by Barbara Jackson, Humanitarian Director, CARE International
“Don’t touch.” I hear this slogan over and over again here in Sierra Leone. I am on a visit with my colleagues from CARE Sierra Leone and our regional office for Western Africa to meet the diverse range of partners and stakeholders with which CARE is working to fight the terrible disease that has ravaged West Africa in the past seven months: Ebola. I hear this advice from all sides: In our initial briefing with CARE’s Regional Safety and Security Manager, from the Sierra Leonean military, to the DERC (District Ebola Response Center) Director, to the traditional Head Chief for the area, and from all of our staff. It is a simple but vitally critical instruction that we must all practice if we are to reach the target of zero Ebola cases in the entire region.
Colleagues tell me that several of the community case management centers are in the process of being closed as is one or two of the major Ebola treatment centers simply because the overall number of people requiring care is decreasing significantly. There is a sense of hope and encouragement that this terrible outbreak which has affected every single person in this country in one way or another is coming to an end.
Yet as we travel to and from Mekene, one of the original hotspots of the Ebola virus, I observe empty local market stalls, and a few scattered buses and local transport vehicles on the streets. Not many people are walking alongside the road - a very marked difference from most of the rural African settings I have seen. I can see that the Ebola crisis is definitely NOT over and that even in the few days I have been here in Sierra Leone the number of cases has risen. Our staff tell me that people are still afraid to report a suspected case, as they may never see their loved one again.
Forcing myself to keep my arms down
I have to consciously hold my arms down to my sides to resist extending my hand for an introductory handshake or to embrace a colleague I’ve known in the past or to hug one staff member in compassion as he tells me how he lost eight of his friends and relatives to Ebola. We are “not to touch” each other. We must maintain not only vigilance but continue to strengthen our joint efforts to prevent more cases, to ensure appropriate and dignified burials, to ensure that people access health care in time. We cannot take our eyes off the most important goal: reducing Ebola outbreak to zero cases. And we need, as CARE, to ensure that our programming continues to reflect this commitment and support.
Everyone with whom I talk to tells us of their appreciation for CARE. Whereas we do not focus on the treatment of Ebola patients our programs look at the needs that were not originally considered yet which are crucial to keep the nation-wide Ebola response running: logistical support to the District Ebola Response Centers, training for appropriate burials, culturally sensitive training and capacity building of local volunteers for surveillance and referral, engagement of the local chiefs who hold so much power and authority and whose leadership has and will be pivotal in not only overcoming this current outbreak but in sustaining practices that will diminish the risk of outbreaks in the future. One donor representative tells me: “We should have listened to you earlier; we needed to hear and be responsive to the communities’ demands, not just respond top-down and impose our actions.” We might not make headlines with our approach, we do not have the medical clinics and the humble and heroic doctors in their white protection suits. But we are the backbone of a system that ensures this response keeps running and is accepted by the communities – and that their voices are heard and respected.
Helping Sierra Leone in the long-term
This is CARE’s strength and I have seen it repeated over and over again in the humanitarian contexts in which we work. We build upon our deep ingrained community knowledge and trust, we seek to find how we can best address a problem that will be sustainable in approach rather than focusing on the quick fix. Here in Sierra Leone, as in the other countries affected by this devastating outbreak, we know that women are often those most affected as they are the caretakers of the ill in the family. They are the nurses and the ones whose livelihoods have been lost as companies have laid off their husbands and sons and who had to seek other means of earning a little bit of money to help the family survive. Our response now and in the future must be seen through the lens of years rather than months and must build upon this local knowledge and respect. At the same time we are working to ensure that donors and governments will enable their funds to be used not only for the immediate Ebola assistance but also for a response grounded in community practices and traditions, as well as essential sustainable capacity building for recovery.
As I depart Sierra Leone after this very brief visit, I cannot acknowledge enough the commitment and efforts of staff here; the empathy and engagement that they have with all the partners - of which there are many - and to recognize that each and every one of them is and has been personally and profoundly impacted by this crisis. Without exception, every colleague had a warm smile and exuded welcome and appreciation. It is us who must appreciate their efforts and continue to deepen our efforts across the CARE world and externally to build greater support for this response. For now, and for the coming months and years, to ensure people recover from this crisis.
While I “do not touch”, I wish I could wrap my arms around this team, and our colleagues in Liberia, to say thank you, stay safe, and you are in our hearts and thoughts; it is you who have helped the world to see that we can and will reach “zero”.
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