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Ebola: One Year Later

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By Erin Nicholson, with reporting from ChildFund Liberia and ChildFund Sierra Leone


Though the headlines no longer clamor for the world’s attention, Ebola is still very much a part of people’s lives in West Africa a year after the outbreak was first reported in March 2014. ChildFund has been working to help care for children who have been affected by the disease. “Emergencies are not new to West Africa, but Ebola came as a very different crisis,” says Billy Abimbilla, ChildFund’s national director for Liberia and Sierra Leone. “We have only recently emerged from years of civil war, yet in many ways our experience with Ebola has been far worse.”


Daniel, age 1 and Rose, age 3, are among some 50 children who were cared for at the Kelekula Interim Care Center (KICC) in Liberia.

According to UNICEF, an estimated 5,000 children contracted the disease, and more than 16,000 have been orphaned, losing one or both parents. In total, more than 10,000 people have died, including many doctors, nurses and other health workers. The already-fragile health systems in the three hardest-hit countries – Guinea, Liberia and Sierra Leone – completely collapsed under the strain. UNICEF also estimates that as many as 9 million children have been affected by Ebola overall, their lives shattered, their families torn apart.

ChildFund has been on the ground responding to the emergency since the epidemic began. Raising public awareness of how the virus spreads was one of the first lines of defense against the spread of the disease, and in ChildFund’s program areas in Guinea, this helped to stem the tide of transmission altogether – no new cases have been reported there since last April.

Unfortunately, in Sierra Leone and Liberia, Ebola was much harder to combat. There, ChildFund staff worked tirelessly to fight the spread of the virus by distributing hygiene supplies, working with government ministries to ensure children and families could access the services and support they needed, strengthening community resilience and response systems, and establishing interim care centers where children who lost caregivers to Ebola could spend their 21-day quarantine periods.

Interim Care Centers Help Children Cope

In these centers (known as Kelekula Interim Care Centers, or KICC, in Liberia, and as Observation Interim Care Centers, OICC, in Sierra Leone), children are cared for and monitored for symptoms while ChildFund and government ministries work to either reunify them with relatives or find them stable foster family situations. Generous corporate donors helped to outfit the centers (and support ChildFund’s overall response) by providing supplies like protective gear, oral rehydration solution and even bedding and toys.


Jesse, 6, lost his mother and grandparents to Ebola and is living with family friends now.

The OICC and ICC caregivers are specially trained to monitor the children’s health and refer them to Ebola treatment units (ETUs) if symptoms arise. Children have their temperatures monitored twice each day and are watched for other Ebola symptoms like headache and loss of appetite. While under observation, they are also given basic medication and therapeutic foods like rice cereal, fresh fruit and milk in order to keep them strong and healthy. “It is very difficult to take care of children, especially small children,” one of the caregivers says. “They … cry a lot, or even refuse to eat.” Another caregiver adds, “Sometimes, you have to take them to the playground, play with them, sing a lullaby and make them feel comfortable.”

When 3-year-old Ferehmusu was brought to the OICC after her mother fell ill with Ebola, she was withdrawn and cried a lot. She also had very little appetite. The OICC nurses and caregivers, all Ebola survivors and thus immune, monitored Ferehmusu’s condition, kept her well-nourished and – importantly – comforted and played with her. Soon, Ferehmusu’s outlook improved, and she began to interact more with the other children in the center. Happily, her mother recovered from the virus, and Ferehmusu is now back at home with her.

But many other children are not so lucky, like 8-month-old Sorie, whose mother died at the Ebola treatment unit as he lay nursing in her arms, and whose father, struggling with substance abuse, had no idea of his wife’s illness until social workers from the OICC contacted him. The neighbors in Sorie’s village adamantly refused to take the baby, stressing that they have their own children and extended family members to care for. So, at the time of this writing, Sorie remains at a ChildFund-supported transit center while the social workers and government officials search for a foster family to take him in. At such a young age, Sorie is unaware of his losses and the stigma that could follow him.

An Uncertain Future for Many Families

“Emergencies are not new to West Africa, but Ebola came as a very different crisis.”
— Billy Abimbilla, National Director for Liberia and Sierra Leone

Despite the ICCs’ interventions, and even in the best cases of survival and reunification, families that were not obliterated are cobbling together the remains of their lives – and facing the stigma of infection and apprehension over what the future holds.

Many families, already struggling on meager incomes, may have lost one or more income providers, and, in some cases, teens who have lost both parents are raising their younger siblings. Families who have taken in young relatives orphaned by the outbreak find themselves suddenly responsible and with less income, more mouths to feed and more children to put through school. “For now, we actually need some supports like clothes and school fees,” says one such caregiver, who took in a 6-year-old boy named Jesse who had lost his mother and both grandparents.

Adding to that stress is the fear of reemergence of the disease with the reopening of schools in all three countries – a very real possibility. Guinea’s schools reopened in January, Liberia’s in February and Sierra Leone’s in April. To help prevent a recurrence among children returning to school, ChildFund has set up hand-washing stations outside all ChildFund-supported schools, along with “no-touch” digital thermometer screening stations.

Meanwhile, the collapse of the health infrastructure is an enormous concern, not only because it means diminished access to basic health care for illnesses typically seen within the community (like malaria), but because the threat of reemergence is so real.

“We must also look at how we can restore confidence in the health care system,” Abimbilla says. “That confidence is lost. Even before Ebola, the system was not adequate to treat normal diseases. If we have more people trained in medicine who are willing and able to stay in West Africa, we might be able to cope with similar outbreaks in future.”

“While the worst of the crisis appears to be over, we cannot be complacent,” he adds. “It is true that Liberia has had no new cases for a number of weeks, but Guinea and Sierra Leone are still reporting infections, so even if Liberia declares the epidemic over, it is not completely over. One single infectious person crossing into Liberia could start things all over again.”


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