West Africa is just emerging from the most devastating outbreak of Ebola the world has ever witnessed. It truly is a tragedy of unknown proportions with many deaths remaining unaccounted for and many survivors still struggling for survival in communities where medical and other aid cannot reach.
This has been especially trying for Sierra Leoneans, who are trying to rebuild their lives after decades of suffering from repeated disease outbreaks and a brutal civil war between 1991-2002, the scars of which are still evident today.
Yet despite the ongoing political and economic challenges, the Sierra Leonean people I met continued to show incredible tolerance and altruism to individuals both inside and outside their own community, alongside an abundance of positivity.
Sierra Leonean staff, Kerrytown Ebola Treatment Centre
Sierra Leonean healthcare workers continued to fight on the front line during the height of the Ebola epidemic despite being at a disproportionately higher risk of dying from the disease because of this. They often worked with no protective equipment to safeguard themselves, witnessing their patients and colleagues die around them.
National Community Health Officers like Amara Sesay fought tirelessly to protect communities in some of the worst hit areas, including Kenema, where British nurse Will Pooley and American doctor Ian Crozier became infected. Amara described the experience of caring for his own tutor Dr Khan, Sierra Leone’s lead expert in viral haemorrhagic fever, who tragically contracted the disease and died:
"I was terrified of going back to work after watching his death, but my mother reminded me of the duty I have to care for my community and the people of my country."
Community Health Officers on duty in Kerrytown’s Ebola treatment centre
All over West Africa, Ebola survivors returned to work in treatment centres to help care for the sickest patients inside the red zone despite traumatic memories of their own experiences with the disease and with little known about immunity and reinfection.
At a community level, we are beginning to see Ebola survivors suffer debilitating fatigue, body pains and both visual and hearing loss. They have formed their own support groups and survivor networks in remote parts of the country where national and international aid cannot reach:
A.B has been deaf since birth. She came to MSF’s Ebola management centre in Magburaka with two small children, having already lost her husband and another child in the village. She was admitted to the red zone and watched both children die. Back in her village over 50 people had been infected and only nine survived. After returning she had no way of supporting herself, but the village donated a plot of land for the survivors who pooled their resources to buy seeds and contributed labour with a hope to splitting the produce if it grows.
Staff in the red zone on a night shift at Kerrytown Ebola Treatment Centre
Survivors often experience stigma and isolation when returning home but we witnessed distant family members and altruistic neighbours adopting Ebola orphans such as ten-year-old M.N, who became sick when both his parents contracted the disease.
M.N was the only one in the family to survive and returned home to his six siblings. The eldest brother quit school to care for the other children and in the spirit of ecumenicalism that is typical of Sierra Leonean culture, M.N attends the Seventh Day Adventist School, whilst his 13- year-old sister attends a Christian school, and the other siblings a Sierra Leone Muslim Brotherhood School.
The people of Sierra Leone have demonstrated inspiring levels of tolerance, collaborating with foreign partners who have been heavily involved in the response to Ebola. Their tolerance, together with a profound degree of altruism, has provided essential support for Ebola patients and survivors, especially in remote areas of the country where no other forms of aid exist.
These local communities provide a valuable and often under utilised resource that international organisations should consider embracing in the future.
MSF’s outreach survivor clinic, Tonkolili District
In the fight against Ebola we have been given an important opportunity to reflect on what we can learn from the cultural responses of West Africans.
In the Western world, where the individual is often prioritised above the community and material assets prized above all else, how would we respond to an epidemic in our homes, communities and hospitals?
Would we show such strength and altruistic behaviours to our patients and neighbours?