It seems like such a joke that, just a few short months ago, I was pondering on this blog how Sierra Leone would protect its stunning beachfronts from destruction in the march towards development.
Georgie and I have spoken often about the likely longer-term effects of this outbreak, worried about the healthcare system, food shortages and the collapsing economy. Asked each other where this will end. We are so used to our own modes of thinking, our own cognitive bias based on the circumstances of our own lives that, living in Sierra Leone, we were often challenged and stunned by the opinions or concerns or alternative approaches of our host country. You could always count on someone to raise a point you hadn’t considered.
Georgie has recently employed George, an excellent Sierra Leonean trainer and mental health practitioner that she had previously worked with in her role with the Enabling Access to Mental Health programme. Her EAMH work seems more important than ever in the light of this outbreak and its effect on the country and I’m thrilled she’s been able to enlist George’s help. She asked him what he thought about the long term effects of Ebola and once again his answer challenged our own perceptions:
He said, “What is so sad about the illness is that is cutting the link between the living and the dead – the links in African cultural between the living and the ancestors is enormous and meaningful and this illness is threatening that.
People get sick in Africa; getting sick is normal and accepted and people get sick so often that they know when it is malaria that they can treat or when it is something else. When it is something else then they call their family to come and care for them.
This is the time when the family can literally show how much they love them, they show it by how much they do for them whilst they are sick, how much they care for them. The care can be feeding them, washing them, giving them medication, letting them lie on them and sleep on their laps or anything.
No one should die alone
It is this time when people come and give messages to the sick person to take with them and tell the ancestors – things like “tell uncle Jimmy not to forget us”
And then when the person dies they are burried in their own grave and every year libation is done and food is taken to the grave and the family keeps the grave clean – because that grave becomes that person’s home.
The dying link the living and the dead and take messages between the two.
No one dies alone or should die alone here -unless the death is suspicious.
Ebola stops that; Ebola has broken this link like nothing before it. The war did not do that because you could see the war, you could see the bullets and you could accept that when the bullets fired into somebody then they would die where they stood, but Ebola is invisible.
Ebola gives you no time to show you care, it doesn’t allow you to touch people, give people messages, give people any dignity in death. Instead it takes you away from your family and ensures that you die alone.
Especially as the doctors and nurses spend a total of three hours on the ward during an eight hour shift because of PPE so you really are alone.
Also when patients die on the ward it takes about an hour to two hours before anyone will come and take away the dead body because they have to get dressed up.
Women are dying whilst breast feeding their babies and the babies don’t know so keep suckling.
One survivor told a tale about being on the ward and staff thought he had died so he was put into a double body bag and it was only when other patients saw the bag move that they realised he was still alive – this happened to him on three separate occasions! Three times almost buried alive.
This is such a different reality from the traditional african way of dying surrounded by people and messages.”
I open another email from Georgie.
“A colleague yesterday told a tale of driving back from Lunsar to Freetown and seeing a body on the side of the road,” She says, “For a sierra Leonean family to chose to dump their dead family members on the side of the road rather than bury them or ask for help to bury is indicative of how desperate people are at the moment – so desperate to avoid being quarantined.”
Georgie asks, “If this link between the living and the dead is cut what will happen to the fabric of the society?”