Worse Than War: Our Year Fighting Ebola

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By Billy Abimbilla, National Director for ChildFund Sierra Leone and Liberia

 

Emergencies are not new to West Africa, but Ebola came as a very different crisis. We have only recently emerged from years of civil war, yet in many ways our experience with Ebola has been far worse.

Fighting Ebola is like fighting an invisible enemy. In a war situation, you would know where the opposing factions were, and you could escape to another village. With Ebola, you don’t know where the problem is because you cannot see it, you cannot feel it, and there are no gunshots, but it is widespread.

Ebola has wiped out entire families, literally. It affected three countries at one time, and all parts of each country. It completely collapsed the health system, killing more than 10,000 people – and the doctors, the people who were supposed to protect us, they were the ones who died first.

Billy Abimbilla

Billy Abimbilla (right), national director for Sierra Leone and Liberia, examines a shipment of supplies that were delivered to Liberia’s Ministry of Health to fight the Ebola virus in October, 2014.

For me and my staff, this has been a very emotional year. The hardest part has been working with the very many traumatized children who have been affected in so many ways. They have lost either their parents or the person who was their primary caregiver. Or they contracted Ebola themselves and survived. Or they watched their parents die. And we are not talking about a few children. We’re talking about thousands of children.

Since the outbreak began, some 5,000 children in West Africa have suffered with Ebola, and more than 16,000 children have lost one or both parents or their primary caregivers. At the interim care centers ChildFund has been operating in Liberia and Sierra Leone, it has been very difficult observing these children who have lost parents and do not know what the future holds for them. They are traumatized — they don’t want to eat or speak to anyone. They are actually scared of the world. It has been challenging to see how best we can work with these children to restore hope.

I am also extremely concerned about the impact of so many months of lost education. An estimated 5 million children across Guinea, Liberia and Sierra Leone have had their education severely disrupted due to the Ebola outbreak, with schools closed for up to 10 months. Guinea was the first to reopen its schools in January, with Liberia following the next month. Sierra Leone has postponed its plans for reopening schools until April.

The impact of the prolonged school closure has been extremely negative for children, parents and the affected countries as a whole. Most children have forgotten what they were learning. There is a backlog of students waiting to progress to the next grade or higher institutions. Some teenage girls have become pregnant since being out of school. In rural areas, children have been engaging in child labor, supporting their parents with farming or other work.

It is critical that children return to school and catch up on their lost education. At meetings we have had with children in different communities, they have told us they feel bad because they haven’t been to school for so long. They miss playing with their friends, they miss learning. Some children have been missing out on adequate nutrition as their school feeding program was providing their only square meal a day, and their parents have lost livelihoods and income since the outbreak began.

At the same time, children feel scared to go back to school. In Liberia and Guinea, some parents are adopting a “wait and see” attitude before sending their children back. Children are concerned that they cannot play with each other as during the pre-Ebola period, because they still need to avoid close contact for their own safety. We are also aware that children who watched their parents die will have emotional issues that could adversely affect their performance at school, while children who survived the virus may shy away from going back to school altogether.

All of these things make the reopening of schools a very complex process. It is not just about ensuring every school has adequate facilities to protect children from the possibility of another round of infections. We must also address the trauma and stigma faced by children who are Ebola survivors or who have lost their parents and are now living with extended family or foster families. And there must be a catch-up plan to restore children’s lost education – for example, through extending the school term from three months to four or putting on after-school or weekend classes. These measures are vital to reduce the long-term impacts of Ebola on this generation of children.

While the worst of the crisis appears to be over, we cannot be complacent. 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.

We must also look at how we can restore confidence in the health care system. That confidence is lost. Even before Ebola, the system was not adequate to treat normal diseases. There is a massive brain drain of medical personnel to other countries, such as the U.S. and Europe. 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 the future.