The Ebola Fighters

After two years and an estimated 11,000 deaths, the largest Ebola outbreak in history has finally subsided. To break the chain of transmission, thousands of people came forward to fight Ebola, from doctors and nurses to hygienists, community educators, drivers, psychosocial workers, burial team workers, and many more. Most of them were from the countries and communities hit hardest by the virus — and were vital members of and partners to International Medical Corps’ Ebola response teams in Sierra Leone, Liberia, Guinea, and Mali. Here are some of their stories.

From left: Tolno saa Papa Adones, Dr. Traoree Nouhou, Cisse Alassane, Koundouno saa Pierre, and Ouamouno Killa, members of the International Medical Corps Rapid Response Team on standby at Donka Hospital in Conakry, Guinea. Photo: Crystal Wells/International Medical Corps

Guinea

Marie-Claire Tchecola, Nurse and Ebola Survivor
Donka Hospital Screening and Referral Unit

Nurse Marie Claire Tchecola checks people’s temperatures before they enter the infectious disease unit at Donka Hospital, the largest in Conakry, the capital of Guinea. Photo: Crystal Wells/International Medical Corps

“I didn’t have hope, but I had courage.”

Marie-Claire Tchecoloa thought her life was over when she was admitted to an ETU in the Guinean capital Conakry in the spring of last year. A nurse at Donka Hospital, the country’s largest, for 15 years, Marie-Claire contracted the virus along with eight of her colleagues when they cared for a patient. “I couldn’t tell she had Ebola,” Marie says. “It is like malaria — the symptoms are so similar. At that point, we were not wearing cloves. Only surgeons and midwives got gloves.”

She spent two weeks in the ETU, fighting for her life. When the doctors said she could go home, Marie-Claire recalls being very afraid of the stigma and fear she would meet outside. She explains what was going through her mind at the time: “Will my children be afraid? Will I be able to touch them?”

When Marie-Claire arrived home, her daughters greeted her with open arms, ecstatic that their mother survived Ebola. “I felt so much relief,” says Marie-Claire. “I stayed one week at home and came back to [Donka Hospital].”

As a survivor, Marie-Claire felt she was in a unique position to identify the virus and fight the rumors and misinformation that was keeping so many people from seeking treatment. “If I am present [at Donka Hospital] I can save lives, so I came back to work,” she explains. But not everyone was so welcoming. “Everyone rejected me [at Donka Hospital],” says Marie-Claire. “I accepted it. I had to be a witness so I could save people.”

Marie-Claire’s fight against the virus that nearly claimed her life did not stop at Donka Hospital. She bravely went out into communities to share her story in an effort to convince people Ebola was real.

Her efforts caught the attention of the American ambassador in Guinea, who invited Marie to make a speech alongside him in a community. The talk was televised and when Marie-Claire came home that evening, she found her daughters sitting outside their home, their belongings scattered around them. The landlord saw the news and they were evicted — he would not rent to an Ebola survivor.

“We had to sleep on the street,” says Marie. “A teacher received us. It’s a very small apartment, but it is better there than on the street.”

Throughout everything, Marie-Claire kept working at Donka Hospital and battling misconceptions about Ebola. It is because of this remarkable courage and conviction that Marie was invited to the White House last year along with nine other women to receive a Women of Courage Award.

When asked why she thinks she was chosen for the award, Marie-Claire shrugs and replies, “I told the ambassador I am nothing in my country. I am like an insect around elephants…I don’t want power, just respect.”

Today, Marie-Claire is still at Donka Hospital, screening people for symptoms of Ebola at the triages that International Medical Corps created at the entrances to the infectious disease ward and the emergency room. “I love to work,” Marie-Claire says. “I studied so I could work.”

Fara Gabriel Tinguiano, Hygienist
Rapid Response Team

International Medical Corps Rapid Response Team member and water, sanitation, and hygiene expert, Tinguiano Far, guides his colleagues through how to safely remove very ill patient from a car and be transported via ambulance to the nearest Ebola Treatment Unit for testing. Photo: Crystal Wells/International Medical Corps

When Fara Gabriel Tinguiano reflects on the past year and a half, he feels proud of his contribution in the fight against Ebola in Guinea. “This is my contribution to improve the health of the population,” he says. “It was also a sacrifice — risking my life to save others.”

An engineer, Gabriel first worked in an ETU as a water, sanitation, and hygiene (WASH) system specialist. When the ETU closed, Gabriel joined International Medical Corps’ Rapid Response Team as the WASH lead, tasked with making sure their ambulance, personal protective equipment (PPE), and other supplies are sterilized and that the team follows strict IPC protocols to keep them safe from Ebola.

His greatest challenge in his work is the community resistance. “They used to threaten us,” Gabriel says. “They would surround us and say we were liars and insult us.”

Gabriel believes a lack of education is at the root of the opposition and defiance around Ebola. While the misconceptions about the virus are reducing, some still do not believe that Ebola is real, while others are suspicious that ETUs kill everyone they admit. “People are scared that when you go to the ETU they will kill you, even sell your body parts,” Gabriel explains.

He spends most of his days waiting at Phebe Hospital, the largest in the country, to transfer anyone who comes to the hospital with Ebola-like symptoms for testing. “I first make sure all the materials we use are in place,” he explains. “Then the medical staff investigates. The doctor tells us to start our work if the person meets the case definition [for a suspected Ebola case]. If it meets the case definition, I put on light PPE and divide the area into high and low-risk. I spray the ground and prepare the ambulance to transfer the patient. Two hygienists then go to collect the patient. After loading the patient, we disinfect the whole room.”

Throughout this process, Gabriel and his colleagues carefully explain what they are doing — and why — to the patient, the family, and the community chief to foster the trust and confidence needed for them to go about their work.

“Based on my experience, I think what the RRT is doing is good work because we respond rapidly to any disease in the community,” says Gabriel. “I hope the government will keep the RRTs going for other disease, not just Ebola.”

The International Medical Corps Ebola Response Team in Lunsar awaits the official announcement that the Ebola outbreak in Sierra Leone, which killed nearly 4,000 people, is over after 42 days of no new cases. Photo: Crystal Wells/International Medical Corps

Sierra Leone

Mariatu Kamara, Ebola Survivor and Psychosocial Officer
Lunsar Ebola Treatment Center

An Ebola survivor, Mariatu Kamara, worked as a psychosocial officer for International Medical Corps at the Ebola Treatment Center in Lunsar. She lost 10 member of her family to Ebola, including her only daughter. Photo: Crystal Wells/International Medical Corps

“When we first heard about Ebola, we thought it was to do with politics,” says Mariatu Kamara. “We denied it. There were those who said it was witchcraft. While others said it was a curse that had been placed on some people. When my sister, who was a nurse, got very sick, I wondered whether it was indeed a curse. I cared for her. I washed her. I hugged her. I held her. I didn’t want her to die, but she did.”

Two weeks later, in September 2014, Mariatu, her 24-year-old daughter Rainatu, and her adopted 12-year-old daughter Fatmata all got sick with the same symptoms. She hired a taxi to take them to Port Loko Hospital, where the doctor advised his staff not to touch them because they suspected they had Ebola. They were put in a big hall on their own. Hours passed and not a single person checked on them.

At around 6 pm that night, Rainatu died.

“Fatmata and I struggled to call out for a nurse but no one came,” she says. “It wasn’t until day break that they came to take her. So I slept with my daughter until they came for her in the morning.”

Four days later, Mariatu and Fatmata were transferred to Kenema Hospital. They picked up three other people along the way — two of them died en route. “I thought, ‘God, after these people, the next has to be me,’” Mariatu recalls.

But she and Fatmata miraculously survived. They returned to their home in Lunsar and found that all the people who rented rooms with them had died or left. “Our area was like a ghost town when we returned,” Mariatu says. “It used to be full of people and was very lively. But Ebola claimed a lot of lives in my area. There are two houses nearby that are empty now. Everyone in those two houses passed away. Whole families were wiped out.”

Mariatu could not shake the grief and guilt of her daughter’s death. When Georgina Campbell, International Medical Corps’ psychosocial coordinator in Sierra Leone, asked to meet with survivors around Lunsar, she went to voice her concerns. “I told them I was hurting and really stressed,” she says. “Out of all the ten people who I know who died, none hurt more than my own child. I told them that even though I had recovered from Ebola, I was stressed and needed help.”

She also said she wanted to work.

“I told them that if they gave us jobs, survivors like me could be an example to the other patients who are refusing medication and losing hope and the will to live,” Mariatu says. “And we could go into the communities to let people who want to deny that Ebola is real know that it is not witchcraft or a curse because of theft.”

The next day, Georgina asked Mariatu to come by for an interview. She was hired as a psychosocial officer, a role that had her sitting beside patients in the Ebola Treatment Center (ETC), encouraging them to stay strong, and out in communities to share the facts on the virus and how it can be prevented. “It is very rewarding for me to have this opportunity because I can see the difference that it makes,” she says.

Through her work on the psychosocial team, Mariatu has become a leader in her community, and no longer faces stigma as an Ebola survivor. When people have problems, they often turn to her for advice. “I have a happy life,” she says. “Everyone is coming to my house now.”

But not a day goes by when she does not think of her daughter. “I still miss my daughter, but I am learning to cope with the pain,” says Mariatu. “If I had held onto that pain it would have killed me even if Ebola did not.”

Aisha Daramy Kabia, Consultant Midwife
St. John of God Catholic Hospital

Aisha Daramy Kabia, midwife consultant, stands in the maternity ward at St. John of God Hospital in Lunsar. Eight staff members died of Ebola at the hospital, forcing it to close until International Medical Corps put a Screening and Referral Unit was put in place in January 2015. Photo: Crystal Wells/International Medicacl Corps

A trained midwife, Daramy Kabia returned to her native country of Sierra Leone after decades living in England to help improve the dismal maternal and child mortality rates in the country. She set up a maternity clinic and founded an organization, Friends of PCMH, which supports a nationwide referral hospital. Then, in March 2014, Ebola erupted in Sierra Leone and Aisha found herself on the frontlines.

“I heard Lunsar was very badly affected,” says Aisha. “People were dying and burial wouldn’t take place for 2–4 days and that was really bad. I am from Lunsar so because of that I decided to head to Lunsar with the hopes that I could be of assistance there.”

The first thing Aisha did was clean the markets with chlorine in an attempt to sterilize high-traffic areas. She also distributed food to quarantined houses, all with her own money. “You cannot hold people in a house together for an extended period without feeding them and that is what was happening here in Lunsar,” Aisha explains. “It got to the point where people were dying here of hunger, not Ebola.”

In June or July of last year, Aisha teamed up with Brother Michael at St. John of God Catholic Hospital in Lunsar. Together, they rolled out infection prevention control trainings and went out into communities to serve more quarantined homes.

“We dealt with 63 quarantined houses in total,” she says. “We gave them wood, coal, water, fish, everything that makes a proper meal. We gave them supplies once a week depending on the household…Every day for 21 days, we would visit these households to take their temperature. So if we had 10 quarantined houses, we went to those 10 houses every day until the 21 days were over and that helped us manage the disease.”

When International Medical Corps’ Ebola Treatment Center (ETC) opened in November 2014, Aisha was one of the strongest referral links, reporting suspected cases to the staff and following up with those Ebola patients she had been in contact with.

Just before the ETC opened, St. John of God Catholic Hospital was forced to close in September after Ebola snuck into the hospital, killing eight staff members, including their chief surgeon, Dr. Manuel García Viejo. Together with International Medical Corps, Aisha helped establish a triage system at the hospital’s entrance to carefully screen for Ebola and immediately isolate any suspected cases. It was because of these efforts that the hospital was able to reopen in January.

“[The triage] gave the confidence to staff because we have so many checkpoints to keep a case from coming into our hospital,” says Eugene Osei-Wusu, the hospital’s administrator. “What we are doing now was all imparted by International Medical Corps.”

Now that Sierra Leone has been declared free of Ebola, Aisha is turning her attention back towards maternal and child health, but continues to work with St. John of God Catholic Hospital and International Medical Corps in her wider mission to improve the health care conditions in her country.

“I am happy,” Aisha says. “I think this is my happiest moment in Sierra Leone honestly. I fought and the people in the village they recognize and they appreciate and everywhere you pass through Lunsar they will tell you if it was not for Mrs. Kabia…”

International Medical Corps hosts a training at Phebe Hospital in Bong County, Liberia on the proper use of protective equipment and safety protocols for working in an Ebola Treatment Unit. Photo: Crystal Wells/International Medical Corps

Liberia

Yarmah J. Cooper, Laundry and Burial Supervisor
Bong County Ebola Treatment Unit

Yamah J. Cooper, Laundry and Burial Supervisor at International Medical Corps’ ETU in Bong County, Liberia. Photo: Crystal Wells/International Medical Corps

Like her friends and family, Yarmah Cooper was afraid when Ebola first came to Liberia, but after seeing so many people lose their lives to the virus, she decided that she needed to take action. “I got the courage, seeing my people dying,” she says. “I decided to come in the ETU to save lives for my brothers and sisters.”

She joined International Medical Corps’ team at the Ebola Treatment Unit (ETU) in Bong County as a waste handler. “I came and the confirmed ward was very, very packed with our brothers and sisters,” she recalls. “Even if you stood out there and saw them, you would shed tears.”

Multiple times a day, Yarmah put on personal protective equipment (PPE) and entered the confirmed ward to collect patient waste — which is highly infectious — and take it to the incinerator to be burned. It was dirty and dangerous work, but without her, the ETU would have been unfit for patients and too unsafe for staff to work in.

Yarmah was soon promoted to laundry and burial team supervisor, where she was responsible for making sure all of the equipment used at the ETU daily was fully decontaminated and that anyone who died at the facility was buried following strict safety protocols. “The hardest thing about all the job was to make sure all staff were protected,” Yarmah says. “Cleaning the materials — the scrubs, the boots, the aprons, the gloves, and the goggles. We made sure we cleaned them good and prepare for the next day for the staff to use.”

The ETU cared for 160 people with Ebola. Seventy-eight of them survived. “We worked hard,” Yarmah says. “The harder you worked, you got more survivors. Because we payed time to our patients. We catered to them. We gave them more care. I think they liked the care we gave to them. That’s why they came out as survivors.”

Harris T. Kollie, Nurse and Psychosocial Supervisor
Bong County Ebola Treatment Unit

Harris T. Kollie, a nurse and mental health clinician, works for International Medical Corps as the psychosocial supervisor in Bong County. Photo: Crystal Wells/International Medical Corps

One of the biggest challenges early on was getting the communities to trust them to take care of them. Many people had gone to ETUs and were never seen again, so Harris and his team went to great lengths to show they were there to help. This included staying in touch with patients’ families by phone.

“I fought fear and stigma,” he said. “People wouldn’t want to eat because they were afraid it was going to kill them. But I fed them, small, small.”

Today, his work continues, meeting with survivors and people who lost loved ones to Ebola. He is also working with this team to help communities reunite after Ebola destroyed social connections and divided what were once tight-knit communities.

As a Liberian, Harris Kollie could not sit by and watch as people from other countries came to fight Ebola. With so much misinformation about the virus, Harris believed that he had a far better chance of gaining communities’ trust than foreign health workers, as he could relate to his fellow Liberians in a way outsiders could not. When International Medical Corps opened the ETU in Bong County, he joined the psychosocial team, where he spent time inside the ETU talking to patients and outside speaking with communities to earn their trust and offer emotional support.

“The biggest challenge in the beginning was to get people to trust us at the ETU because people had so many misconceptions in the community that if they came to the ETU they were going to be killed,” Harris says. “Or poisoned with the food that was going to be served to them. So we were taking time to talk to people, to speak in our own vernacular. So that they would be convinced that we were here to help them, not there to kill.”

He recalls one patient who was so afraid that the ETU staff would kill him that he hid a knife in his bag. “I introduced myself as a psychosocial officer and that we were there to help him and that no one was against him,” Harris says. “I asked him, ‘What is in that bag?’ He said, ‘It’s a knife.’ And I said, ‘What are you doing with it?’ He said it would peel an orange. I said this was a medical area and we had other patients and really couldn’t allow people to come inside with a knife…I told him, ‘We are not an enemy to you. We are Liberian brothers.’”

It took some time, but the man slowly began to trust Harris and his colleagues. He started to eat and take medicines as instructed — and was soon discharged as a survivor.

While he may no longer be working at the ETU, Harris is still helping communities cope with the destruction that Ebola left in its wake. He and his colleagues are working in four hard-hit communities to help them heal and forgive after the virus took the lives of so many of their friends and family. “Some are divided in their own community because of Ebola,” Harris explains. “There were divisions and there were other conflicts. For now, we are in the community to talk to them so they can see the reasons why they can reunite. It was Ebola that brought all of this into our country.”

Medical and non-medical professionals participate in a hands-on simulation on the use of personal protective equipment, proper hand-washing, and dead body management. Photo: Crystal Wells/International Medical Corps

MALI

Dr. Boubacar Niaré, Rapid Response Team Coordinator
Rapid Response Team

Dr. Boubacar Niaré led International Medical Corps’ three Rapid Response Teams in 2015. Today, he is working on disease surveillance and response systems in to prevent outbreaks. Photo: Crystal Wells/International Medical Corps

One of the biggest signals of success for Dr. Boubacar Niaré is when health centers report a suspected case. “People know the symptoms and are on alert,” he says. “Now people know what Ebola is and that is a good result.”

That was not the case when Dr. Niaré started his work as the Rapid Response Team leader earlier this year. While Mali managed to quickly contain the Ebola outbreak at eight cases, the country remains at high-risk, as it borders Guinea, the likely source of the epidemic. He spent much of his time visiting health facilities to teach staff about Ebola case management and make sure they were compliant with basic IPC protocols.

“The biggest challenge was to organize all the activities so people could come together and share information,” he says. “We created a rapid response team and took both public and private facilities into account so the whole health system can work together.”

That is why each and every call from a health center about a suspected Ebola case is a small victory for Dr. Niaré — it shows that the system is working so that if the virus does resurface it is quickly contained.

“I am proud because I brought something positive to the fight against Ebola,” says Dr. Niaré. “As a Malian and a medical doctor who specializes in infectious disease, the most important thing we could do was training because Ebola was unknown. People have to know how to stop it.”

Today, he is widening these efforts as part of a program funded by the CDC to help Mali establish disease surveillance and response systems. “I promised to save lives and also save people from pain,” says Dr. Niaré. “This does not stop at Ebola — in the case of any disease we have to work hard to help people.”

Ramata Traore, Training Officer
Rapid Response Team

Ramata Traore traveled to Liberia with International Medical Corps to attend a week-long training in Ebola case management. She shared her knowledge and skills to equip other potential Ebola responders in Mali. Photo: Crystal Wells/International Medical Corps

A nurse, Ramata Traore feared Ebola like so many of her health care colleagues in Bamako, Mali. She saw the virus decimate Liberia, Sierra Leone, and Guinea and worried Mali faced a similar fate.

She decided the only way forward was to face the virus head-on and join the fight with International Medical Corps as a training officer. Ramata traveled to Liberia to attend a week-long training in Ebola case management, an experience she says equipped her to not only teach others in Mali about the virus, but also be prepared to respond to any suspected cases.

“Ebola is not a disease we used to have in our country,” says Ramata. “Health workers were afraid of this disease. Before I went to Liberia, me too, I was afraid. But after Liberia, I was ready to do anything against Ebola.”

Once back in Mali, Ramata focused on training non-medical staff, such as drivers, security guards, and hygienists, on what symptoms to look for, how to protect themselves, and how to handle any suspected cases. “I tried to help them be ready and at ease,” she says. “Before I couldn’t imagine doing anything like that — so I did my best to help others do the same.”

Today, Ramata is now moving to a new program funded by the CDC to help Mali establish disease surveillance and response systems not just for Ebola, but any infectious disease. “We are trying to be ready,” she says. “It is very important to keep on working together and be ready for any suspected case.”

On a personal level, Ramata is proud of the role she played as a trainer for so many professional in Mali. “I really learned a lot from International Medical Corps,” she says. “I was nervous to talk in front of people. Now I am relaxed. I became a teacher.”

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