Sierra Leoneans mark Ebola-free status, but outbreak's effects persist

FREETOWN, Sierra Leone — Thousands of people in Sierra Leone's capital danced and sang in the streets to celebrate the official end of the country's Ebola outbreak, declared by the World Health Organization on Saturday.

At Friday night's celebrations many wore yellow, the official color to symbolize the fight against Ebola in Sierra Leone.

The World Health Organization officially declared Sierra Leone Ebola-free at a press conference in Freetown on Saturday after the country marked 42 days with no new case of the virus, the official indicator for being considered free of the outbreak. Liberia passed that landmark in May, while Guinea, the third West African country at the epicenter of the outbreak, is still struggling to completely eradicate the virus.

The Ebola outbreak killed more than 11,000 people in West Africa since December 2013, including nearly 4,000 Sierra Leoneans.

For many in Sierra Leone, the Ebola-free declaration was a somber reminder of what they had lost. Ebola survivors visited cemeteries across the city where family members and friends who perished from the disease have been buried.

“It’s a remembrance day. We want to offer prayer and remember them,” said Yusuf Kabba.

Kabba contracted Ebola in October 2014 and has vivid memories of the deaths he witnessed in the treatment unit. On top of this trauma, he said, Ebola survivors are often shunned by their families and sometimes their entire communities. In response to this, Kabba created a support group called the Sierra Leone Association of Ebola Survivors.

“I have lost about nine family members — my wife, my father, my children, my brother. All of them are gone because of Ebola,” said Daddy Kamara, another Ebola survivor mourning loss and a member of Kabba’s group.

"To think about this is not a day of celebration,” he said.

The outbreak had a devastating economic impact on the region, with swathes of the country under quarantine and schools closed for nearly a year. Idrissa Conteh, who works in construction, says he is glad the spread of the disease is over but he is also worried because so many people have lost their jobs.

And even with the outbreak over, health complications like joint pain and vision problems — sometimes even blindness — continue to plague Ebola survivors. 

Jacob Maikere is head of the mission for Doctors Without Borders (MSF) in Freetown. The organization has been fighting the outbreak in West Africa since its onset.

He said MSF will scale back their operations in Sierra Leone, but continue their Ebola survivor clinic. He worries about how the country’s health system will cope, with so few medical specialists and so many survivors experiencing health complications and emotional trauma.

MSF had repeatedly warned the international community to speed up its response in the early stages of an Ebola outbreak. It took the WHO and international partners several months to recognize the outbreak as a global health emergency and bring in aid such as medical personnel and treatment facilities after repeated pleas for help.

“It should have been quicker and I have a feeling we could have stopped the outbreak if response had been quicker,” Maikere said.

An additional challenge in the fight against the virus was spreading the message about the dangers of traditional burials, in which loved ones often wash and dress the deceased, putting themselves in contact with bodily fluids of the corpses. The virus is most contagious right after death.

By raising awareness about the risks, Ebola survivors, community leaders  and international NGOs started to have an impact. Safe and dignified burial teams were established across the country, and every burial had to be done by a professional team.

This day has been a long time coming for many burial workers.

“I feel relieved, I feel my work that was so hard has succeeded. We burial workers — we are champions, working sometimes 18 hours a day has been hard,” said Mohamed Kamara, who is a burial team member with the Sierra Leone Red Cross.

The government mandates testing of all bodies for Ebola until June 2016, and safe burials will be carried out in targeted regions of Sierra Leone. Trained burial teams will also be on standby in all districts.

During the height of the outbreak, Time magazine named the health care workers in the Ebola fight as “person of the year” for sacrificing their lives on the front lines daily.

More than 200 local medical workers died along with 11 local doctors, including the country’s only virologist, Dr. Sheik Umar Khan.

For Mustapha Koroma, a nurse in the Ebola isolation ward at Connaught Hospital in Freetown, the moment of the country becoming free of Ebola is bittersweet.

“My family abandoned me because I put myself to work in the isolation unit … I had nowhere to go. I was staying in Connaught Hospital,” he said. “It was a very difficult time for us. We were stigmatized from family and friends. Even in the hospital some of the nurses stigmatized us because we were in the isolation unit.”

While the ward where Koroma works will continue to serve as an infectious disease unit, labs and treatment facilities across the country are shutting down due to the reduction in cases. However, at least one will remain open in each region according to the World Health Organization and the National Ebola Response Centre (NERC).

And although the end of the outbreak in Sierra Leone is a remarkable accomplishment, neighboring Guinea is still reporting new Ebola cases as of the first week in November.

Officials warn that Sierra Leoneans must stay alert, as an outbreak can begin from just one case.