Going Viral

Memories of working in Sierra Leone:

I’ve had enough of this. Their voices start to blend into the mechanical monotony of the air conditioning unit. Sitting opposite each other at the far end of the table, they gesticulate like policemen directing traffic at a busy junction.

“I’m just going to get some fresh air, I’ll just be outside” I say as I begin to shuffle past them to the door. They pause their conversation to theatrically rearrange the furniture; ensuring I don’t come within a couple of metres of them as I go past. As the door opens, the stale heat envelops me. I light a cigarette and make my way over the cobbled courtyard to a welcome area of shade.

We’d just got a call to say the little boy had died. The news was like a sucker punch. Hit after hit after hit had been raining down but this had come when we were looking the other way. He’d been through so much. From the day he arrived at Kerrytown, he’d never been far from death, but his malnourished body had fought with unexpected strength.

After two consecutive negative samples, we knew he had to be transferred out of the Treatment Centre, and we were hoping the Government hospital could take him across the finishing line. We’d taken all the medicines and supplies he needed with us, as health care is not free for children over five in Sierra Leone.

I’d taken him myself, and remembered his face when he stepped out of the Red Zone and realised he could touch someone else for the first time in months. I’d seen him every day in the Treatment Centre but it was the first time him and his Mum had seen me without a mask, goggles and hood.

Now he was dead. And like every unexpected death it was investigated. His swabs had come back positive. As I transferred him without PPE, I was a contact. I might need to be isolated, I might need to be sent home. Should I tell Amy? Probably best not to worry her about it, she’ll have her hands full with the kids anyway.

Amy. The kids. My family. I get overcome by a sudden wave of sadness when thinking about my kids and all the kids I’ve treated here. I feel ashamed that after hearing the news my first thoughts were about me and my family. But the feeling passes. You’ve got to be realistic: keep your head down, be practical. My cigarette’s finished but I decide to stay out for another. I feel no compulsion to rush back to the meeting. I’ve travelled half-way around the world but still can’t escape hospital managers.

I sit down in the smoking shelter, an open canvas covered structure with an old oil drum placed inside. Behind me the Treatment Centre bustles with activity, in front of me the army-run Health Care Worker facility lies dormant, a shining beacon of inequality set in the scarred landscape.  Its full intensive care facilities standing by for infected overseas workers, but not accessible to the general population. They’ll pull out all the stops for those of us foolhardy enough to come here, but won’t for those here through no choice of their own. 

I don’t know why it took me so long to realise, but it finally strikes me then, watching the rising smoke superimposed on the soot from charcoal fires on nearby hillsides. The focus on Ebola distracted us from the real killer here – inequality. It surrounds us – ubiquitous, insidious. No amount of PPE will protect you from it. Ebola was just the final hit - slamming the broken, punch-drunk country down to the canvas. If it hadn’t been that, it would have been something else.

I take out my phone and look at the pictures of my kids I’d loaded onto it before I left Scotland. I think about the lives they’ll lead and the opportunities open to them. I think about the life the boy would’ve had if he survived. I found out later that the medicines and supplies we’d brought with the boy had been taken soon after he arrived at the Government hospital. His Mum said they never received medicines there. I presumed they’d been stolen to sell in one of the backstreet pharmacies. After all he’d been through, Ebola hadn’t killed him. Perhaps inequality had.

I get up slowly and walk past the noticeboard, where on Armed Forces Day the local staff had written the names of their friends and colleagues who had died during the outbreak. And I think how different it will be for us and for the local staff when the job is over. For them, will the job ever be over?

For the international staff, us merry bunch of missionaries, mercenaries and misfits, we came knowing we could leave it all behind when the deployment was over. We had our safety blanket of the Army base and the RAF ready to bring us back home if the worst happened. There was only one way the local staff could leave it all behind.

What would greet us when we got home? The worst we’d experience were the uneasy public, sympathetic but careful not to come too close. Edging uncomfortably away while waiting for us to summarise the experience into an easy soundbite so we all could get on with our lives.

David Cameron, always keen to shamelessly ride the wave of public opinion, announced a medal would be minted. Lauding British healthcare workers whilst systematically dismantling the infrastructure of the NHS. Doing his best to spread his own brand of inequality. The leader of an un-developing country, relentlessly pushing corporate interests into the frame like unremitting YouTube adverts.

But where were the medals for the local staff? Teachers, farmers, ex-child soldiers, coming together for their communities, giving their all to their country and government, which had given them so little in the past. Those unsung heroes, who always had more to lose, who were always at more risk. Buried in the warm red earth, in sanitized bags, far from their homes.