Making it through when your mind is breaking

When I meet Alexander he is standing in the visitors’ area for confirmed Ebola patients, anxiously waiting for his son to come out from the tent so he can see him. ‘I thought we’d find you here’, says Henrike, MSF’s psychologist smiling at him. ‘How are you feeling this morning?’

When I meet Alexander he is standing in the visitors’ area for confirmed Ebola patients, anxiously waiting for his son to come out from the tent so he can see him. ‘I thought we’d find you here’, says Henrike, MSF’s psychologist smiling at him. ‘How are you feeling this morning?’

Alexander is a pharmacist by profession and has been working as a health promotion officer with MSF in Foya, Liberia since the beginning of September. His story with MSF goes back much further, to 1998, the time of the civil war in Liberia.  At that time he worked as a nurse assistant in a therapeutic feeding centre. Later, between 2000 and 2004 he moved to Bong County, south of Lofa to work for MSF as a pharmacist in a displaced persons project. ‘I worked with a big team’ he tells me proudly. ‘I was working with the expats to place orders for medicines with the warehouse in Bordeaux. I was looking after all of that.’

Alexander on his way to visit his son in the confirmed patient area of the Ebola management centre in Foya. © Katy Athersuch/MSF

Today he is looking anxious, but he is smartly dressed and he allows himself to smile when he talks to us. ‘As you can see I have put clean clothes on’ he says with a smile. ‘They say my son is doing just fine. They say he is looking strong.’

We chat about the developments in the centre. The psychosocial team have been able to install a mobile phone booth and supply a phone with credit, so that those patients coming from afar can call their friends and family to keep in touch. Alex is very pleased with this and tells us he has already seen a few patients come out to make calls this morning. He agrees to meet me later so he can tell me his story, but for now he wants to wait there and check on his son.

PHOTO: Alexander on his way to visit his son in the confirmed patient area of the Ebola management centre in Foya. © Katy Athersuch/MSF


The utter devastation that has been wrought on Alexander’s family in the past three weeks is hard to fully grasp. When we sit together later his eyes are full of tears. He takes long pauses, bites his lip and stares off into the fields behind us for minutes at a time. ‘Saturday 21st of September, a day I will never forget in my life’ he begins. He tells me about that day, how he was out working with MSF, visiting villages and telling people about Ebola: how to protect themselves and their families, what to do if they start to develop symptoms, and making sure everyone has the MSF hotline number to call. As they were finishing up for the day his phone rang. ‘It was from my wife’s number but it was not her. I answered the phone but nobody could talk.’

He had become increasingly worried about his family over the past few months. His wife worked in marketing in Monrovia and wanted to stay in the city with the children. He wanted them to come up north and stay with him. The last time he was with them was to celebrate Independence Day back in July. ‘At that time Ebola had come to Liberia so I tried to talk to them about the virus and to educate them, but my wife did not believe. She did not listen. She denied Ebola.’  He returned to Lofa county where he was working at the time, but says he called his wife every other day pleading with her to leave Monrovia and bring the children so they could be together up here.

Later in the evening on September 21st, Alexander’s phone rang again. It was his brother on the line and he broke the difficult news that Alexander’s wife had died of Ebola. ‘I dropped the phone. I threw it away and it broke apart. My neighbours around came and put the phone back together. They brought it back to me.’ He shows me his phone and takes it apart to show how it had broken. ‘They called my brother back, but I was just sitting and looking. I felt like I’d lost my whole memory. I was looking but I didn’t know what I was looking at. I had no vision.’

Later that same week Alexander’s loss deepened. He got another call. His older brother had also died. He was a health worker based in Monrovia and had been taking care of his sister-in-law, Alexander’s wife. ‘He died. He followed her’, he says gritting his teeth. ‘Then my two little children were taken to the centre in Monrovia. They were very sick and they too died.’

It’s clearly very difficult for him to talk about what he’s going through. ‘I felt even more helpless. I was breaking in my mind. I had been working hard to establish a good life for my family, so I was thinking, “but if my family is going to die, why should I continue to work? There is nothing for me left. What am I doing alive? I should just be gone.” My desire was just to die. To be finished and follow my wife, brother and small children. I couldn’t make sense of anything.’

Alexander’s eldest son was still in Monrovia in the house where his family had died. He called Alex, ‘everyone got sick, I don’t know what to do.’ ‘You get in a car and you come here,’ Alex told him. He came, passing through seven checkpoints on the journey. At every checkpoint, his temperature was taken. It was fine. He was showing no signs of illness.

When his son arrived, Alexander took him to his hometown, a nearby village. ‘When we arrived, people would not accept us. They told me, “We do not want you in this town. Your family have all died and now you bring your son to cause everyone to die here! We don’t want you here! We don’t want Ebola here! Take your son from here!”’ Alexander was angered by their reaction. ‘I knew that he wasn’t showing any signs of illness, so he was not a threat to them, but because of that stigma they wouldn’t let us stay in our own home.’

They went to move on, but Alexander realised his son was looking more tired than usual. ‘I started to be worried about him. He was not vomiting, he didn’t have diarrhoea nor was he showing any signs of Ebola, but he was tired.’ Feeling concerned, Alexander decided to call the Ebola hotline. MSF sent a car to pick up his son and brought him to the Ebola management centre in Foya to be tested. His only sign of illness was tiredness.

Unfortunately his son’s test for Ebola came back positive and he was admitted to the ‘confirmed patient’ area of the centre. ‘That was a night of agony. I didn’t even shut my eyes for one second. I spent the whole night just sitting in agony, crying and thinking about what would happen now to my son.’ Early the next morning, Alexander was back at the centre in a state of acute anguish. He started demanding that the nurses give him the protective clothing so that he could go in and see his son. ‘They stopped me. The psychosocial counsellors took me aside and tried to calm me down. They told me to wait. To hold my peace. I sat with them and we talked and talked.’

Later that day Alexander’s son came out of the tent where he had been sleeping. ‘I was able to see him, so I called out to him, “Son, you’re the only hope I got. You have to take courage. Any medicine they give to you, you have to take it. You’re the only hope I got.” But he told me, “Papa, I understand. I will do it. Stop crying Papa, I will not die, I will survive Ebola. Stop your crying. My sisters are gone, but I am going to survive and I will make you proud.” They continued talking. Alexander was anxious to do anything he could to save his son. ‘He told me he wanted energy drinks’, he tells me. ‘I brought him bananas and drinks. He drank the drinks, but he put the bananas down. He did not have enough strength to eat.’

Alexander barely left the centre over the next week or so. ‘The last days I have been crazy. My clothes have been dirty. I’ve just been spending all my time here like a crazy human being. Sometimes in the middle of the night I come here. The security ask me, ‘what are you doing here?’ But I tell them ‘I have to come.’ He tells me how much he values the support of the psychosocial team here. ‘This brother here’ he says, pointing over to Francis, one of the psychosocial counsellors at the centre as he walks by. ‘I will not forget him, this Francis. He played a very major role in my life. A very major role.’

He tells me that he feels let down by his friends, ‘no one is coming to me. None of them is asking how I am. This plays on my mind.’ By contrast, Alexander says he feels grateful for the support he gets here at the centre. ‘Every day the counsellors make sure they see me, and they sit with me so I can talk. The way the counsellors talk to me, it helps me to relax. Even just when Henrike smiles at me, I feel I have to smile too. Even though I am grieving, I see her smiling and supporting me and I have to feel a little better. They know it’s not a small blow that I am receiving in life. It’s not a small blow.’ He trails off and looks away again, biting back his tears.

I try to distract him from his thoughts by asking after his son’s health. ‘But Kollie is doing well today, no?’ I have not met Kollie yet, but I know the staff here are feeling relieved by how well he seems to be recovering. Alex turns back to me. ‘When I saw him yesterday he was moving around. He was doing much better, he was doing well. I finally allowed myself to wash properly and put clean clothes. I brought him clean clothes too.’ But Alexander is still looking worried. ‘He’s much better, but his eyes are still very red. He’s still showing signs of the virus. I am praying to God that he can be free of it and test negative. I just want us to be together now.’

Alexander at the visiting area for 'confirmed patients'. © Katy Athersuch/MSF

MSF health promotion officer Alexander at the visiting area for 'confirmed patients'. 'Look

that's my son, he's eating, he's looking stronger.' © Katy Athersuch/MSF

Later that afternoon, we go together to visit his son across the orange fence. He is looking very smart with his clean outfit on. After bringing him some snacks from outside, and eagerly watching to see if he seems to have a good appetite, Alexander spends most of his time nagging his son to keep clean.

‘You must keep washing. Wash with the chlorine water here. It will keep you clean. How is the body to get better if you are not clean? How will it sweat if the skin gets dirty? You must keep clean.’ His son takes this advice like any teenager would, looking down at his plate and giving the occasional nod to show he’s listening whilst probably wishing his father would stop going on at him. He is looking very clean!

Six days later as I pass through security to enter the centre, I see Alexander out of the corner of my eye. He is smiling from ear to ear and talking excitedly to a colleague. I go over to him. ‘How are you, Alexander? I ask, smiling and tilting my head to indicate that I want to hear this exciting news. ‘I hear that my son has tested negative. He has tested negative and they say he can soon be discharged.’

An hour later, Kollie James dances out of the centre as people around him cheer. Catianne, the international staff in charge of health promotion is leaving today and has brought a crate of soft drinks in to share with her team. They call Alexander and his son over to join them and it becomes a double celebration.

‘He’s a survivor! We are all very happy today,’ one of the team says to me. ‘Tomorrow I will be back at work as a health promotion officer!’ Alexander declares. ‘I am ready to rejoin my team!’

Alexander (R) with his son Kollie James © Katy Athersuch/MSF

Alexander (R) with his son Kollie James © Katy Athersuch/MSF