Human touch essential to hold on to in response to Ebola crisis

Port Loko Letter: bereft teenage boy a reminder of human toll of virus outbreak

A burial team member is assisted in the decontamination process as grave diggers fill the grave of Ebola victim Isatu Sesay, (16), in Kissi Town, Sierra Leone. Burial teams are often rejected by their communities out of fear. Photograph: Daniel Berehulak/The New York Times

A burial team member is assisted in the decontamination process as grave diggers fill the grave of Ebola victim Isatu Sesay, (16), in Kissi Town, Sierra Leone. Burial teams are often rejected by their communities out of fear. Photograph: Daniel Berehulak/The New York Times

 

Stricken with grief – a phrase from romantic fiction. But there was nothing romantic about the scene I was witnessing. A new burial ground with 30 or more recent graves, beside an older graveyard in a small village community in the Port Loko district in rural Sierra Leone.

A few of the graves were freshly dug and open, waiting to be filled. Simple uniform markers had been placed on the graves, some with a name, some marked unknown but with a number. Perhaps some day the number might be able to help put a name to the body buried within. In the meantime there are families waiting, not knowing what happened to their loved one since they last saw them being taken away to isolation.

We were there to observe the burial process in order to give technical advice to the teams. The four strong young men on the burial crew quickly donned personal protective equipment until they were unrecognisable as humans behind the plastic.

Disinfecting with chlorine

Two on each side to carry the body, which was unloaded off the truck, sagging slightly in the white body bag. Two other alien-like creatures carried chlorine tanks on their backs, and, one on each side of the funeral procession carried a spray hose in their hands disinfecting at every stage of the process.

After the body was lowered into the grave, long sticks were placed upright around the body and then covered with dry brush in accordance with local tradition. Then, a second body in the neighbouring grave, after which the men gradually reappeared after carefully doffing their protective equipment. They then picked up a shovel and continued to work solidly in the intense humidity until a large mound of earth covered each grave.

This is thankless and risky work. These burial teams are often rejected by their communities out of fear. They take the work because they want to eat and feed their families, and sometimes because they want to help end the Ebola outbreak in their country. But, like so many workers in this response, they have problems getting paid. Despite the vast amounts of aid money available for the response it does not seem to be trickling down to where it’s needed – to pay the people doing the work and to buy the basic equipment that is needed to get the job done and keep the workers safe. It is not surprising this disease continues to spread and cause unnecessary deaths and misery.

Bewilderment

As soon as I saw the boy it was clear he was grieving. He stood close to us as if for comfort, standing straight and silent and still. Literally stricken with grief. I could see the pain on his face and sense his bewilderment. I was told he was 17 years old and came to see his father being buried. He had already lost three family members to Ebola, and the rest were away in an isolation facility. He was alone. He did not look angry.

Maybe that will come later. Will they all become angry?

Watching him, I felt some anger. At the politicians who propagate fear and stigmatisation for political gain. At the organisations who jostle for the limelight. At those of my medical colleagues at home, sitting fearful in their offices, who seem to have forgotten that with the privilege of being a healthcare worker come responsibilities. At those who from the comfort and security of their homes in the West value self-preservation above all else. At those Africans who profit from the misery of the poor. At those who simply couldn’t care less. Those who display no humanity.

I wanted to give that boy a big hug – I have children that age. But that was not possible: human touch is discouraged because of the fear of spreading the disease. I did shed a tear, the only one I have allowed myself since coming to west Africa in September. After all, there is a job to be done. But that tear was important to me to remind myself that I am human. This boy is a person and his family are people too. And this response must be first and foremost focused on people. But from this vantage point there is not a lot of evidence of that.

We set off in a little convoy of vehicles to our next task. To collect the body of a child from its home. As we pulled away I saw the boy getting on a bicycle and pedalling away. I have no idea where he went.

Dr Eilish Cleary is in Sierra Leone as a consultant to the World Health Organisation’s global outbreak alert and response network