The landscape could put many of the world’s most beautiful and popular vacation destinations to shame — but the scenery is now pockmarked with cemeteries the size of football fields.
In the devastating outbreak of Ebola in West Africa — a region comprised of 18 countries with an area of more than 5 million square kilometres and a population of some 340 million — Sierra Leone has been the hardest-hit country. The already poverty-stricken population, which has been working to rebuild and recover after a decades-long civil war, now has the weight of more than 10,000 cases of the deadly infectious disease, and more than 3,000 deaths on their shoulders.
And yet, there are good news stories too.
A Canadian Armed Forces medical team was deployed just before Christmas as part of Operation Sirona. Thirty-seven personnel, including medics, doctors, nurses and support staff have been working to support a 20-bed British-built clinic.
Courageous teams like these are to be thanked for the recent decrease in new case incidents in the country.
Lieutenant-Colonel Gary O’Neil, the commanding officer for the Canadian operation, said the CAF is particularly strong at putting together a highly skilled team quickly, and was ready to deploy almost immediately after receiving the request for assistance.
Master Seaman Nicole Spivey, a medic with the Canadian Armed Forces, was chosen to go to Sierra Leone with the first wave of clinicians. At first, she said her friends and family were concerned about her health and safety, as she would be working on the front lines in a fight against something that can’t be seen, but can so easily be passed from person to person.
However, once she completed her extensive training in Britain, and after learning more about the protective equipment they would wear and the stringent protocol they would be following, she said both she and her family felt more confident.
A day in the life
A day working at the clinic is filled with painstaking processes. While commuting to the treatment centre, it is not uncommon to be pulled over at random checkpoints.
Highway checkpoints are something Canadian Armed Forces members are used to; in most circumstances, their vehicles and persons are checked for weapons, or proper documentation. However, as O’Neil explains, at these checkpoints all passengers are examined and have their temperature checked before they can continue on their way.
Once arriving at the clinic, all personnel must don what is referred to as a PPE — personal protective equipment — and are closely monitored both while putting it on and taking it off to ensure there is no way for the disease to penetrate or find its way to exposed skin.
The biohazard jumpsuits, often white or yellow, are accompanied by three layers of rubber gloves, rubber boots, and a full mask that is not unlike a welder’s shield.
Everything is disposed of after a single use, except for the boots and face masks, which sometimes get used several times after soaking in bleach. “It took some getting used to,” said Spivey with a laugh, adding that working in the PPEs “can definitely be warm.”
That’s an understatement. Temperatures in Sierra Leone at this time of year can hit 42 degrees Celsius at the height of the afternoon, and health workers can only stand to be in the gear for a couple of hours at a time, O’Neil explained.
Despite spending much of her time fortified inside what is essentially a giant rubber glove, Spivey says she has had time to take in the wonders of the country she’s in.
The people are incredibly kind and friendly, she notes, and she has been “absolutely blown away” by the natural beauty of the scenery.
Local nationals have shown enormous appreciation for the presence of international militaries, health care workers, and charity organizations, she added. “I’ve been thanked about a million times,” she says.
O’Neil explained that Operation Sirona was initially intended to just treat health care workers, but that the scope of the mission changed the night before they arrived, giving them the freedom to treat local nationals as well.
So far, he estimates the Canadian team has treated 22 health care personnel (both local and international) as well as about 10 locals.
Signs of success
The World Health Organization (WHO) says that case incidences are decreasing, but that Sierra Leone remains the worst affected country, with 184 new confirmed cases in the week of January 11. Spivey notes that a large element to ridding the country of the disease is education, and that this also seems to be improving. Misinformation, myths about the disease, and persistent traditions — especially when it comes to burials — have been fuelling the spread of the disease.
Typical burials in Sierra Leone involve the family of the dead washing, dressing, and kissing the body in a ritual that is meant to ensure the soul passes successfully to the afterlife.
Medical organizations such as WHO and the Red Cross have been organizing education campaigns to spread awareness that a corpse can be up to 10 times more contagious than a person living with the disease.
Burial teams that are carefully protected with PPEs have been collecting bodies as quickly as possible after death, and disposing of them in what appears as a harsh, but necessary, medical burial in mass cemeteries. Graves are garnished with nothing more than a wooden name marker.
According to on-the-ground reporting by CBC, there are plans to come back to the graveyards and finish each grave in a respectful way once the disease has been eradicated.
Often, the disposal team will bury their protective gear in the last grave of the day to reduce the risk of contamination.
Spivey explained that some locals in secluded rural areas have been hesitant to believe that the disease is real, but she added that the education campaigns in the country are starting to show signs of success. Educational posters can be found “everywhere” Spivey says, and people are remembering to limit person-to-person contact.
Spivey says the most incredible moment she has witnessed so far happened when one of her patients finally became disease-free after fighting hard to survive. Before he left the clinic, “he wanted to teach me a special local handshake,” she said.
Despite the three layers of gloves on her hands, he was elated to be able to touch someone in a friendly way, without being pulled away from like a pariah. He was overjoyed to have that sense of human contact, she explained.
Both Spivey and O’Neil emphasized that, despite the challenges and the often-disturbing aspects of the mission, they are both honoured to be a part of Operation Sirona (a name taken from the Celtic goddess of healing).
“I’m really, really enjoying my time,” Spivey said.
O’Neil added: “I’m extremely proud to be here.”
