Freetown, Sierra Leone – The traditional healer was not at home when Saudatu Koroma arrived at his clinic in the bustling Wellington neighbourhood of Sierra Leone’s capital. This probably saved his life. Saudatu was suffering from the incurable Ebola virus, the first person to contract the disease in the capital, and was on the run from the hospital.
“She couldn’t eat … couldn’t sleep,” said Sulaiman Foday, a neighbour who was present at the time. Foday watched as police and a medical team arrived at the scene to recover the patient, who was by now lying on the floor of the healer’s house.
“We saw them come with those devil masks and we were so afraid,” he said. Women and children locked themselves inside their houses. Others fled the area.
The medical team had no protective clothing, so for three hours Saudatu stood and waited before being put in an ambulance and taken away. She died before she reached the hospital. It was not until four days later that officials came back to the area and advised residents to disinfect the compound with chlorine and water.
“We had to use our own money and do it ourselves,” said Foday.
State of emergency
The outbreak, which began in neighbouring Guinea back in March, is both the largest on record and the only one to reach major urban centres.
At least 729 people have died in Sierra Leone, Guinea, and Liberia. For weeks, cases were largely confined to the east of the country, but increasingly they are now starting to appear in the capital itself. According to a spokesman at the ministry of health, six people have now tested positive for the disease in Freetown.
On Wednesday, President Ernest Bai Koroma declared a state of emergency and cancelled a trip to Washington where he was to attend a US-Africa summit.
“Extraordinary challenges call for extraordinary measures,” he said in an impassioned address to the nation. “Sierra Leone is in a great fight. We are a resilient people. And we must not fail.”
The areas hit hardest by the disease will be quarantined, Koroma announced, along with all houses where the disease is present. He called on the army to enforce the plan, which includes house-to-house searches to track down Ebola suspects as well as a ban on public gatherings.
Sierra Leone is in a great fight. We are a resilient people. And we must not fail.
The government had faced criticism over its management of the crisis, with many feeling the initial response was too little and too late.
The country’s tourism minister sparked outrage when he requested that journalists report Ebola in a less negative way to avoid scaring away the few intrepid tourists who make it to this corner of West Africa.
A spokesman for Sierra Leone’s health ministry insisted the city was ready to cope with the disease. “We have isolation units in all major hospitals,” he told Al Jazeera. “And we are building a new treatment centre in Lakka [outside the city].”
He also said dozens of foreign experts are due to arrive to back up a health service that is overstretched at the best of times. Given a chronic lack of skilled personnel, much of the battle is currently being fought by volunteers.
Health workers have been hit hard by the disease. Twenty staff members at the main government-run hospital in Kenema are said to have contracted Ebola.
Nurses have been striking intermittently for weeks, demanding better hours and the payment of a monthly risk allowance worth about $20. They are also demanding the takeover of the hospital management by the medical charity Medecins sans Frontieres, who are operating the world’s largest ever haemorrhagic fever treatment centre in the far east of the country.
In Freetown, the slum neighbourhood of Kroo Bay – a labyrinth of shacks and muddy pathways perched at the edge of a large rubbish dump stretching out into the Atlantic Ocean – has not yet been hit by the virus.
But community health officer Baba Musa is worried nonetheless. “I am afraid,” he says, sitting in a dimly lit office at the local health clinic. “These places are always prone to outbreaks.”
He has reason to be concerned. Infectious diseases have a history of spreading like wildfire through the crowded shanty town. An outbreak of cholera in the slums of Freetown in 2012 killed almost 400 people.
Series of rumours
Efforts to control the current outbreak have been hampered by a series of rumours that health workers and the government are intentionally spreading the disease for their own gain. It is this fear that drove Saudatu’s family to break her out of hospital and seek help from the traditional healer instead.
Massive awareness campaigns have sought to dispel these rumours and teach people how to avoid contracting the disease. However, progress has been patchy. Health outreach workers acknowledge it takes time to break through a deeply ingrained distrust of the government, fuelled by decades of opaque governance and endemic corruption.
I haven't seen anyone die of Ebola yet, so I can't say I believe it's real.
“There has been lots and lots of sensitisation here,” says Musa, as a rat scuttles back and forth from behind the cupboard in his Kroo Bay office. “Initially we had denial, but with the death of Dr Khan [Sierra Leone’s top virologist, who died of Ebola last week] more people are now accepting the disease is real.”
But two months and hundreds of deaths on from Sierra Leone’s first registered Ebola case in the far eastern district of Kailahun, many still simply do not accept the disease exists.
“I haven’t seen anyone die of Ebola yet, so I can’t say I believe it’s real,” says Kroo Bay resident Anna Musa Koroma, sitting outside her corrugated iron hut surrounded by her many children. “I am not afraid at all. I just look to God.”
This sense of fatalism is common in Freetown. Despite being in a state of emergency, life for the vast majority of the city’s residents continues as normal.
Though a few have started to wear protective latex gloves, most seem as inclined to put their trust in God instead of adopting preventive measures. The buckets of chlorinated water that have appeared outside some of the city’s businesses and restaurants are nowhere to be seen in the slums.
In a teahouse in Wellington not far from the traditional healer’s clinic where Saudatu was picked up by the police, Al Jazeera asked people what they knew about preventing the spread of the disease. The response was unanimous: “We will pray to God.”