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 July 14, 2014

EBOLA DIARY

by

Paul Conton

I am filled with a foreboding by this Ebola outbreak, a sense that the worse is yet to come, that the government is not being completely open and that things may be out of control. Are all the wasted decades, the neglect of our most important institutions, of our economy and our Health Ministry and our hospitals and our schools, is all this finally coming back to haunt us? Is all the complacency and the lack of seriousness as we slip and slide from one catastrophe to another finally going to end in national disaster? The figures keep rising with every new update. The WHO says 337 sick and 142 dead based on government figures, but the government figures are lower. And I hear other alarming reports that indicate the situation could be even worse. The disease first started far from Freetown, in Kailahun district on the border with Liberia, but now is threatening the cities. A VOA correspondent in a recent report talks of walking into remote villages and finding them devastated by Ebola; the government is careful to point out that its figures are based strictly on blood samples testing positive at the only Ebola testing laboratory in the country. So if the blood sample of an Ebola victim was not sent for testing it would not be counted in the official figures.

The gateman in my compound approaches me with a worried look on his face. Several of the children in his neighbourhood have fallen ill, he reports, including his grandchild. He isn’t sure what the problem is. They are vomiting and have diarrhea.

“Are they passing blood?” I ask.

He hesitates a fraction of a second. “Yes,” he replies.

I tell him to go back home and take them immediately to a government hospital.

"Boss, it's an ordinary fever," he says, reading my mind. " It's not that bad sickness they're talking about." I feel guilty, that I am only too ready to ostracize the poor and the weak in society.

“Take them to a government hospital,” I say. “They will treat them there.”

“They’ll want money at the hospital,” he replies.

I tell him this is a special responsibility of the government and he should make sure he goes to a government hospital. I give him money for transport.

I am in a bar in Freetown on a Saturday afternoon, having a beer. The conversation turns to Ebola. I am in a group of five or six men, including the bar owner, who is well known for being a member of the political opposition.

“Of course we can’t control it,” he says with unyielding certainty.

I ask him why not.

“They could have controlled it if they had handled it properly at the beginning,” he says. “But they took the people and injected them and they died straight away. The people gave their sick people to the government hospital and the same day the hospital came back and told them they were all dead. Now everyone is afraid to take their people to the hospital. When you test positive they give you an injection and you’re dead.”

I express astonishment at this analysis.

“It’s the only way to stop the outbreak,” he says. “It’s how they did it in Zaire. Ebola has no cure. So if you test positive they take you to the isolation center, and once you’re there it’s only you and the medical people. They inject you to stop you infecting anyone else.”

My astonishment is mixed with outrage and disbelief, but the others join in against me.

“This is well known in Kailahun,” one says. “They don’t have a cure. So the best thing they think they can do is finish you off quickly. So now even people with an ordinary fever don’t go to hospital anymore. Because if the test comes back positive they take you away and that’s it.”

I struggle in vain to disabuse my companions of their theory.

“What about the government?” I ask. “What about MSF? What about the World Health Organization?”

“They’re all in it. It’s how past outbreaks have been ended.”

My companions are all reasonably well educated, well-off members of society, in the higher levels of the socio-economic scale. But my mind goes back to my house help, in the lower levels of this scale, who had told me two or three weeks earlier about people going round with a purported cure for Ebola, an injection, which killed you straight away. At the time I had dismissed her remarks as isolated rumour mongering.

My mother and brother, who stay in the same family compound as I do, want me to lay the gateman, Pa Kemoh, off immediately.

“This is a threat to my family,” my brother tells me.

I explain that Pa Kemoh shows no sign of illness and reports that his grandchild is improving. No one has been confirmed positive for Ebola in Pa Kemoh’s neighbourhood. In any case there is normally not close contact between any of us and the gateman.

“You can keep your windows rolled up as you pass through the gate,” I tell him.

"This doesn’t affect you alone," he says angrily. "He uses the same toilet as people who work in my house. The virus could enter my house that way."

I tell him he's panicking and becoming irrational. If the virus is transmitted that easily then we're all doomed, whatever we do.

At the same bar, I talk to a nurse, an MCH Aide working in Freetown.

"It's all lies," she says. "There's no Ebola."

"What?" I say, astonished again.

"It's all about money. There's big money coming in for this thing. Big money! From outside. So they're faking it. It's not one or two people. There's a whole group involved. It's all lies."

"And your Ministry of Health and your Minister," I ask. "They are all lying?"

"Yes. All lies."

"And the journalists who investigate and report about it? They are all lying."

"Yes. Lies."

"What about President Koroma, who gave a national address just a few days ago?"

"He believes anything they tell him."

"MSF and the World Health Organization?"

"They're all part of it"

I look at her and become angry and disgusted at her dogged, deliberate ignorance, sitting in her small corner in Freetown and passing judgment on a deadly crisis she's done nothing to investigate.

As a precaution I decide to do my own investigation, of Pa Kemoh's case. I go to Syke Street, in central Freetown, and look for the government health facility he has told me he took the children to.

"Hospital?" the worker at the school dental clinic on Syke Street asks me. "This is the hospital."

"No," I say. "Not dental. One that admits patients."

He thinks for a while. "The Catholics have a hospital just after Globe Cinema."

"The Catholics? It's not a government hospital."

"No. It's not a government hospital."

I drive up Syke Street and am eventually directed down a narrow side street and then into an even narrower drive, unpaved and rocky. Past a duplex in need of paint, clothes to dry hung about the frontage, I see a small gate, with three mechanics working on a vehicle part.

"Where's the hospital?"I ask.

They motion me to go further in. I enter the yard and see a small, perhaps two-room, structure made of corrugated iron. There are two women outside it.

"This is the hospital?" I ask.

They nod.

"I'm asking about the children you had here over the last two days?"

They look blank. Pa Kemoh lied. No government hospital. No Syke Street.

I do some research on the internet on the Great Plague in England. It makes grim reading. A filthy, congested city. A poorly-understood disease for which there was no cure, readily spread from human to human. Corruption and ignorance. 100,000 dead within a few months. And this was a small outbreak compared to the "Black Death" plagues that had earlier spread across Europe.

Could it happen again? I wonder. In the twenty first century. Everyone has his own reality in this crisis. The Ministry of Health and the World Health Organization each have their own realities, with two different sets of figures. The VOA reporter has his. And the nurse and the beer drinkers. My brother and Pa Kemoh. All have different realities. Where does the truth lie? I wonder. How will it all end? As I settle down for the night I pray that the coming day will bring news of a drop in the number of new cases.

 ...read Ebola Diary 2