Blame it on Ebola

Since the 7th of November Sierra Leone is officially Ebola-free.  Even if the outbreak lasted far too long and it was far too painful, there is reason now to celebrate. The NGOs responsible for the Ebola response are now preparing for the phasing out. Life comes back to normal. Well, this is exactly the problem. The normality to which Sierra Leoneans are allowed now to return is not less absurd than the outbreak was itself. The state of education, the state of health care, the state of physical rehabilitation for people with disability – to mention only a few supposedly public services – are in ruins. „Ebola poel all ting” is a phrase that can often be heard everywhere, but this statement is only partially true. These sectors were already ailing before Ebola; the long emergency state only added to the damages.  It is not that Ebola ruined everything, it is rather that everything that had been bad before, logically have not become any better. And when the spectre of Ebola is not there anymore and people would like to be relieved, they have to realise painfully how dim and absurd is indeed the background that Ebola left in the shadow for long. Sometimes even the Ebola response contributes to this sentiment of absurdity.

B lives in one of those collective polio houses that I discovered during my fieldwork and which I admired so much for their capacity of self-management and for their ability to provide some basic security for their members. Nobody knows where B comes from, nobody knows his family.  He is also a polio-victim and he was welcomed in this collective refuge, where he was given a room. He fell sick 3 months ago, during the times of Ebola. He was taken for a check, but was sent back: he did not have Ebola. His state did not improve though. Soon he barely moved, he could not eat or drink anything without giving it out immediately. He was taken to the hospital three times, three times he was sent back home, without any medication, with the same diagnose: no Ebola. That he was obviously dying did not weight too much in the deliberation.   His case represented no interest after the test proved him negative. He would not have had the right to die at home should he had had Ebola, now he simply did not have right to any treatment, even palliative one.

blame it on ebola

It is hard not to think that people here have all the right to die freely from whatever diseases unless there is a threat that the disease might cross borders. Then and only then the international community cries scandal and rushes to the spot with millions of dollars. But even the millions of dollars do not change the condition of those who are unfortunate enough to suffer only banal every day suffering. Or at least that is what I believed until I discovered that there is a new post-Ebola project coordinated between the greatest NGOs who are supposed to come to the rescue of the most vulnerable: children, women and people with disabilities with a special “protection unit” in case of major health risks. That is fantastic!  There is skilled staff, ambulance and money to take the patients to hospital (without which they would not be taken). I learned that the project had started one and a half month ago and will last until end of December. It was not hard to discover all this; it was enough to phone a friend who works for an important NGO which is part of the protection unit network. She readily promised to send an ambulance for the man. I did not want to believe my ears. This “project” had been there all this time and nobody thought of linking it to this man who was slowly  fading away laying naked on the floor of his tiny room without any medical help for months.

When I see him, it is obvious that it is too late. He looks already like a cadaver, his abdomen is hollow, his skin is tight on the bones, no flesh remained, his jaws are like that of a skull. In the room there is two little children and a woman with him. The woman takes care of him and she does not have another place to go to sleep with her children. I only hope that he is not affected by any transmittable disease. The reason for the mismatch between the NGO project and the reality of the terrain is simple: nobody knows of this project there where the help is needed. No systematic communication is taking place. No procedure planned. Slowly and naturally the word of mouth transmission might change this situation, but by the time the information can be shared , the project will be long finished anyhow. It would have probably saved some lives, but would almost certainly not have brought major changes. No surprise. Projects are simply not made for that.  At the end of December the protection unit will fold up. Its mission will be fulfilled. There will be numbers and indicators and a report. The report will say the project was successful. Nobody will ask what could have been done instead to do more. The protection unit will soon be forgotten. People will fully recover their right to die unhampered by any external actor, from whatever disease, wherever they want to. The Ebola period was a parenthesis and now it is closed. Outside of it this is how normalcy looks like.

I heard of B on Monday evening. That was when he had been lying sick for already three months. I phoned my friend in the NGO on Tuesday morning asking for her help. By Tuesday afternoon the protection unit knew about the case. They went there on Wednesday but did not take the patient.  They needed to make arrangements with the hospital – they said.  Quite a relaxed attitude in a situation of immediate danger – I would say. They promised to come back the next day. They did not have a chance. B. had died by Thursday morning – as out of a last gesture of revolt.



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