Reflecting on My Time in Sierra Leone During the Ebola Outbreak

12/29/14

Kelly Melton is a Children of the Nations sponsor who traveled to Sierra Leone this fall with a medical aid organization, helping to set up Ebola treatment clinics. She has graciously agreed to share her trip journal, to give you a firsthand view of how the Ebola outbreak is affecting the people of Sierra Leone. Here is an entry from November 19. (You can read Kelly's previous updates here.) 

Before I came to Sierra Leone, the level of fear in the States surrounding Ebola was extremely high. People had this perception that Ebola was everywhere and just by flying into the country, I was at great risk. Like I would somehow trip over it in the street and 'catch it'. I'm not an Ebola expert, but I do have a different perspective on the situation after living in Freetown the past month.

 
Ebola is still on the rise in Sierra Leone. Help protect children by giving to COTN's Ebola emergency fund here. (Source: Centers for Disease Control and Prevention.)
 
Every Ebola patient who has been admitted into a treatment unit has a known contact. That means they either lived with a person who was sick, treated a sick person, or attended a funeral. To my knowledge, there are no 'accidental' cases where someone brushed up against a patient walking down the street, or touched a doorknob. They have always been able to trace it back to a known exposure.
 
As the disease progresses, you become more and more infectious. That means a dead body is in its most infectious state. Traditional burials involve washing and touching the body, which is incredibly dangerous and often results in infecting several people. Could you imagine having a tradition that has been passed down for a thousand years suddenly become the cause of so many deaths? I can understand why the local people are so resistant to changing their ways just because some 'white person' came in and told them to. It doesn't surprise me to hear that people are still hiding dead bodies to secretly bury them at night.
 
It is difficult for most people in other parts of the world to relate to how people live here. It is common to have an entire family sharing one room, and most likely only one bed. In fact, almost everything is shared—cups, plates, silverware, clothes, toys, blankets. Living so closely with other people, it's no wonder Ebola spreads so quickly through families and communities.
 
Families are constantly in close contact in Sierra Leonean culture. Can you imagine not being able to touch your child if he or she became ill? Or having your child quarantined away from you?
 
Babies are constantly carried on a caregiver’s back for nearly the first year of their life, so they’re always in contact with someone. Could you imagine being told not to physically comfort your children if they became ill? Could you imagine trying to find someone else to care for your children should you become ill? Caregivers have gone into treatment units to continue caring for their babies, and have been exposed. On the other side, babies have been brought into treatment units when there is no one left at home to care for them, and have been exposed.
 
To reduce the risk of transmission, the government will put a house under quarantine if they have had a known exposure. The government has an agreement to feed that household for 21 days to eliminate the need to go out for food and keep the people inside. But with the Sierra Leonean economy struggling even more than usual, some people are so desperate they have been willingly going into houses that have been quarantined to try to get food—knowingly putting themselves at risk to have a meal.
 
Nurses as they wait for their next shift in the holding unit.
                                        Nurses as they wait for their next shift in the holding unit.
 
Local healthcare providers are at great risk. Many nurses will volunteer for a year or two at a hospital or clinic with the hope of getting a paying job there at some point. Many of them work on the side or privately to make money. Working outside the hospital has been highly discouraged, but is unfortunately still happening. There have been many cases where nurses have worked after their regular shift at private clinics, or within their community. People know they are nurses so they are sought out when anyone in the community falls ill. Outside of the hospital, they do not have access to appropriate protective equipment. Most of the healthcare workers that I heard became infected admitted to treating patients outside the hospital.
 
Money has become such a huge issue. People in high risk jobs have been promised a 'hazard allowance' to continue working.  The amount they are paid varies by position, for example nurses and burial teams are paid the most. Earlier this week the nurses went on strike because they still hadn't been paid their wages for October. Again, I'm not sure what I would do if I were in their shoes and needed to feed my family.
 
The number of deaths reported is only for those that are Ebola related, but there has also been an increase in other non-Ebola deaths. I know of two in the last week that occurred when women had pregnancy complications and no one would treat them. 
 
 
Living in Sierra Leone has been challenging for years. Before Ebola, the people were trying to recover from a horrific civil war that left their country with very little infrastructure. The level of poverty here is unlike anywhere else I've ever seen.  People here are desperate and doing what they can to survive, but it is unrealistic to think they can do it on their own.
 
I desperately wish I could stay longer to help. There is still so much that needs to be done.
 
Help fight Ebola in Sierra Leone. Give to the Ebola emergency fund here