Our former CEO, Justin Forsyth, visited Sierra Leone last week to visit Save the Children teams and see first hand the continuing fight against Ebola. Here he shares his experiences of meeting Ebola survivors and the human cost of the disease. In part one of his blog he wrote about meeting survivors, here he writes about the wider implications of the epidemic on the country.
Since the crisis began 221 health workers in Sierra Leone have lost their lives of a total of 1536 in a country with a huge shortage before Ebola struck.
At the children’s hospital in Freetown you realise the impact of every health workers’ death.
They lost one of their most impressive doctors last year. They now have only have three for a 200-bed hospital. This means they have to work 24 hours a day.
During the peak of the crisis, some rural clinics closed – up to half in some areas.
Scared to access healthcare
As panic engulfed the country, patients feared they would get Ebola from health centres and so refused to go to them only to die at home from treatable illnesses like malaria, pneumonia and diabetes.
The health ministry estimates there was a 39% drop in children coming to clinics to be treated for malaria and a 21% drop in child immunisation.
Pregnant mums didn’t come to give birth. At Tombo health clinic the midwife Justina showed me the wall chart of births and pointed out the sudden drop – by half – at the peak of the Ebola crisis.
Mums told me how they feared getting infected or being sent to an isolation unit. Despite a huge and effective public education campaign there are still many myths – one survivor told me she thought she got Ebola from her malaria medicine.
It is not just health services that have been affected. Schools have been closed since last March.
Children will soon have missed a year’s education and although there have been innovative programmes to help children learn through the radio, the impact will be profound for each child’s future.
The consequences of not going to school has had a specific and devastating impact on girls.
A girls group I met told me how they had become more vulnerable to older men forcing them to have sex, as they were no longer at school during the day.
And as the economy grinds to a halt, the increase in poverty has led to girls have sex for money. One girl said they can get paid as little as 15p.
This amazing girls group were fighting this sexual exploitation and doing a survey on teenage pregnancy. When I asked them what they wanted to do in life they all said to go to university and study to be lawyers, doctors and NGO workers.
These girls thankfully didn’t contract Ebola, but they are casualties of the crisis. Through lockdown and the effect on the education system, it has threatened to rob their future too.
Ebola is not over. But as we begin to get to get on top of the immediate crisis in all three countries – Sierra Leone, Liberia and Guinea – affected. This will take continued focus and drive and we also need to begin to think about the future.
No going back to the status quo
There is a big debate raging in all three countries on the lessons of what went wrong and what worked. We need to make a commitment to help these countries build a better future. This will take international support and solidarity.
But we don’t want to go back to the past. All the Sierra Leoneans I met talked about making sure this tragedy becomes a launch pad for something better.
This will mean building a health system stronger than before, harnessing the huge expertise built both in terms of national systems and training of thousands of health workers.
It will mean a huge education push to reopen schools and then to use them as a basis for better infection control through involving the children themselves.
Continuing solidarity with Joshua
It will also mean harnessing the remarkable coalition that came together to fight Ebola.
Everyone, from local and rich world governments and the private sector to the Cuban and NHS volunteers; from charities like ours to international bodies such as the UN, EU and World Bank; all of us need to help build a stronger and more resilient system that puts the needs of the brave people of the region first.
As I got up to leave, Joshua slowly raised his head to show tearful eyes.
“It’s hard when I think of it”, he said, still clutching his ‘Survivor Certificate’, evidence that despite everything, Joshua beat Ebola.
He’s still shaky on his feet but he’s looking forward to playing football and crucially, going back to school.
Like his country, he’s making early steps towards recovery and we have a duty to both to stand side by side with them until they’re strong enough to flourish again.