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Local nurses at Sierra Leone’s Ebola clinics are risking their lives for low or no salaries – while being shunned by the community and separated by their families
The women’s staff room at Hastings Ebola Treatment Center in Western Rural Area, Sierra Leone, is cramped, stuffy and hot from the sunlight flooding through the window.
The nurses in blue scrubs squeeze onto the rickety beds and try to sleep during their break in the Green Zone.
In a while, they will go to the Yellow Zone, pull on their Personal Protective Equipment (PPE) and go back to the wards, the Red Zone.
For many of these health workers, the hospital is the only place where they are not shunned by the community or their families.
And for most, it is passion and not money that drives them on.
“We rent houses and when [the landlords] know we’re working here, they give us notice,” says Joya Koroma, 32, a nurse.
“When we go to our families, they drive us out of their houses. Even our relatives are afraid of us.
“We are doing it because we are trained to. We have to serve humanity.”
Joya and the rest of the staff haven't been paid in two weeks.
The clinic, which has 100 beds, and is treating patients including several children ill with Ebola, is 100 per cent government funded, with no aid agency money or funds.
Joya says she and her exhausted colleagues have not been given any food all day.
Others like male nurse Alieu Kamara, 19, sleep overnight in the men’s staff room, just steps away from the patients they treat.
“My family kicked me out, so this is why I stay here,” says Alieu. “This is where I can sleep. Most of us here, our families have abandoned us because of the good work we are doing.
“We are here to push the virus out of the country, you understand?”
Health workers in Sierra Leone are being hit hard by Ebola, with chronic underfunding meaning a lack of robust facilities and scant equipment.
The fatality rate of Ebola-infected healthcare workers is currently 57 per cent, according to WHO, which says the situation for such workers is of great concern.
As of 28 September, 377 health workers across West Africa had been infected with the virus, 216 of whom had died.
At Hastings, the sophisticated isolation units of London and Washington seem very far away, and everyone is aware that being on the Ebola frontline brings the greatest risk of all.
And for Joya, Alieu and their colleagues, the most unfair twist of all is that such dangerous work does not even mean more money or benefits.
“We are hungry now,” says Joya. “There’s no food. Since we started working here, we have no money for pay for anything.”
Gandhi Kallon is the District Social Mobilisation Coordinator for the Ministry of Health and Sanitation in Western Rural Area.
He says the challenges for health centres and their workers are still emerging, with many more resources needed.
“As we speak now, some of our health staff residing in rented houses within the city are faced with the challenge of being evicted from those places. They are being given eviction notices.
Kallon says he has lost many colleagues in the health service, adding that he monitors his family on a daily basis for symptoms.
"I had a colleague, we lost him, we lost his wife and all his children, and even his mother in law. The other one, we lost him, but he was quick to recognise the symptoms and he told his family, 'nobody come near me, if I have to die, I'll die alone'."
Aid organisation Plan International is responding to the crisis across Liberia, Sierra Leone and Guinea in areas of child protection, social mobilisation and psychosocial support.
“The outbreak is affecting the lives of children, parents and their communities in diverse ways,” said Farai Zisengwe, Acting Country Director of Plan Sierra Leone.
“For the health workers working at the front line of the outbreak, it is having a direct effect on them and their families. Many of them are being separated from their homes, close family and children, with knock on effects across the community. We need more resources to support the health workers and their families.”
“Usually aid workers are hailed as the heroes in such crisis situations,” says Dr Unni Krishnan, head of Disaster Response and Preparedness for Plan International.
“However, in the case of Ebola, the local health workers are the true lifesavers. The risks they take are huge, and thus care and support should be a priority. The selfless service they offer is often at the cost of isolation from their families.”
At the holding centre in Newton, Western Rural Area, where people suspected of having Ebola are brought before being treated, nurse Fatumata Koroma, 28, supervises the red zone.
She says the health workers of contracting the virus, but are also determined to beat it.
“When we started [the staff] were afraid,” says Koroma from the makeshift plastic hut that serves as a staff work room at the centre.
“Now they are getting used to it, but they are still afraid because of our colleagues that have now been infected.
“It’s our war. There’s no way to escape this war, we just have to fight it. It’s a war for us because you can’t touch your close relatives, neither your mother nor your sister. But I’m ready to fight this war, I’m ready for it.”