The day after the end of the outbreak

With the World Health Organization declaration on Saturday that the 18-month Ebola outbreak in Sierra Leone was officially over, it was a poignant weekend. On Sunday morning, when the champagne glasses hadn’t yet been cleaned, the crowds were still dispersing from the overnight beach parties, and the church congregations were dancing and clapping in jubilation, we were back on the road for a traditional reconciliation ceremony in one of the capital’s former Ebola hotspots.

Ebola kills quickly – after 21 days you’re either a survivor or dead. But surviving doesn’t mean everything returns to how it was before. On an individual level, health issues can persist in addition to lost livelihoods, stigma and trauma. At a community level, Ebola has also caused considerable damage – something that UNICEF with support from DFID is working to counteract. The day after the Ebola outbreak ended, we’re back at work.

At the dusty Lion’s football field in the Ferry Junction area of the capital, men, women and children shelter under a make-shift tarpaulin roof that billows up and down in the heavy winds. The rainy season is sending out a parting shot before it leaves for next year. After the introductions, it’s the turn of 12-year-old Aminata* to take the microphone. She tells of the care she received from the community when she was in Ebola quarantine – the encouraging hand-written notes passed to her by friends along with gifts of fruit and other small presents. However she also shares the downside – being kept apart from her brother after he was discharged from the treatment centre: those around thought they were protecting her from further harm.

She also speaks about the moment she was told her mother had died of Ebola – news she only received after the burial had taken place. As she described losing her “best friend”, her “everything” and “the only person she had ever felt close to”, people throughout the small gathering sobbed heavily. Her father had first gotten ill, and been cared for at home by Aminata’s mother and brother. All three later died while under care at an Ebola Treatment Unit.

Aminata was followed on the podium by a young boy, Ibrahim*. He had lived with an uncle who fell sick with Ebola. A neighbour called the 117 hotline and the uncle was taken away by health care workers, though he died the same day. In the coming weeks several other people in the household were also infected, and the house was under quarantine for around 60 days. Ibrahim described how his friends stayed away, and how his home was nicknamed the ‘Ebola house’. When the quarantine ended, no-one wanted to play with him and friends ran away. At football time, no-one picked him for the team. In school, no-one wanted to sit next to him.

In communities, Ebola has caused divisions, hurt and trauma that puts social cohesion at risk. In response, UNICEF is working with partners to use traditional healing ceremonies to promote dialogue and restoration. This sort of ceremony was last used at the end of the civil war in Sierra Leone to help facilitate community healing.

Many families were unable to say goodbye to the deceased in the traditional way, either because of the speed of burial or because they themselves were in quarantine or isolation. The normal rites such as vigils, religious ceremonies, and the traditional sharing of ‘fourah’ (rice paste) with kola nuts and the meat of a sacrificed animal were limited by quarantine, restrictions on gatherings, and economic hardship. “A lot of people felt they hadn’t been able to move on because these acts of remembering and sharing are very central for communities, including in the appeasing of the dead,” said Batu Shamel, a Child Protection officer with UNICEF. “In some communities they believe that without these ceremonies, the deceased won’t transfer successfully to the next life.”

A woman stand at a microphone to talk about reconciliation.
UNICEF Sierra leoneSocial worker Hawa Mansaray from NGO partner DCI introduces the ceremony at Ferry Junction.

The Ebola outbreak has also created divisions between neighbours, and between community leaders and communities. Unresolved tensions and accusations of blame remain in instances where neighbours might have called the 117 hotline to report a sick person next-door, who later died after they were taken away. Contact tracers who placed people in quarantine attract residual ill-feeling even if they were just doing their job. And some survivors and other affected people continue to feel the effects of stigma and discrimination.

These community healing ceremonies represent the first chance for such grievances to be aired. In an emotional scene, one community member openly accused a local councillor of being responsible for the death of his relative because of the councillor’s reporting of the sick man to the 117 hotline. The meetings give opportunities to community leaders and others to explain why certain things were done, and to ask for forgiveness for the hurt caused. At the end of the meeting, dialogue was restored between the two parties, and a greater understanding of what went on.

On Sunday 8 November 2015, the day after the ending of the outbreak, a memorial church service was held in Ferry Junction and the names of the deceased were read out and commemorated. In the afternoon, as the wind and rains died down, prayers were said, and after testimony from children and adults, community leaders asked for pardon, and promised to support the affected. As the sun came out, a lamb was killed and shared out, with rice paste and kola nuts. The world may not yet have a cure for Ebola, but the hard work of healing its after-effects is now underway.

*Names changed

John James is a Communications Specialist with UNICEF Sierra Leone

 

 

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