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Holly Taylor normally works out of the Oxford, England, office of Oxfam, the international development and relief agency. But earlier this month she did something many people would find unimaginable — volunteer to go to Ebola-ravaged Sierra Leone. Oxfam, whose US headquarters are in Boston, has joined a global effort to contain the spread of the virus, mostly through education and by supplying water. Taylor, a communications coordinator, arrived in Freetown, Sierra Leone, on Oct. 16 and has been keeping a diary. These excerpts chronicle her first four days on the ground.
Absolutely mad first day. It started out on the plane from Morocco. Before the flight, I got a really panicked call from my mum. She begged me to stay in Morocco and said she would pay for my flight home. So I was probably feeling the most anxious yet but put on a brave face.
When I arrived in Sierra Leone, I had to get on a bus and then a boat, after which a driver took me to the Oxfam guest house. Then it was straight to the office in Freetown. You have your temperature checked and wash your hands before entering.
I met the campaigns and advocacy manager, who told me about the work Oxfam is doing to provide safe drinking water. She explained [that] the public health messaging tells people to wash their hands all the time, but in reality in poor rural areas where they have to walk miles to get water, they are not going to prioritize hand-washing — they prioritize drinking and cooking. That opened my eyes to the reality and the importance of providing clean tap water.
She talked about people not wanting to be quarantined, as they would be separated from their family. She told me we need to start thinking of the survivors because they are often pushed out of their community. Women whose husbands have died no longer have an income.
I also spoke to the Oxfam project manager, who has been working into the early hours every day, her whole life consumed by this response. When a loved one dies, surviving family members often become scared — they can face two years in jail for failing to report a case of Ebola, so they leave the body. The project manager said bodies are sometimes left on the street for days. And if you call in a burial team, the whole community gets quarantined. People don’t want to be responsible for that.
I traveled to the other side of Freetown to visit community health workers being trained by Oxfam. On the way, we went to the District Ministry of Health — the base for burial and surveillance teams. Seeing burial trucks and vans with spray hoses made it a bit more real. When I got out of the car, my colleagues told me not to touch anything.
‘I cannot imagine how my mother would feel if she couldn’t hold me or comfort me if I was calling out to her.’
Mimi, the public health promotion adviser, explained that burial teams take away the body but also burn all the clothes and sheets and mattress. The same thing happens when someone is brought in for treatment. This means survivors can be left without clothes, a bed, etc. Oxfam is going to provide packs with sleeping mats, sheets, cloths, and sanitary pads for these people. There are so many more casualties than those dying.
The idea in this area is to train mothers about how to stop the spread in the hope they will talk to other mothers and pass on the message. Women are often the most vulnerable because they are the primary caregivers. If their husbands or children are unwell, their instinct is to go and care for them. With Ebola, however, they stay clear of their children [and] must immediately report any symptoms. I cannot imagine how my mother would feel if she couldn’t hold me or comfort me if I was calling out to her.
Last night, I thought a lot about what I had seen so far. What really struck me is how normal everything is here compared to how I had imagined it. I haven’t yet really seen many signs of Ebola. People seem pretty relaxed. I’m really not sure what I was expecting — maybe that everyone would be in their houses, markets would be deserted, and everyone would be wearing protective clothing.
I came to Sierra Leone apprehensive about what I was walking into, but everyone is much calmer than you might have been led to believe. The reality is the people of Sierra Leone have been living with Ebola since March. You can’t just put your life on hold for that long — you still have to earn money, see your friends, and continue with life as normal.
Today, I traveled to Kabala, which is a town in Koinadugu, a district that managed to stay Ebola-free until last week. I was told to wear long-sleeved clothes to avoid skin-to-skin contact with anyone.
The drive was amazing. Sierra Leone really is such a beautiful country. I would like to come back when there is no Ebola. We stopped at multiple checkpoints. You get your temperature taken. I asked what would happen if your temperature was high. They said you would be made to stay where you are and they would call an ambulance and treat you as an Ebola patient.
In the car I really wanted to ask the other staff members whether they knew anyone with Ebola. But people really don’t like answering this question, partly because of the stigma attached and the fear that they would be treated as suspicious and not be allowed into the office. And they are right — if someone in the car said their friend had Ebola, I would irrationally worry. Everyone talks about Ebola as if it is happening far away, like you are somehow removed from the situation.
We arrived at the hotel and met Doris, one of the staff members. She talked about Ebola coming to the district and how people were hiding bodies and pretending that no one had died. She also talked about how when they took the first patient to a hospital it was miles away and they got stuck overnight, so he died.
Hearing these stories makes you feel so sad. This crisis is completely horrendous. Beneath the calm must be utter terror.
The first interview we had was with the chiefdom clerk. The chiefdom team includes local leaders who work with district government teams. I spoke to the clerk about what his team did to keep Ebola at bay for so long. He said he went from village to village talking to people and making sure they understood what Ebola was and how to prevent it. It really made me understand the importance of health messaging. Prevention is completely fundamental to tackling Ebola at its root. It’s really not as simple as just quarantining cases, because if people don’t understand how the disease spreads they will hide the dead bodies.
The clerk also said he told each village not to trust other villages and to report strangers straight away — something that must be so unnatural to do. In the UK, we would just trust what the government and media said and — on the whole — do as we were told in a crisis situation. But people in Sierra Leone have such strong beliefs in traditional practices that it just isn’t the same.
We then walked to look at the Oxfam tap water stands. I was proud of Oxfam — it’s been part of the reason this district has managed to stay Ebola-free until now. While we don’t treat the sick directly, we do our best to make sure people don’t get sick in the first place. With no cure for Ebola, that’s pretty vital.
Everyone I met today was so determined to get through this. They used the word “embarrassed” to describe how they felt about Ebola getting to their district. They said they are not going to let it take hold.
Oxfam staffers get picked up from their accommodations and dropped back at the end of the day. Only staff and partners can travel in these vehicles, which are disinfected once a week. There have been reports of taxis taking Ebola-infected people to hospitals and then carrying out their normal service.
I went with our photographer to Tengeh Town, an area in Freetown. We met up with local people volunteering as Oxfam community health workers and followed them around. They are giving up their time and putting themselves at further risk to try to save their communities. One of them, a woman named Mary, told me her friend lost 10 of her family members from the same house.
I also met Priscilla, who is a community health supervisor and nurse. She said she was worried about her child and nieces and nephews because she works at a hospital (that doesn’t treat Ebola), where one of her colleagues died and another is ill with the virus. She said she is worried that if she gets sick she would infect them, because how do you explain to a child that they can’t touch their mother? It’s an example of another brave lady worried about everyone else, putting her own life at risk. Imagine the burden of knowing that you are placing your children’s lives in danger but if you don’t work, you won’t have food on the table.
Everywhere I went, people thanked me — well, actually, Oxfam — for still being here.
I also spoke to my mum today about coming home. She and Dad had joked that I can’t come to visit them for 21 days. My boyfriend’s dad said he hadn’t told anyone at work where I was because they would worry he might get infected. While they were all joking, their words provided me with a small glimpse into what it must be like to be a survivor, or the family member of someone who has died. No one trusts you; no one wants to be near you.