them. “Sometimes I come back to my office and cry, I wonder what will happen to these children and their future. I have been a protection officer for 10 years, and this situation is just so hard. Ebola is a secret war, there are no guns but people are going through the same traumatic events,“ she said the morning we met.
We visited an Interim Care Centre or halfway house, run by UNICEF’s partner Save the Children that had become a home for kids whose families have been destroyed by Ebola. There were three volunteer carers acting as guardians to children they had only recently met. Each child had lost a parent or two, or had parents still in the treatment centre suffering Ebola, some had survived the disease themselves and the rest were considered Ebola ‘contacts’. This meant their temperature was monitored each day and any sign of a fever was pounced on with an Ebola test.
Despite the sadness of their situation, all were brave little humans, resilient in spite of the cruel blow that this disease had served them. On my first visit to the house, there were seven children inside, four of them just toddlers. They huddled together giggling and playing, unaware of the scope of the situation and concerned only with their immediate needs. Hawa Joy one of the volunteer carers had become the centre of their world, her warmth and attention was exactly what they required and it was clear they were quickly growing fond of her.
I was drawn to a couple of the older kids, Francis a 13-year old and his beautiful sister five year old Rose. They knew more than the little ones, and noticed what was happening around them and while they were older and stronger they somehow seemed more vulnerable. They had lost their mother and father, their baby sister and finally grandmother after all had become infected in their village of Kusedou in Kissi Teng chiefdom.
Francis hovered around the table where I sat with Hawa and Mamie Kpulum, I got the impression he is one of those delightfully nosey children who has one ear on adult conversations. His brilliant smile wouldn’t budge, I was confused why this kid whose life had been turned upside down in such a ruthless way was still grinning. We chatted for a bit and he told me how much he missed his Dad, “I miss his encouragement, and the way he used to walk together, he would talk to me and advise me, I miss that because now he is gone”.
Little sister Rose was not in the mood for small talk, hiding behind Hawa’s skirt, eyeing me suspiciously. Eventually she warmed up and showed me the certificate she was given by the Ministry of Health and Sanitation after surviving Ebola. How strange that a diploma of good health had become a badge of honour for a select group of children in Sierra Leone who are being described as the ‘lucky’ survivors. Indeed they have narrowly escaped a horrible death, but on that afternoon visit, these kids seemed in no way fortunate.
My whistle stop tour of Kailahun continued with a visit to the MSF compound where I met Mary, a health promotion officer from Norway who had been in town for just a day. “This is worse than a war, it’s dangerous because it is lurking in places we don’t know about”. She had hit the ground running and despite having worked in conflict zones, Ebola was something she was not prepared for. Part of her job was to support family tracing and reunification of children with families and she was quickly understanding the weight of what these children are carrying.
The MSF Ebola hospital is about 10km out of town, set amidst more of the district’s lush Jurassic style foliage where perspective is warped by oversize grass that stands almost as tall as the trees. The hospital appeared well organised and resourced and nothing less than what you would expect from the organisation that holds the gold standard for the safe management of Ebola cases. In truth the clinic is bursting with a constant influx of suspected patients. Almost four months into the outbreak, Kailahun is still a district recording some of the highest numbers of new cases each week. Up until three weeks ago, the treatment centre was one of the only two hospitals in the country which was treating patients, this meant Ebola cases were being referred from most other districts as well. “Ebola is overwhelming this country, we are not on top of this disease, we are still behind the curve,” said one MSF worker.
I met with some of the health promotion team at the hospital. Dressed in Africana scrubs, they were upbeat and welcoming and keen to tell me about their experience. Tamba, a Kailahun local said his life has been changed by the disease, “I didn’t know anything about Ebola before this outbreak. I used to be afraid of Ebola and I even refused to come to this hospital. But now I know more than anyone about Ebola, ask me anything and I can tell you”. He was rightly proud of his role and his new fashion-forward uniform. It seems premature to start pointing out any positives that have emerged from this catastrophe, but if there was one, it’s the sense of comradery and pride the response has fostered amongst those fighting on the front line.
We left Kailahun at the end of the two-day visit, heading back towards Freetown on a muddy road that had been ravaged by the previous night’s rains, making hard work for my driver Vixon. He stopped abruptly as we approached a row of houses, curious about the crowd that had gathered outside one of the homes. Through the rows of people I could see a burial team arming themselves in white plastic suits, as they prepared to go and retrieve the body of a suspected Ebola victim. The community watched in silence. I looked around at countless empty expressions. “This should not be happening”, Vixon said before we got back in the car and drove on.