Kenema, Sierra Leone – When the Ebola ambulance team arrived to pick up the parents of eight-year-old Fatima Bockarie last month, they faced a tough decision. What to do with the child?
Fatima showed no symptoms of Ebola, but having lived in close proximity with her parents, the risk was huge that she, too, had contracted the disease.
Family and friends in the village were also aware of this and, as is common across the country, nobody was willing to take her in.
You survived and you have this immunity. This is your shield. You are warriors.
Now she grins widely from behind a wire mesh fence in the eastern Sierra Leone town of Kenema, where the Red Cross is running a trial of a new system that employs Ebola survivors to care for high-risk children whose parents are being treated for the disease.
‘Warriors’ to the rescue
One such survivor is Mohamed Yillah, a former nurse at the Government Hospital in Kenema. Along with dozens of other staff at the hospital, he contracted Ebola in late July and spent two weeks battling the disease.
“Everyone thinks they will die when they get Ebola. We know there is no cure,” said Yillah, who was vomiting and had blood in his urine when he checked into the treatment centre. His elder sister was also infected, and she died days later.
When he was eventually discharged, no one would go near him. Even though Ebola survivors are not contagious, widespread fear among the community leads to many being cut off by their friends and family.
“They are my special forces,” said Joachim Gardemann, head of the Red Cross Ebola treatment centre in Kenema. “I tell them, ‘You survived and you have this immunity. This is your shield. You are warriors.'”
It is believed the antibodies that develop in the blood of Ebola survivors remain with them for up to 10 years. Crucially, this means they do not need to wear full protective equipment, or PPE, when dealing with the children.
|Ebola survivor Mohamed Yillah has developed immunity to the disease and can interact with children without the intrusive protective gear [Tommy Trenchard/Al Jazeera]|
“We’re in full PPE when we go in there. But in PPE you have to come out after 40 minutes,” said Gardemann.
The plastic suits that protect health workers from the virus are stifling to wear in Sierra Leone’s tropical heat. Wearing them in direct sunlight feels akin to being in a sauna.
Without PPE and the threat of contagion, staff can also offer a much higher level of care, especially for vulnerable children going through a deeply traumatic experience.
The aim, said Gardemann, is to create as normal an environment as possible, and for staff to be able to have their faces exposed is an important part of that.
It seems to be working. The children play and smile like children anywhere else, and they seem to have little awareness of the gravity of their situation. To them it is all a game.
The intimate bonds that have grown between them and the survivor staff is at the same time touching and tragic.
“This is my father,” said Fatima in the local Mende language, pointing at Yillah who stood by in blue scrubs keeping an eye on the five children currently inside the enclosure.
All of the children call him “papa”, and hug him frequently.
Tucked away out of sight just across the road in the much larger treatment centre for confirmed patients, their real parents were fighting for their lives.
Every now and then a child goes on to develop symptoms and is sent across the road to the treatment centre. Even those who escape the virus have a high chance of finding themselves orphans when they are discharged.
Gardemann said the system also provides a kind of psychological therapy for the survivors themselves, who often find it hard to go back to their pre-Ebola lives.
In time, Yillah’s family learned not to fear him. “I forced them to interact with me,” he said.
But for many, going back to their communities is not a comfortable option. At a time when they are most in need of emotional support, survivors are shunned and rejected. Many, too, carry a sense of guilt at having survived while others died, Gardemann said.
Some can be seen just passing the time at the treatment centres where they had been patients. One survivor woman still wanders into the Government Hospital in Kenema every night to sleep out on a bench in the “psychosocial” department.
“She feels more comfortable here than in her own community,” said a member of the hospital staff. “People here understand. They give her the attention she needs to be comfortable.”
For many survivors, joining the Ebola response is a cathartic experience and helps ease the struggle to reintegrate. “We see it in all disasters. People want to do something,” said Gardemann.