慈濟傳播人文志業基金會
Deep in Sierra Leone

 

EBOLA ORPHANS

The Ebola epidemic left behind many orphans in Sierra Leone. The relatives of many of these orphans have refused to care for them for fear of contracting the disease from them. Thanks to some kind-hearted people, these children, sitting in front of their school, have been provided for and are receiving an education—for now. Nobody knows what the future holds for them.

Glimpses of Sierra Leone

Text and photos by Hsiao Yiu-hwa

Translated by Tang Yau-yang

The West African Ebola virus epidemic broke out at the end of 2013. Before it was contained in 2016, more than 28,000 people had been infected, half of them in Sierra Leone, which had barely recovered from a civil war. The country needed help. Tzu Chi has been providing aid since 2015.

arrived in Freetown, Republic of Sierra Leone, West Africa, in late September 2016, 33 hours after I left Taiwan. What took me there? How did Freetown get its name? For that matter, how did Sierra Leone get its name?

Let me start my story from the year 1462, when Portuguese explorers first arrived by sea. While mapping the range of hills that surround what is now Freetown Harbor, they named the oddly shaped formation “Serra da Leoa,” Portu­guese for “lioness mountains.” That name eventually evolved, via Spanish, into Sierra Leone.

CITY CENTER, FREETOWN

A bustling downtown scene in Freetown, the capital of Sierra Leone

By 1495, Portuguese traders had built a fortified trading post at the harbor. The Dutch and French also set up trade there later. Then came the English. They traded in the abundant natural resources of the region, such as minerals and timber. The trade later expanded into slaves, which were needed for labor on the New World plantations in the Americas. Sierra Leone became an important center in this business.

Following the American War of Independence (1775-1783), some freed slaves were returned to Sierra Leone. They were settled in an area that was given the name of Freetown, denoting their status as a free people no longer under the yoke of slavery.

 

A CIVIL WAR VICTIM

Missing an arm, this woman in Newton is one of the numerous collateral victims of the civil war.

Post-independence

Sierra Leone became an independent nation in 1961, freed from being a British colony. The country covers an area of 27,699 square miles and has a population of about seven million, according to 2015 census data. Freetown, the capital, is the largest city and an economic and cultural center.

Diamonds, aluminum and titanium ores, cocoa, and coffee are among the nation’s main exports. Natural resources, especially diamonds, are rich enough to sustain a good economy, which the nation enjoyed for a period of time after the country was founded.

However, those good times were soon followed by periods of power struggles and unrest: the final years of democracy (1964–1967), military coups (1967–1968), a one-party state (1968–1991), the Sierra Leone civil war (1991–2002), and the reinstatement of democracy (2002–2014).

About 50,000 people lost their lives and over two million were displaced during the war. The destructive 11-year armed conflict was characterized by extreme brutality and widespread human rights abuses. Thousands of people suffered the atrocities of limb amputation. Many victims were not even actual participants in the conflict. They were targeted merely because of their tribal affiliations or religion, or because they were suspected of aiding the other side. Many amputation victims were plainly innocent civilians.

The civil war set the already weakened nation back a great deal. But then, just as it was beginning the long journey back from violence and chaos, the country was broadsided by an Ebola outbreak.

 

An open-air hair salon and peddlers—people’s daily needs can all be met in the slum.

Ebola

The vicious Ebola virus disease sank the poor nation to new lows, but its media exposure skyrocketed throughout the world.

Fruit bats are believed to be the normal carrier of Ebola, able to spread the virus without being affected by it. It so happens that people in Africa hunt these bats for food.

A child in a Guinea village who is believed to have started the Ebola outbreak in December 2013 may have contracted the deadly virus through contact with a fruit bat. The disease quickly spread into Sierra Leone, which neighbors Guinea. The outbreak overburdened the weak healthcare system in Sierra Leone, resulting in more deaths from medical neglect than the virus itself.

To put things in perspective, prior to the Ebola epidemic there were only 136 doctors, 1,017 nurses and midwives, and 114 pharmacists in Sierra Leone. The civil war had driven many of the country’s healthcare professionals away. Those figures were stark indicators of how few healthcare resources the nation had. When the Ebola epidemic hit, the health system simply was unable to cope, so the World Health Organi­zation and humanitarian medical groups from many countries rushed in to combat the transmission of the virus.

After much pain, suffering, and brave effort, the situation was brought under control two years later. The WHO declared Sierra Leone free of Ebola in March 2016. Since the first confirmed case in May 2014, more than 14,000 people had been infected and nearly 4,000 had died.

Having sustained such a crushing blow, the nation badly needed help.

A small business stall in the slum

Help

The Tzu Chi Foundation has monitored the situation in Sierra Leone since shortly after the epidemic erupted.

In 2015, the foundation signed a memorandum of understanding with Caritas Freetown and the Healey International Relief Foundation (HIRF) to deliver aid to the nation. Caritas Freetown and HIRF are two organizations that provide much needed medical and material help throughout Sierra Leone. The memorandum of understanding was primarily a result of the efforts of Stephen T. Fomba, a Sierra Leonean who migrated to the United States after the brutal civil war.

The first batch of Tzu Chi aid arrived in Sierra Leone in March 2015. Fomba was on the scene on behalf of the foundation to work with Caritas Freetown and HIRF personnel. They distributed such items as portable beds, blankets, and instant rice to government hospitals and clinics, nonprofit clinics, Ebola orphans, and amputees and their families.

Tzu Chi initiated more distributions afterwards, including medical supplies such as latex gloves, surgical masks, and stethoscopes. Then, in late September 2016, a delegation of seven Tzu Chi people from Taiwan and the United States traveled to the nation and worked with partners to distribute rice. I was on that delegation to cover the event for the Tzu Chi Monthly magazine.

Taiwan’s Council of Agriculture had provided 200 metric tons of rice for Tzu Chi to distribute to the needy in Sierra Leone. Caritas Freetown, HIRF, and the Lanyi Foundation joined forces to compile rosters of recipients and work out the logistics of moving and storing the rice. On September 27, 2016, Tzu Chi and its partners kicked off the distribution of 60 tons of rice, the third set of Taiwanese rice distributions.

The first stop was in Newton, home to 20 amputee families of 150 people. Despite the brutal treatment the amputees had received during the civil war, the government had not given them any help. One hundred and thirty-nine ten-kilogram (22-pound) bags of rice were distributed here.

Pigs seek food in an open ditch. All beings, human and animal, have their place in the slum.

Then our caravan proceeded eastward to Bo, the second largest city in the nation. We visited the Commit and Act Foundation, one of the organizations that Tzu Chi had helped. This foundation primarily provides assistance to battered women and children.

Our caravan spent the night at Bo and set out the next morning for Koindu, the origin of the Ebola outbreak in Sierra Leone, on the easternmost tip of the nation.

Soon after we set out, the rice truck had a flat tire. Our party re-distributed its load of 180 bags of rice among the other three vehicles and moved on. Along the way, we had to plow through a 17-kilometer (10-mile) stretch of muddy mountain roads before reaching Koindu at three o’clock in the afternoon.

The rice was unloaded and piled up neatly on blue plastic sheets. Before it was handed over to recipients, the village head reminded the assembly that Tzu Chi was the first organization to come to Koindu and distribute rice since the Ebola outbreak had been brought under control.

KROO BAY SLUM

Sixty thousand residents are packed in this Freetown shantytown, the size of three soccer fields. There is no running water here except for a few public faucets. There is likewise no public, legal power supply. Getting electricity into a house is entirely up to the owner’s savvy. The area, located by the sea, is humid and poorly ventilated. Over­crowded, with poor sanitary conditions, it could easily fall victim to another epidemic like the last Ebola outbreak.

Why help?

Koindu was home to 54 families who had survived Ebola and more than 40 Ebola orphans. One hundred and seventy-one bags of rice were handed out there.

People may be curious as to why the Tzu Chi volunteers traveled all the way to Sierra Leone just to distribute some rice that might feed recipients for just a short period of time. Before answering that question, let me offer a background story.

At the height of the Ebola outbreak in Sierra Leone, many medical care professionals in the nation and from many other countries were on the ground fighting the epidemic, one of the worst in the history of mankind. When the situation was finally brought under control two years later, 3,956 people had died, including some excellent medical care professionals.

With their skills, these professionals, domestic or foreign, could have looked the other way, stayed well out of harm’s way, and lived out their lives in comfort and safety. But instead of running from the risk of fatal infection, they waded into the midst of the danger. They had direct contact with Ebola patients, and they died as a result on the front lines of patient care.

Why did they do it? Were their efforts worth it? I cannot answer those questions for them. But reading about their valiant deeds from a distance, I have realized one thing: Those medical professionals had willingly and bravely chosen their battles. Even though they ended up losing their lives, they had done what they felt they needed to do. The profound effects of such valor and love cannot be fully appreciated by someone who was not on the ground in the nation and witnessed the Ebola devastation, or who didn’t pay much attention to news reports on the ravages of the disease.

I believe that a spirit of humanitarianism was among the main factors that had propelled them to act the way they did. It is easy to notice the outpouring of help from all corners in the aftermath of a disaster. It is human nature to want to reach out to help in unfortunate times, and this is why many international humanitarian organizations and non-government organizations have consistently rushed to help disaster victims. Tzu Chi has been but one of those groups.

It has been a Tzu Chi practice to help people in a selected disaster area over an extended period of time. Therefore, I expect that its aid to Sierra Leone will also be a long-term engagement. As long as circumstances allow, the footprints of Tzu Chi will be found again and again in this West African country.

That’s why our delegation, during our week-long stay, visited many local charities to gather information, share experiences, and network with their people. That’s one of the ways we can learn to improve our work in this nation in the future.

After the distributions in Sierra Leone, members of our delegation, each with a stack of information that we had gathered, returned to our own countries. Delegation members reported to Tzu Chi management about what had happened during the trip, and they perused the information that they had brought back to prepare for and nail down the best time for the next course of action.

But before any further action could be planned, Hurricane Matthew ravaged Haiti. Volunteers who had just returned to the United States from Sierra Leone revved up again to take up the Haiti project. But that is another story for another time.

KING TOM CEMETERY

More than a thousand Ebola victims here bear witness to the horrific epidemic that took their lives.

 

Resilience After War and Ebola

By Stephen T. Fomba

Photos by Hsiao Yiu-hwa

When the Ebola epidemic that had dragged on for two years finally came to an end, people returned to their lives of poverty and want. In an environment that lacks food, medical care, and education, dealing with the aftermath of the disaster will need long-term attention from all corners of society.

Ebola killed these children’s parents. These orphans, who survived the disease, have been adopted and are receiving an education in Koindu. Still, their Ebola experiences—being treated for the infection and losing their parents—could very well have greatly impacted them both physically and emotionally.

My country, Sierra Leone, is said to be rich in mineral resources, but the reality on the ground tells a different story for its people. From the decade-long civil war to the deadly Ebola virus that ravaged the West African region, this country has suffered greatly. The senseless war left thousands dead, millions internally displaced, and thousands of amputees. Even now, 14 years after the war ended, people still remember it through the scars of the war-wounded and amputees. During the war, rebels would ask their victims if they preferred “long sleeve” or “short sleeve” before amputating them with a cutlass or axe. Short sleeve meant amputation above the elbow, and long sleeve meant cutting off their hand at the wrist. Many of those victims also lost their legs. When you couple the war and the Ebola epidemic with high illiteracy and poverty, you can easily see that Sierra Leone is a country in need of many different forms of help.

When the unprecedented Ebola virus made its way to West Africa—mainly to Guinea, Liberia and Sierra Leone—the Buddhist Tzu Chi Foundation offered compassion and relief to the people of Sierra Leone. Not only did Master Cheng Yen offer prayers for the victims of the epidemic, she mobilized the foundation to send help in the form of food, medical supplies, beds, blankets, etc. I was privileged to be in a position to volunteer for Tzu Chi and bring aid to my country. Debra Boudreaux, Executive Vice President of the Buddhist Tzu Chi Foundation USA, had contacted me to explain Tzu Chi’s philosophy and encourage me to volunteer. I hesitated at first because I was very busy with school, family, and work. But after looking into this opportunity to transform lives in my country, I became excited about volunteering and helping.

The formation of the partnership to help the people of Sierra Leone began with then United Nations Under-Secretary General, Dr. Kandeh Yumkella. It was rather fortunate that I knew Dr. Yumkella at the time. I contacted him for advice on how Tzu Chi could go to Sierra Leone. He recommended that we work with the Healey International Relief Foundation (HIRF) and Caritas Freetown. After virtual introductions, teleconferences, and a visit to HIRF in New Jersey, the partners met in Taiwan to officially sign a memorandum of understanding. HIRF was represented by its president Bob Healey, Jr. and executive director Benjamin Parra. The Tzu Chi Foundation was represented by Global Affairs Director Stephen Huang and Debra Boudreaux. Mrs. Philomena Yumkella represented her husband and witnessed the signing of the MOU.

A worried woman cares for a sick child in a Catholic hospital in Pendembu. There is no question that Sierra Leone badly needs to make education and medical care available to its citizens, but without money, the question is how.

In March 2015 Tzu Chi arrived in Sierra Leone for the first time with needed relief. The situation on the ground was dire as Ebola was still ravaging people. The Tzu Chi multi-functional beds were enthusiastically received by health facilities, especially because they were easy to sanitize, which prevented cross-infection. The beds and blankets served children in orphanages, especially Ebola orphans. The food supplies were an important relief to Ebola survivors, orphans, war-wounded, and amputees. The instant rice was admired for its easy preparation and delicious flavor. Despite the support that many nonprofit organizations like Tzu Chi have provided the people of Sierra Leone, the needs of those affected by Ebola are still many.

The government of Sierra Leone created the President’s Recovery Priorities, an initiative to help meet the various needs of those directly and indirectly affected by the deadly disease. The main objectives are to provide care in the areas of livelihood and health. To accomplish these objectives, the government advocates involvement by nonprofits and the private sector for the needs of those affected, as well as provides support directly from various government agencies. Free medical services are provided for all Ebola survivors. To track all support to them, a Presidential Delivery Team works with nonprofits and others who give donations of any kind to survivors.

In this rudimentary classroom in Newton, about 24 miles east of Freetown, some students have no school supplies and cannot learn to write, so they learn by reciting and memorizing.

Despite these initiatives, many survivors report that the help they get from the government does not measure up to what nonprofits like Tzu Chi give them. The free medical care is also reported to be ineffective for two main reasons: (1) the lack of accessibility for thousands of survivors who live in remote areas, and (2) the inadequacy of the healthcare sector. Sierra Leone still records one of the highest infant mortality rates and the highest maternal mortality rate in the world.

In the last two years my Tzu Chi volunteer work on the front lines with our local partners, the HIRF and Caritas Freetown, with implementation assistance from the Lanyi Foundation, provided substantial support to those directly and indirectly affected by Ebola even before the President’s Delivery Priorities were set up. Tzu Chi and its partners have provided support to 29 health facilities across Sierra Leone, hundreds of Ebola orphans, war-wounded and amputees, and all survivors of Ebola in the form of food supplies, beds, blankets, stethoscopes, latex gloves, protein powder, clothes, school uniforms, and shoes. Our recent rice distribution to all Ebola survivors in Sierra Leone has received praise from various stakeholders including the Honorable Minister of the Ministry of Social Welfare, Gender and Children Affairs, Dr. Sylvia Blyden, and the Presidential Delivery Team. According to the government of Sierra Leone and the Sierra Leone Association of Ebola Survivors—an organization set up by survivors of the disease to fight against social stigmatization and advocate the needs of all survivors—our partnership is the first to provide support to all survivors in the country. This task is very strenuous due to poor road conditions and the remoteness of many areas, yet we have been able to make it happen.

A volunteer bows respectufully as she gives an amputee a bag of rice.

Since our arrival in 2015, lives have been transformed. From orphans who struggled with hunger, health facilities that lacked basic supplies, students and adults who had to walk barefoot, flood survivors, poor people in slums, war-wounded and amputees who were still neglected and in poverty, to survivors of Ebola who had lost almost everything, Tzu Chi and its partners have successfully improved their lives by providing them with the most needed relief. Those who have benefited from our support rejoiced and thanked Tzu Chi for the help they had received, reporting that what we gave them not only came in time but also changed their lives for the better. Today we see poor students, orphans, and adults in our shoes, uniforms, and clothes. We also see how much difference our rice has made in the lives of Ebola survivors during the rainy season, also known as hunger season. Health facilities are still benefiting from all the medical supplies, beds and blankets that we donated. War-wounded and amputees have been benefiting from our partnership since 2015, and they report that our relief supplies have helped make life easier.

Residents in Newton receive rice from Taiwan. More than 150 amputation victims of the civil war live in Newton, and the town has also taken in Ebola orphans. But there is a deficiency of government support.

An example of a life that was touched by our relief support is that of great-grandmother Kadiatu Tarawallie, the only person in her family who survived the deadly Ebola virus after they were infected in 2014. The 76-year-old reported that she lost all of her relatives, including her children and grandchildren. She is not sure which relative was the initial carrier who infected the family. But when asked about bodily contacts being the source of the infection, she said, “How can one see her child sick and crying and not respond? How can a grandmother see her grandchild in pain and not offer comfort? How is it possible to lose a loved one in front of your eyes and not touch the body in mourning?” She covered her face with a cloth to wipe away the uncontrollable tears that sprang from her eyes. She added that she wished she had died instead of her children as she is old and no longer useful, while her children and grandchildren were just beginning their lives. She said that she lives by herself and depends on neighbors for food and water, among other basic needs. She happily thanked Tzu Chi and its partners for the rice she had received, saying that the donation was more important to her than we could imagine. She ended by saying that she would make the rice last her as long as possible because hunger was something she battled frequently.

Tzu Chi vehicles had to navigate stretches of muddy road like this. Here a couple of other vehicles got stuck in the mud, blocking the road that Tzu Chi vehicles were trying to get through.

Even though the people in Sierra Leone have demonstrated their resilience against war, Ebola, and extreme poverty, they still have many unmet needs. From our experience, the direst needs that we have identified are education, healthcare, and employment. Sierra Leoneans need opportunities to earn a living in order to become self-sufficient and climb out of poverty. Healthcare in our country is so poor that when one falls severely ill, there is no hope for recovery—one can only expect an early death. Children under five still die at a very high rate, a crisis that seems to be getting worse despite the government’s initiative for free medical care for children under five. This scheme must struggle to keep children healthy and alive because government hospitals and clinics almost never have the needed medications, and staff members are not qualified to provide good healthcare. Sierra Leone is still a place where being pregnant is like committing suicide—the country records the highest maternal mortality rate in the world.

A group photo taken before a distribution at Koindu, where the Ebola virus first reached Sierra Leone.

Additionally, health facilities still struggle to get the most basic medical supplies like gloves, medications, and blood pressure gauges, let alone modern medical equipment. Medical personnel also lack the needed knowledge to accurately diagnose diseases and provide care with compassion and professionalism. Education is perhaps the most important unmet need in Sierra Leone. The country records illiteracy as high as 68 percent. During our distributions, we see firsthand how serious a problem illiteracy is in my country. A large majority of people who benefit from our support are unable to sign their names, and about the same number do not even know their ages or other basic information about themselves. Illiteracy is high because of the poor educational system, the government’s underinvestment, lack of access due to location, and affordability. The poorer the community and people, the less their chances for formal education. Many school structures in poor communities are makeshift. Sierra Leone could benefit from suitable classrooms with dedicated teachers. School materials such as stationery supplies, textbooks, and literature books would be of great benefit to students and adult learners.

From the initial contact to our first trip to Sierra Leone to the just concluded Tzu Chi and HIRF delegation visit there (led by Debra Boudreaux), I have felt reassured each day that our partnership of Tzu Chi, HIRF, and Caritas Freetown has without any doubt brought hope to people here. During the visit of our joint delegation from the USA and Taiwan, we had the opportunity to inspect what we have been doing, how we have been affecting lives, and how our partnership has been holding up. After a week with an intensive schedule that included a trip to Koindu, where Ebola started in Sierra Leone, we agreed that the partnership is effective and efficient. We pledged to continue working together to transform more lives in a country that needs so much.

Tzu Chi volunteer Debra Boudreaux, from the United States, entertains Ebola orphans in Koindu.

A recipient cheerfully carries a precious load.

Volunteers visited the Catholic Mile-91 Clinic in Guadalupe. Sister Patricia Dominic (front row, center), a family medicine physician from Spain, is in charge of the clinic.

 

Spring 2017