After Ebola – in pictures

Sierra Leone
Africa
EbolaPhoto09 - Holding a photo

by Hazel Healy

The world’s media has moved on but people in Sierra Leone are still living with the consequences of the most deadly outbreak of Ebola in history. In this photo gallery, we look at out how they are coping, two years on. Photos and text by Hazel Healy unless otherwise stated.

A promise

Above, Alhassan Kemokai holds a picture of his mother, Madame Basheratu Kemokai who caught Ebola at Kenema Hospital. She was one of more than 40 hospital staff to die at Kenema – site of Sierra Leone’s only isolation ward – which, in the early days of the epidemic, was overwhelmed by cases. On her death bed, she took the hands of her eldest son in hers and told him he should not forget his younger siblings; Alhassan survived Ebola to find himself at the head of a vastly expanded family.

‘We are jam packed!’

The family of Alhassan Kemokai (pictured centre) grew exponentially from two boys, aged 2 and 9, to 17 orphaned children and young adults from his extended family (front row: left to right: Titi (3), Alhassan (31), Kumba, Alhassan’s girlfriend, and Mansoor their son (2), backrow left to right- Zeinab (12), Kumba’s sister who has been drafted in to help, Halima (9), Issatu (17) and Agustin (11)). Alhassan, is energized, and coping – just – thanks to a job at German NGO Welthungerhilfe, but talks of a ‘deficit every blessed month!’ and worries that he may have to give up the youngest child (his niece Titi, on his lap) for adoption. Alhassan is still plagued by aches and pains and advocates for other survivors in the district of Kenema, Sierra Leone to help them access promised free health care.

Sharing is not easy

Kumba Kendema absorbed nine children orphaned by Ebola from her partner Alhassan Kemokai’s family. ‘When they call me mother it makes me happy – we treat them all equally,’ she says. ‘I want them to feel they are our own.’ Her two-year-old son Mansoor, pictured, is less pleased about sharing his parents, she admits, and tries to keep the other children away from her. She baulked at the added responsibility at first but friends talked her into staying put, convincing her that things will change. And so she shouldered this formidable domestic burden – laundry alone takes 3-4 hours a day – drafting in her sister, and aunt (pictured below) to help.

Satta and Paul

Not all orphans have a solid foundation to fall back on. Ebola survivors Satta (3) and Paul (6) are now being cared for solely their 22-year-old aunt Serah, who is also bringing up five other cousins, in Koindu, Kailahun district the early epicentre of Ebola. Both children suffer Ebola after effects, with chronic eye problems and relapses into fever. Serah has been unable to finish her own schooling or find work, and relies on a charity Smile With Us to feed and educate the seven children in her care, which it does entirely through donations raised by the Sierra Leonean diaspora in the US and Australia. The charity Street Child estimates that over 12,000 children have lost their primary care giver to Ebola, and over 3,200 have lost both parents.

Back to school

Ebola spread haphazardly through Sierra Leone, devastating some areas but skipping others altogether. The remote small town of Kamakwie in the northern Bombali district had just one positive case, after local communities organized an Ebola task force, support by the NGO Health Poverty Action, to keep the disease at bay. But residents country-wide were all affected by measures to stamp out the virus, such as closing down schools for a year. At the time of this photo, 14-year-old Andrew Kayo (pictured above, known as City Boy as he comes from the capital Freetown) was prepping for an exam the following week, struggling to catch up on a year of missed schooling. Pictured below, Mariama Kamera, Balza Sesey and Mbulu Kamara.

Picking up the pieces

Laurence Ivil

Elizabeth Katta has taken charge of the baby boy of her 14-year-old sister who became pregnant during Ebola. Her sister is one of many girls exposed to sexual exploitation during the financial hardships of Ebola when teenage pregnancy jumped as much as 60 per cent in some areas, according to research by the Secure Livelihoods Research Consortium. Elizabeth’s intervention means that her sister has been able to stay in school – but one far from home. ‘My sister loves Munda, she rings for news of him every day,’ says Elizabeth. ‘But she was so ashamed the father did not recognize his son that she has gone to live with another sister, and studies 100km away.’

Rebuilding trust

Maternal health promoters Fatu Bangura, Foudea Turay and Memuna Bangura (left to right), who are trained and supported by Health Poverty Action, spent a month visiting villages to persuade pregnant women and nursing mothers to return to their clinic in Kamakwie. Sierra Leone already has one of the world’s highest maternal mortality rates and during the outbreak at least five women in the area died in childbirth after shunning the clinic for fear of infection. But on the day of the photo, Fatu was satisfied their work had hit its target. ‘People know us – and respect us, they listen to us,’ she explained. The previous day had seen a full house of breastfeeding mothers, and 65 immunizations against measles, BCG and yellow fever.

They brought us on board too late

Pa Mohamed Sesay is a paramount chief and head of a secret society in Makeni. Responsible for performing traditional burials, the societies inadvertently helped spread of the disease by washing and burying the dead when the bodies of Ebola victims were highly infectious. But after influential society members were engaged in the Ebola response and trained by Health Poverty Action, the secret burials stopped and people began to hand over their sick to the Red Cross. Sesay always believed in the disease. He says community resistance came partly from poor messaging saying Ebola had no cure. ‘People said, “why would I bother going to the hospital, if I go there to die?”’. He is anxious to perform rites and bless those who died while traditional ceremonies were banned, so they can have eternal rest.

Surviving stigma

During the outbreak, many Ebola survivors were ostracized by communities afraid of catching the virus. Nine-year-old granddaughter Christina (second on the left) was rejected by her school mates until a teacher Joseph Ali Kanu – who was trained by Health Poverty Action as a ‘psycho social’ worker to help reintegrate survivors – won them round by hugging Christina whenever he could declaring: ‘this is my school girl! She’s your sister – your friend!’. Christina’s grandmother, Esther Turay (pictured centre) fell sick after her husband Agustin, a community health worker died from Ebola, swiftly followed by her six-year-old grandson and her son, a miner, who was also the family breadwinner. Ester is struggling to make ends meet: she has suffered chronic joint pain since Ebola, and is unable to do her previous work of making bread and farming; government help for survivors has dried up.

Seeking closure: The final resting place

Biosafety imperatives rode roughshod over social rites during Ebola, especially during its peak, with loved ones buried far from home, sometimes in unmarked graves. Families, who were left ignorant of the fate or final resting place of the sick who were taken away, are still trying to trace their dead. Mariama B Jalloh lost her father and 27 other relatives when Ebola ravaged her hometown of Kumala in northeast Sierra Leone. He was taken to a treatment centre hundreds of kilometres away, where he died alone. Eighteen months later, she came in search of his body in an overgrown, neglected Ebola graveyard in the southern city of Bo.

Grave 187

Mariama Jalloh collected her father’s death certificate from the council with the number 187 of his grave. After hours of searching (‘it felt like a disaster, I nearly lost hope’) she found the faded stick (pictured above) in the chaotic burial site with the help of a gravedigger who remembered where her father was buried from the date of his death. She arrived just in time. But it will soon be too late for hundreds of other families – unable to afford the journey to distant graveyards such as this one – to find the graves of their loved ones as temporary markers fall away from graves, and with them the only means of identifying them as someone’s lost child, mother or brother.

‘I feel he is with me’

Laurence Ivil

After Mariama bought a permanent metal marker, gravediggers cleared the soil around the grave of her father, Alhaji Musa Jalloh, and prayed with her. ‘I was able to say the prayers that you must say when a Muslim dies in Sierra Leone,’ she said. ‘I asked god to take care of him, the way he took care of me when I was small. I felt closer to him, I felt he could see me.

‘When my father died so far from home it caused my family great pain. They did not bury him with respect. Now that I have identified him, my family can come – they will not need to suffer as I have.’

Offering solace

Michael Duff

Moved by the distress of families like Mariama’s, the charity Concern Worldwide took over ‘safe and dignified burials and body management’ in and around the capital Freetown, in October 2014. Over the next 18 months, their workers would dig more than 16,300 graves at the cemeteries Kingtom (pictured above) and Waterloo, each grave marked with a permanent headstone. Families trying to trace those who died still arrive daily; Concern – which was recognized by the EU for its Ebola response work – has also bussed people in from nearby villages and run radio jingles inviting families. Unlike the forgotten burial site in Bo, on arrival in Kingtom mourners are given a condolence card, with a name and number. ‘It’s good to be able to offer some solace in the face of so much sorrow,’ says Fiona McLysaght, Concern Country Director in Sierra Leone. ‘We had a survivor looking just last week for their grandchildren, daughter and son-in-law. When someone has lost most of their family, you can at least make sure they are able to find the graves.’

Known unto God

Michael Duff

During the fear-filled, chaotic early days of Ebola, many bodies that came for burial could not be identified; some were buried in mass graves. They were those who had come to clinics already sick and delirious, or had died on arrival. They were the unaccompanied under-fives or those people whose bodies were found in the street. In Kingtom cemetery in the capital Freetown, there are 665 unnamed graves marked only as ‘known to god’ that date back to this time. If bereaved families have the date of the death of a loved one, Concern Worldwide’s Family Liaison Officers are often able to pinpoint the area of the graveyard that the person is buried in, so that, even if there is no named headstone, families have a place where they can come to pray.

All the children

Michael Duff

Stillborn babies and under-fives accounted for almost half the burials in Kingtom and Waterloo cemeteries, highlighting the inherent weakness of Sierra Leone’s health system. Not all deaths were due to Ebola, but during the outbreak all burials had to be treated as suspicious and be carried out in 24 hours. Since November 2015, normal, non-medical burials are allowed again, but all dead bodies are still swabbed and four burial teams are still on standby for suspicious cases.

‘The best gift is to be alive’

A brilliant young army medic, Boie Jalloh, ran an Ebola Treatment Centre (ETU) on the outskirts of Freetown, just months after completing medical school. He went on to treat 1,000 patients at the ETU – which was set up and run by Sierra Leoneans and had impressive survival rates – and has since won a presidential award. Despite the suffering he witnessed, he says the epidemic changed him in a good way – ‘I am more humble. And I appreciate life more now – I was sure I would not escape Ebola.’ Jalloh will go abroad to specialize in infectious diseases but will return home – refusing to join the exodus of trained professionals seeking better opportunities in the industrialized word. ‘We are the most experienced people in the world [at fighting Ebola],’ he says. ’I love my country, but also I will have more responsibilities here. Elsewhere, as a noncitizen you only go so far.’

Moving on

‘I’m looking for a loving, caring man – with money,’ says Mabinti, pictured here doing Kadikadi’s hair before a community dance organized by the women’s group of Magazine Wharf, a former Ebola hotspot, one of Freetown’s largest slums and source of the last cases in the capital. The group of smoked-fish sellers has called the first dance since the time of Ebola ‘Pick someone up’. ‘We want to talk together, eat together and dance – for our good health,’ says Kadikadi, who is being filmed for the Back in Touch digital feature.

‘People are very excited that Ebola has gone,’ says citizen reporter Mohamed S Camara, whose mother is one of the organizers. ‘Women have a hard life, they need to relax. Tonight is about dancing, and forgetting.’

The After Ebola project was a partnership with On Our Radar supported by the European Journalism Centre’s Innovation in Development Reporting grant programme.

It funded an investigation in our June 2016 magazine into the humanitarian response to Ebola, as well as the Back in Touch webdoc by citizen reporters, which has been nominated for the AIB Media and Lovie awards.