Kenema, Sierra Leone - Until Friday, Hawa Daboh lived with 25 others in an unpainted concrete house in Sierra Leone's third largest city, Kenema. Now she lives with 24. Usually known for its diamonds, Kenema has become the nerve centre for the fight against what is now the worst outbreak of Ebola on record, which last Friday claimed the life of Alpha Lansana, Hawa's stepfather.
Ebola has now killed 467 people across Guinea, Sierra Leone, and Liberia and infected many more. In Sierra Leone alone, 99 people have died - and for the first time, President Ernest Bai Koroma commented on the disease on Wednesday: "Ebola is real. Ebola kills," he said.
But Ebola does not simply kill. It spreads fear and mistrust among friends, divides communities, destroys livelihoods and puts a stop to education. For the residents of Hawa's peaceful, suburban home, it has changed everything.
"It affects us bad," Hawa told Al Jazeera. "Now there is nobody to help us. And the children are out of school." Being associated with someone who died of Ebola has made the family social outcasts. All of them were tested for the disease after Lansana's death and all came out negative.
But unable to get a medical certificate to prove it, this has had little impact on how they are treated. Even friends have stopped visiting them. If family members visit, neighbours on the street say they will be kicked out.
"E no easy," said Hawa's aunt, Aminatta, in the local Krio language. She and other women in the family used to make a little money from trading at the market, she explains, indicating the woven wicker basket she used to sell. Now nobody will buy their products and the small revenue they brought in has disappeared.
Lansana had been the main breadwinner of the family, holding down a coveted job as a laboratory technician at the local hospital. Over the course of a few days, the family's financial security crashed.
Shunned and shut out
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Across the street, one man who wished to remain anonymous to avoid the stigma of being associated with the disease, tells a harrowing story. A resident at the family compound, feeling unwell, went for testing at the local hospital, where she was diagnosed with typhoid, a common complaint in subtropical Sierra Leone. And so relieved family members went to visit her. By the time medical staff realised the disease was in fact Ebola, seven members of her family had also contracted it. Four are now dead. Three others are at the hospital being treated.
As in Hawa's home across the street, the remaining family members have been ostracised. The children, who tested negative, requested certificates so that they might be able to sit exams - but none was granted. One of Ebola's cruelties is that it is spread through contact with the fluids of an infected person, which means that friends and family are infecting each other, parents passing the disease on to children.
The disease has hit health workers particularly hard. When Al Jazeera visited the Kenema government hospital on Monday, workers from the Ebola ward were on strike. "For now, no driver will go to pick up a case," said one striking nurse.
Seven of their colleagues, including an ambulance driver, have now died from the disease - and so they decided that 100,000 leones ($23) was not sufficient compensation for the risks of dealing with Ebola.
Many of them, fully trained and certified, have long been working unpaid at the hospital. The head matron told Al Jazeera the strike had been resolved by the end of the day.
They, too, feel the force of the Ebola stigma, simply for having been in close proximity to the disease. One nurse told of being kicked out of the house by her husband as a result of her work.
United Nations Resident Coordinator for Sierra Leone, David McLachlan-Karr, compared it to the early days of HIV/AIDS. He told Al Jazeera that more efforts were being made to reach local communities, many of whom still do not understand the disease - even denying that it exists at all.
Even Hawa and her family, who witnessed their own father and seven neighbours catch the disease, do not believe it exists. Hawa insists he died of stress, despite testing positive for Ebola. Her sister Tiangay too, does not think Ebola is real. "I cannot say I think it exists," she says. "I still have not seen that disease."
They refuse to come to the hospital because they are afraid. People outside, they think we kill people.
Rachael Musa, who works in the Ebola screening room, explains that she faces two problems: Those who believe Ebola is real stigmatise her for being associated with the disease, and those who still deny Ebola exists are openly hostile to her.
"They refuse to come to the hospital because they are afraid," she said. "People outside, they think we kill people, [that] we give them Ebola injections. So we have few patients now."
Meanwhile, other conspiracy theories are running wild. Many believe Ebola is a cult whose members remove body parts from the patients. This, they say, explains why bodies must be instantly bagged and buried without the usual customs. Others see it as an aid industry plot to raise money. Even those that believe the disease is real, harbour misconceptions; a potent local whiskey, for example, is said to give you Ebola immunity.
Such is the mistrust of Ebola and those trying to treat it, that police last week had to use tear gas to disperse a mob intent on recovering the corpses of friends and relatives. Health workers in the field have also been prevented from doing their job. Dozens of suspected cases are on the run, fearful of what happens behind the closed doors of the isolation wards.
The reality is that testing and treatment offer the best chance of survival.
One man who did just that is Adikali Kamara, who committed himself to hospital early. Kamara spent a week in the Ebola ward, in the same room as his friend, Alpha Lansana, from whom he had contracted the disease. On the same Friday that Lansana died, leaving Hawa and the family to fend for themselves, Adikali tested negative and was discharged: a survivor.
"I was scared a little bit," he said. "But if you believe, it is simple."
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Source: Al Jazeera