The normally bustling streets of Freetown are empty, silent. From time to time a vehicle appears on the deserted road with the emergency lights on and keeps on going.
It’s 7 am on the 19th of September, the first day of the Ebola Virus Disease (EVD) house-to-house sensitization campaign in Sierra Leone – or Ouse to Ouse Tock as it’s called in the local Krio language. There are almost 30,000 outreach workers around the country, organized in groups of four, who are telling communities about the Ebola, with the aim of reaching 1.5 million households.
One of the sensitization teams start in eastern Waterloo, one of the Ebola hotsposts of the wider Freetown area. They enter a labyrinth of narrow streets – families wait patiently, seated in the halls of the houses, cooking, washing clothes, listening to the radio or playing checkers.
A volunteer with bright red hair explains how Ebola is transmitted, what the symptoms are and how to prevent it. Everybody listens in silence, even the youngsters. A woman in her twenties hanging out the laundry asks questions about the way Ebola is transmitted. Afterwards she starts screaming dramatizing a scene: “Do not touch me, do not touch me” whilst her mother chases her, stretching her arms, opening her palms, and touching her belly. The neighbours laugh. Humour is a common antidote in the face of this dreadful disease.
The redheaded volunteer hands over to another member of the team who carries a box with soap, and delivers one bar to the family explaining the correct way to wash hands: “Slowly, washing the nails, the forearms”. The family accepts the soap but says that it is not enough. The volunteer explains that the soap is to promote hygiene, but each family has to buy more soap with their own means.
When the sensitization finishes, it’s time for questions. Another member of the team glues a sticker on the wall to certify that the volunteers have visited the household. Soon they move to the next household.
Another team visits the Dovecut market where cartons, rotten fruits and muddy water cover the ground. Suddenly an ambulance appears on one corner of the street.
The neighbours surround a young pregnant woman who walks with difficulty to the vehicle. She complains of persistent abdominal pain. Nobody helps her onto the stretcher fearing she has Ebola. A nurse, wearing latex gloves, helps her to lie down and tightens the safety belt. The ambulance rushes from the market to the Princess Christian Maternal Hospital in the east of Freetown.
The pregnant women asks in anguish: “Is it Ebola? Am I infected with Ebola?”
Two nurses, protected by latex gloves and masks, place a thermometer under her arm. The three minutes spent waiting for the reading seem endless. Finally another nurse uses an infrared thermometer. A 35.2 Celsius appears in red on the small screen.
The woman has no fever and no Ebola. She disappears behind the doors of the consultation room. She has been diagnosed with an infection and will need to remain for several days in the hospital. Health care is free for pregnant women and children under the age of five in Sierra Leone.
The matron’s assistant confirms that in this woman’s case it is an infection but adds that “there is an Ebola positive pregnant woman in the holding centre”. Nobody can go near the ward except for the nurses because of the highly contagious nature of the illness. While there is a small sign indicating the dangers, but the doors are open and anybody could enter by mistake.
The health worker points to a window at the back of the holding centre through which the patient can be seen. There are two bricks located strategically under the window to allow people to step up and peer in. Before I climb up I am told: “Don’t touch the window!” Thought the iron bars of the window an inexpressive face can be seen. A pregnant woman dressed in blue sits on the immaculate white bed. She is alone in the room.
“A member of her family is in the hospital, but he cannot enter the holding centre,” says the matron.
Ebola is the most dehumanizing of illnesses. It’s not only highly infectious but moreover it forces the patients to overcome it or die. Alone.
According to the Government of Sierra Leone, 130 Ebola cases were identified during the three day sensitization campaign; 39 more cases are waiting for blood test results. More than 75 percent of the targeted 1.5 million households were reached according to the Health Ministry.