On a concrete platform overlooking the cluttered landscape of a steeply sloped neighborhood in Freetown, Daddy Hassan Kamara reflects on the tin-roofed shack where he once lived with his family. “I was living here with my father, mother, wife, brothers,” he recounts mournfully. “Within a span of just one month, I lost all my relatives,” he adds, his voice tinged with sorrow.
Ten years ago, the deadly Ebola virus swept through West Africa, claiming the lives of over 11,000 individuals, nearly 4,000 of whom were from Sierra Leone – representing around 40% of those infected in the country. At the onset of this catastrophic outbreak, a vaccine was not yet available, leaving communities vulnerable and terrified.
Today, there exists a vital stockpile of half a million doses of the Ebola vaccine. This significant supply is adequate for implementing preventive vaccination initiatives targeting frontline workers in nations historically impacted by Ebola, with additional doses maintained in reserve for emergency distribution during potential outbreaks.
Sierra Leone is poised to make history this week by becoming the first nation to implement a comprehensive nationwide preventive Ebola vaccination campaign aimed at those most vulnerable to the virus. Over a span of three weeks, health officials are set to distribute 20,000 doses of Merck’s Ervebo vaccine, establishing a routine vaccination effort to be repeated every two to three years to safeguard public health.
Doses will be administered to healthcare workers, a group particularly susceptible as the country lost a devastating 7% of its entire medical workforce during the horrifying Ebola outbreak from 2014 to 2016. Additionally, soldiers and motorbike riders will be targeted, as they serve as primary transport providers for the majority of Sierra Leoneans. The vaccination effort also includes village hunters who risk exposure as they search for bushmeat, considering that Ebola can circulate among wildlife and spill over into the human population.
The forthcoming vaccination initiative is welcomed with optimism, representing a crucial step toward establishing a more robust healthcare system capable of facing any future epidemics. However, the haunting memories of the catastrophic events of 2014 remain vividly etched in the minds of many, including Kamara, who recalls, “Sometimes, when I’m in my bedroom, I just sit down and cry.”
On 30 October 2014 – five months after the onset of Sierra Leone’s Ebola outbreak – Kamara’s mother began experiencing troubling symptoms. Despite their fears, a doctor reassured the family that her illness was attributed to diabetes and heart issues, rather than Ebola.
Kamara recounted, “I said, ‘Oh thank God’,” as he and his family huddled around their mother in relief. “So all of us – my wife, my father, all of those that [later] died, we started to embrace our mother. I would feed her, use my bare hands to wipe her tears when she was crying. She died on the second day.”
The traumatic moments unfolded when he held her body close, overwhelmed by grief. Just two days later, laboratory results confirmed the devastating truth: her death had been caused by Ebola.
By early November 2014, Kamara himself began displaying alarming symptoms, including “weakness, diarrhoea, pain all over my back.” He was subsequently transported by ambulance to a medical treatment facility. While he fought for recovery, his relatives were tragically succumbing to the virus. His father was taken to a separate treatment center, hours away, where he too fell victim to the disease.
Two of Kamara’s brothers came to his treatment center in dire need of assistance. “They died in front of me,” he recalled heart-wrenchingly. Even after his release from the facility, he faced an agonizing return home – only to discover that his beloved wife, son, and stepmother had all perished in the outbreak.
Kamara subsequently emerged as a spokesperson for the Sierra Leone Association of Ebola Survivors, passionately advocating for support for those affected by the epidemic. He traveled internationally as an ambassador to garner assistance for survivors, emphasizing the plight of Ebola orphans and widows, many of whom were forced into precarious circumstances, including sex work, to support themselves.
Today, he laments that those crucial support systems have faded into memory. A former professional footballer who harbored dreams of international success, Kamara now bears the responsibility of supporting 13 younger relatives. Despite his best efforts, he finds himself struggling to secure stable and well-paid employment, a difficulty compounded by his caregiving responsibilities and the ongoing health issues that plague many survivors.
The cemetery where his family is laid to rest has been reclaimed by nature, overtaken by weeds and overgrowth, much like the fading hopes of survivors. Meanwhile, the government has withdrawn funding support for the association Kamara once represented, leaving him uncertain about the status of previously promised social investment funding.
Survivors face ongoing health challenges, with over 23 health complications identified, including eye issues, impotence, and hearing loss. Although officials vowed to provide free healthcare for survivors at government hospitals, Kamara expresses deep frustration, stating that patients confront pervasive stigma and are often told they must pay for their medications.
He remains “100% supportive” of the new vaccination initiative, understanding its significance in preventing future outbreaks. The vaccines are drawn from a global stockpile created by Gavi, the vaccine alliance, which is also financing the execution of this vital campaign. Participants will contribute to research that examines long-term health reactions to the vaccine and its efficacy compared to earlier vaccines used in previous trials and pilot programs.
The emergence of another outbreak is considered “just a matter of time,” warns Dr. Desmond Maada Kangbai, who oversees the Expanded Program on Immunization within the Ministry of Health. “We don’t want to go back to where we were in 2014, when healthcare workers were dying, and patients were being abandoned at treatment centres and hospitals.”
Ebola made its grim entry into Sierra Leone when an infected individual crossed the border from Guinea in search of a traditional healer. Tragically, that herbalist contracted the virus and died, and in the ensuing funeral, attendees who came into contact with the corpse unwittingly transported the virus back to their communities.
The new vaccination is not a panacea for the deep-rooted challenges that still plague the healthcare system. Essential access to sanitation and clean water remains a pressing issue, particularly in rural areas. On the road from Kenema to the capital, Freetown, vendors can be seen holding out freshly killed bushmeat to passing vehicles, reflecting the ongoing risks to public health.
In the border community of Kailahoun, Yusuf Marrah, a 30-year-old herbalist, expresses his willingness to encourage his clients to receive the vaccine. However, he articulates a need for greater support for traditional healers. During both the Ebola crisis and the Covid pandemic, traditional healers were directed to suspend their practices without any financial assistance, leaving them vulnerable.
Dr. Mohamed Alex Vandi, who served as the district medical officer in Kenema during the 2014 outbreak and is now the deputy director of the National Public Health Agency, asserts that the nation is in a considerably better position today. Community health workers are now equipped with tablet computers for real-time reporting and tracking suspicious symptoms of viruses.
“We don’t take chances,” Vandi emphasizes. The threat of Lassa fever—a known viral hemorrhagic fever endemic to Sierra Leone—is detection in new regions. Recently, Marburg, another viral hemorrhagic fever, sparked concern due to an outbreak in Rwanda.
Weekly, potential cases of viral hemorrhagic fever are reported, with tests conducted to identify Ebola, Marburg, and Lassa infections. Fortunately, the majority of tests yield negative results.
“If the vaccine was not there, it would have made it very difficult for our workers to be comfortable handling cases they suspect could likely be one of the VHFs,” he remarks. “Of course, you’re going to take precautions. But at least this will give you some confidence.”
-
This reporting trip was paid for by Gavi, which is funded in part by the Bill and Melinda Gates Foundation, a philanthropic organisation that also contributes funding to support the editorially independent global development section at the Guardian
The Resilience of Sierra Leone: Rising from the Ashes of Ebola
Ah, Sierra Leone! Where the hills are steep, and the stories of survival are even steeper. Just ask Daddy Hassan Kamara, a man who’s seen more loss than a bad poker player. He points to his old tin-roofed shack and recounts how in the blink of an eye, he went from a family man to a solitary figure, mourning in silence. A whole family wiped out in just a month by Ebola—a viral tsunami that crashed into West Africa roughly a decade ago, leaving over 11,000 souls adrift in its wake. It’s like a Netflix horror series, but sadly, it’s real life and there’s no happy ending in sight.
Fast forward to today, and we’ve got a superhero in a vial—the Ervebo vaccine. Not just any vaccine, folks, but a half-a-million dose stockpile ready to tackle the very virus that once wreaked havoc. That’s right, Sierra Leone is on the launchpad, ready to kick off its first nationwide preventive vaccination campaign. It’s like they finally found the “on” switch after fumbling in the dark since 2014. The mission? Delivering 20,000 doses to those most at risk, including healthcare workers, the backbone of any health system, who once were fetching their own body bags.
Kamara is now calling the shots—and doing quite a bit more than that. He’s not only a survivor but an ambassador for the Sierra Leone Association of Ebola Survivors, advocating for those left behind. It’s a job he never signed up for but wears like a badge of honor, even if the government’s support has vanished faster than your motivation on a Monday morning.
But let’s get a bit cynical for a minute—because why not? The memories of that horrific outbreak linger like a bad smell. As Kamara puts it, “Sometimes, when I’m in my bedroom, I just sit down and cry.” It’s heavy stuff, and no amount of gorilla glue can put those shattered pieces back together. The trauma isn’t just emotional; it lingers in the air, ready to pounce on anyone who dares tread the same path.
Now, let’s turn our attention to the vaccinated superstars—those healthcare workers and soldiers who will soon have superhuman defenses against Ebola. But don’t get swept away in the euphoria just yet. Despite this movement towards a stronger health system, the harsh reality is stark: Gaps and challenges remain as wide as a politician’s promises during election season.
Remember those sweet snacks we call clean water and sanitation? Yeah, a good chunk of the population is still dreaming of them. On the road between Kenema and Freetown, locals are waving like they’re at a parade, not selling freshly killed bushmeat. And here’s a kicker: traditional healers, often scapegoated during the outbreaks, still wander through this tumultuous landscape, desperately seeking resources to keep them afloat while they attempt to do the good work they claim.
Dr. Mohamed Alex Vandi, a superhero in scrubs, confidently tells us that the country is in a better position today, with community health workers all armed with tablet computers. Because nothing screams “We are prepared!” like a tech upgrade. Now, any suspicious symptoms can be reported in real-time—an upgrade that makes ‘ghosting’ your doctor a whole lot harder.
Granted, the vaccine rollout is a massive step forward. Yet, experts remind us that just because we have a vaccine doesn’t mean the sky has turned sunny. If the previous outbreaks taught us anything, it’s that we can’t just pop a pill and call it a day. More awareness, better access to healthcare, and a proactive community are crucial for this vaccine to take root.
As the dust settles from this announcement, one can only hope that for Kamara and the people of Sierra Leone, this is more than just an exercise in déjà vu. It’s their chance to rise from the ashes, bury the shadows of the past, and embrace a future where laughter, not cries, echo through the hills.
So, if you’re looking for a lesson in resilience, look no further. Sierra Leone is not just a country; it’s a testament to the human spirit’s ability to weather the storm—even when the clouds are dark and the winds are howling.