A Deadly Chain: Tracing Ebola In A Sierra Leone Village
It began with a little boy.
A 4-year-old who was feeling sick. His family sent him to a neighboring village called Royail, where his grandmother lives, so she could care for him.
In this tiny place, surrounded by tall grass and palm trees, the grandmother lived in a house on a dirt road. Her name was Sinnah Turay, but people refer to her as "the mami-back" — that's what some folks in Sierra Leone call a grandmother.
What happened in Turay's house has set off a deadly chain of infections in a country where Ebola is now surging, where government and aid groups are scrambling to build treatment centers and where local communities, like the district that Royail is in, are straining to care for patients, with mixed results.
Adamsay Fofanah (center) lives in the village of Royail, which has been hit hard by the Ebola outbreak. Her mother died the day before, most likely of the virus.
Standing outside the house, a youth leader, Samuel Bangura, tells what happened. The grandson's symptoms became really serious. Vomit. A bloody nose. Bloody diarrhea. All classic signs of Ebola. The other villagers were alarmed. At their insistence, Turay sent her grandson back to his home village. He died there, a week ago. But by then Turay had already started to feel sick, showing the same symptoms.
The villagers called an ambulance. Turay's son, Alpha Fofanah, says when it arrived, his mother refused to get in. She said she only had pain. She didn't think she had Ebola.
All last week Turay grew weaker. Finally another ambulance came for her. Once again, she resisted. She said, "I'd rather die at home." And right then, right there, that's what she did. With the ambulance still parked outside.
But Ebola wasn't done with this village. A traditional healer named Baby Sesay had treated the 4-year-old boy. Now she was feeling sick. When the ambulance first came for her, she hid in the jungle. The villagers say it's not surprising — there are a lot of myths surrounding this outbreak. Many people believe that if you fall sick and are taken to the hospital, you'll be injected with poison and die.
The next day, Sesay changed her mind and asked for help. The problem: Right now there are only a few Ebola treatment centers for all of Sierra Leone. So officials will refer only those people with the most severe symptoms — what they call the "wet cases" — for treatment. The "dry cases" — people like Sesay, who present with only a fever or body aches — are sent to a newly built community care center to wait until they can be tested for Ebola.
Foday Kamara is the leader of Royail, a tiny village now battling Ebola.
The nine-bed center is a concrete block building surrounded by two rows of tarp fencing. The man who runs it is Alfred Kamara, the local chief. When we arrive, he says Sesay is feeling well enough to speak.
A middle-aged woman in a print cloth dress walks out. She moves very slowly, and grips a pole to steady herself. We speak to her from the other side of the fence, about 12 feet way.
I ask, "How are you feeling?"
She says, "My body weak, I have a headache."
Suddenly, her body seizes up. For several seconds she's rigid, hands locked on that pole. Eyes wide and frozen, breathing heavily.
Just as suddenly, she's back. Still, it is clear she's in no condition to give an interview. I urge Kamara to tell her to go back inside and lie down. Since he's not wearing protective gear, all he can do is call out to her.
Sesay staggers back toward the building. Another patient watches nervously. He came in with a mild fever to get checked out. But it's taking days to get his test results. Now his fever's gone. Stuck in a small room with Sesay, he's worried he could get Ebola from her: "I don't want her to be so close."
Kamara agrees this is a dangerous situation. Instead of stemming Ebola, this community care center could be spreading it. He gets on the phone with an official to tell him Sesay's condition is deteriorating. He wants her sent to a treatment center. He says she can't wait. "Ebola is not waiting," he tells me. "He's aggressively destroying your important systems inside your body."
When he finally hears back, it's not the answer he wants. There are no free beds. Baby Sesay will have to stay.
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Transcript
DAVID GREENE, HOST:
In Sierra Leone, there is a new surge in Ebola cases. We're going to visit a community that might tell us why. NPR's Nurith Aizenman found a village called Ruyail where a 4-year-old boy set off a deadly chain of infections. Nurith wanted to find the house where this began.
NURITH AIZENMAN, BYLINE: We're walking with the headman of this village on a dirt road. The headman is pointing to this.
UNIDENTIFIED MAN #1: (Foreign language spoken).
AIZENMAN: This is the house?
UNIDENTIFIED MAN #1: Yes.
AIZENMAN: Neighbors crowd around. A youth leader, Samuel Bangura, tells the story. The child was from a neighboring village, but he was feeling sick. So he was sent to this house where his grandmother lived so she could take care of him. Her name was Sinnah Turay. Almost immediately, her grandson's symptoms got really serious.
SAMUEL BANGURA: Before they die, we see blood coming out of their nose, toilet - blood and then the vomit.
AIZENMAN: Vomit, a bloody nose, bloody diarrhea - all classic signs of Ebola. The other villagers were alarmed. On their insistence, Turay sent her grandson back home. He died there a week ago. But by then, Turay had already started to feel sick. She had the same symptoms. The villagers called an ambulance. Turay's son, Alpha Fofanah, says when it arrived, his mother refused to get in.
ALPHA FOFANAH: She refused to go thinking that all she had was just basic body pain and not Ebola, so she wouldn't go.
AIZENMAN: All last week Turay grew weaker. Finally, another ambulance came for her. Once again, she resisted. She said, I'd rather die at home. And right then, right there, that's what she did, with the ambulance still parked outside.
FOFANAH: Mommy died.
AIZENMAN: But Ebola wasn't done with this village. A traditional healer named Baby Sesay had treated the 4-year-old boy. Now she was feeling sick. When the ambulance first came for her, she hid in the jungle. Villagers say it's not surprising. There are a lot of myths about Ebola.
BANGURA: That if you fall sick and they take you to the hospital for Ebola, they're going to inject you and you'll die.
AIZENMAN: But earlier this day, Sesay changed her mind and asked for help. The problem, right now there are only a few Ebola treatment centers for the whole country. So the local official will only refer people with the most severe symptoms, the wet cases, for treatment. The dry cases - people like Sesay, who only present with a fever or body aches - they're sending those people to a newly built community care center to wait until they can be tested for Ebola. We drive out there and come upon a low cement-block building surrounded by two rows of tarp fencing. The man who runs this nine-bed center is Alfred Kamara. He's the local chief. He says Sesay is feeling well enough to speak.
ALRED KAMARA: (Foreign language spoken), Baby?
AIZENMAN: A middle-aged woman in a cloth, print dress walks out. She moves very slowly and grips a pole to steady herself. We speak to her from the other side of the fence - about 12 feet away. How do you feel?
BABY SESAY: (Foreign language spoken).
AIZENMAN: My body is weak, she says. I have a headache. And suddenly, her body seizes up for several seconds. She's rigid, hands locked on that pole, eyes wide and frozen. Just as suddenly, she's back. Still, it's clear she's in no condition to give an interview.
KAMARA: (Foreign language spoken).
AIZENMAN: Go lie down? Tell her to go lie down.
KAMARA: Yes. (Foreign language spoken).
AIZENMAN: Is she going to go lie down?
KAMARA: (Foreign language spoken) Yes, she's going down.
AIZENMAN: She needs to lie down.
KAMARA: (Foreign language spoken) Hey.
AIZENMAN: She staggers back towards the building. Another patient watches nervously. He came in with a mild fever to get checked out, but it's taking days to get his test results. Now his fever is gone, but stuck in a small room with Baby Sesay, he's worried he could get Ebola from her.
UNIDENTIFIED MAN #2: Yeah. I don't want to be so close with them. Yeah. That's why I'm just very careful.
AIZENMAN: The chief, Alfred Kamara, agrees this is a dangerous situation. Instead of stemming Ebola, this place could be spreading it. He gets on the phone with a local official to tell him Sesay's condition is deteriorating. He wants her sent to a treatment center. He says she can't wait.
KAMARA: The Ebola is not waiting. He's aggressively destroying your important system in your body.
AIZENMAN: But when he finally hears back, it's not the answer he wants. There are no free beds. Baby Sesay will have to stay. Nurith Aizenman. NPR News, in northern Sierra Leone. Transcript provided by NPR, Copyright NPR.
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