The Toll of Ebola

I was interviewed recently about Ebola and my time in Sierra Leone in 2014 during the crisis.  In mulling things over I thought there might be a story there. So here it is.

Pay the Price

I watched his two brown fingers thump against my arm.  “Aha,” he muttered under his breath, then I saw the needle poised slowly before it plunged into the vein.  Has it come to this?  I thought morosely as I slipped away into somnolence while my blood dripped into the bag. Shortly, I awoke with a start to find Mamadou grinning down at me. “Okay, Jimmie,” he grimaced, “all done.”

“You rest until dark, then go. Arrangements are in place. You’ll be safe.”

I nodded assent. I was indeed ready to go.  Two and a half years in Sierra Leone was more than enough. I had dawdled and procrastinated, found myself bound by slippery ties to a place that I didn’t really like and to a culture that I could not fathom.  Yet that is partly why I stayed to try to make some sense of it all.

I spent nearly two years as a Peace Corps Volunteer English teacher at St. Joseph’s Secondary School in Bo.  Initially, I enjoyed it immensely. The wonder and exoticness of it all overwhelmed me. There I was in a small trading town in the heart of Africa charged with the responsibility of inculcating the virtues of the English language to several hundred eager young minds.  It was certainly a task.  At first I could not understand their upcountry palaver. In turn they found my American English distinctly different from the British inflected pronunciations Sierra Leoneans judged proper. We worked through this, however, and focused a bit on grammar, but mostly on the memorization of poetry and Shakespeare and whatever else was prescribed in the national curriculum.  I found that a teacher’s authority was conscribed. Innovation was frowned on.  Classes became repetitive.  It soon became a job.  But still the students were fun. Their ideas and questions about American cowboys, about snow, about Obama, all provided grist for conversation. They, in turn, readily talked about their villages, the roles of women, age ceremonies and witchdoctors. Witchdoctors intrigued me. As time permitted I sought out a few traditional healers and asked them to explain their craft.  Few spoke even rudimentary English. While they were willing to treat me or sell me various potions for this or that, virtually all were reluctant to reveal any secrets of their very mysterious operations.

 

I guess in the absence of other diversions, I became fixated on learning more about the witchdoctor business. So when my Peace Corps assignment ended I cashed in my plane ticket home and tapped my re-adjustment allowance and stayed on in Sierra Leone.  I moved east to the town of Kanema, over towards the Liberian border.  There I found a room in a house allocated to Raymond Chretien on the medecins sans frontiers compound.  Raymond was fiftyish, a medic of some sort with the Foreign Legion, who had signed up with MSF apparently to atone for a life of sin.  In any case he was a quiet man utterly devoted to his new calling.  Although house mates, we led solitary lives.

I contacted several of the notable healers in the area.  I explained I was interested in the psychological aspects of their work, that is did healing happen because patients thought it would?  No one was able to separate out this aspect of their calling, for them it was a holistic undertaking.  Of course folks felt better, they told me, because the cures worked.

Perhaps I got to know a man named Mamadou best. He had more English that the others and practiced at the crossroads of Kalihoun, about twenty clicks from Kanema.  He would let me sit and observe his consultations, his preparations of remedies and his incantations as he administered them.  He and other practitioners claimed real knowledge. My judgment was that it worked. Some of the herbs obviously had real medicinal value, but importantly, the people believed.

I fell into a routine: visiting, watching, talking with patients afterwards, writing up some notes.  Back home in Kanema I became friendly with Isobel, at first it was just a sexual transaction - she was very good at that - but I became fond of her and she sort of halfway moved in with me.

Then it began.  Raymond came home exhausted and agitated. He reported the clinic was being overwhelmed with sick and dying patients.  All had contracted a hemorrhagic fever called Ebola.  They ran high fevers, had aches and pains, vomited and quickly died.  The disease spread rapidly, already several of the nurses contracted it.  Apparently, the contagion passed through bodily fluids. After a week a nationwide emergency was declared. Roadblocks were established. Kanema was quarantined. No one in, no one out. People were admonished not to touch the sick or wash the dead. Public funerals were prohibited. These strictures caused chaos and panic in the region.  Who was infected? Who was not? What could you eat or drink? Who could you touch?  Paranoia became widespread. Everyone was suspected of infection.  I too panicked.  This was not my country, not my people, not my disease. Time for me to leave.

I formulated half a plan to get up to Kalihoun near the border with Guinea and then onwards to Bamako, Mali and out of Africa.  Just as I was beginning to pack, Isobel arrived.  She pecked me on the cheek, said that she was feverish and asked for some aspirin. I gave her some.  She collapsed on the bed.  I felt her forehead, indeed she was hot.  Too hot for a headache!  I panicked anew.  If she had Ebola she would be dead in days, me too if I stayed.  I kissed her sweaty forehead, said I had an appointment in Kalihoun and would be back tomorrow. I left.

Local transport, i.e. a beat up old pickup truck, was still going north. I paid my fare and jumped on the load.  Mamadou greeted me cordially when I entered his compound. “Jimmie, you are welcome. What brings you to my humble abode while all this fracas is going on?”  I explained that the quarantine and the curfews had forced me northwards. It was time for me to leave Sierra Leone. I could not get to Freetown. Monrovia too seemed like a bad idea. I needed to keep moving north. Could he help?  Mamadou pulled on his raspy beard and agreed to think the matter over.  Later over a cup of sweet tea, he opined that he could help, but that it would come at a price.   “Certainly,” I agreed, “I am ready to pay.”

“No, not money,” he said.  “Blood.”

“Blood,” I asked?  “Yes,” he replied, “your blood.”

He elaborated, “You see Jimmie, white man’s blood is an effective medicine against this Ebola.  We have learned this because the white men, the doctors from Liberia who contracted the scourge, did not die from it. They lived. Their blood was powerful. Their blood was able to fight the fever back.”  Mamadou paused. Then continued, “That’s what I need, your blood. I need it for me and I need it for my patients. Blood is the price for my help.”

I mused this over.  Asked what help he could give, Mamadou said his brother was a trucker who travelled back and forth to Bamako.  Currently he was in Guekedou, Guinea. If I got to him he could deliver me to Bamako.  Mamadou added that his brother would expect money.  And for getting to Guekedou,  Mamadou said a nephew regularly made the trip by back paths on a motorcycle.  Again for a fee his nephew could take me there.  I only pondered a short while.  “Agreed,” I sealed the deal.

In the morning, Mamadou sat me down and prepared to draw blood.  “Don’t worry,” he said, “I have done this before. My equipment is boiled clean. There will be no infection.”  I gritted my teeth, told him that I hated needles. “Then, don’t look,” he wisely advised.  Sadly, I did look, but it was over quickly.

That afternoon his nephew arrived as promised.  We skirted out of Kalihoun down forest paths, splashing though shallow streams and swarms of butterflies. We crossed several larger streams in pirogue canoes. The paddlers knew the drill. Theirs was a standing arrangement.  One time the motorcycle went in one boat and we in another.  It was all very efficient.  Apparently we crossed into Liberia first and then on into Guinea. I was mesmerized by the droning motor, the weak light probing ahead and the shear need to stay awake enough to hang on. We snuck into Guekedou just as first light was breasting the eastern sky.  I paid and tipped the nephew nicely as he turned me over to Mamadou’s brother.  Soon our truck headed north.  I was well hidden under the load in order to pass the border station into Mali.  Brother explained that the border was technically closed, however, “local considerations” took care of that.  Afternoon found me in Bamako.

Air France judged my Dad’s credit card was valid so sold me a ticket to New York.  Despite a bit of a hassle at the airport because I did not have Malian stamps in my passport, I left that night for Paris.

I am writing this summary of the past few days as I fly towards New York.  I don’t see it as a justification for my action, which was probably morally despicable. Rather this is an explanation, perhaps written with some premonition.

CDC CASE FILE 0044 of October 1, 2014.   The journal replicated above was found at the Econolodge near Kennedy airport amongst the belongings of James R. Greer of Tulsa, Oklahoma.  Mr. Greer called 911 on September10, 2014 to report that he was sick, probably with Ebola.  Appropriate medical teams evacuated him to Jamaica Hospital, Queens where he lapsed into a coma and died on September 13.  Greer’s room was sanitized and tracing conducted for all his contacts. All of the passengers seated near him and the crew in the rear cabin of the Air France flight were isolated, similarly with the staff of the hotel. As of October 1, the taxi driver who drove Greer to the hotel has not been identified, however, given the passage of time it is improbable that he was infected.  French authorities traced possible contacts at Charles De Gaulle airport and with Air France staff in Bamako. Malian officials also tracked contacts in their nation.  Happily, no confirmed cases of Ebola have yet been identified arising from links to James R. Greer. Finally, interestingly, Mamadou Deng, the well known traditional healer from Kalihoun, Sierra Leone is reported to be a survivor of Ebola.