From Saturday, Sierra Leone is officially Ebola free. But memories of the disease and the devastation it caused are still fresh. The country will have to deal with the consequences for many years to come.
"Has anyone in your village died from Ebola? Have you had contact with a sick person?" These are everyday questions in Sierra Leone. They are part of the routine for anyone wanting to enter a hospital. Staff are expected to fill out a questionnaire and measure every visitor's temperature. The aim is to identify as early as possible anyone suffering from Ebola.
The disease caused havoc in Sierra Leone - a country with a population of six million. There were more than 14,000 suspected cases and the official death toll is put at 3,589, although the true figure is probably much higher. For 42 days no new infections have been registered - which means that on Saturday (08.11.2015) the World Health Organization can officially declare Sierra Leone to be "Ebola free." Of the three West African countries worst hit by Ebola, Sierra Leone had the second highest number of cases, after Liberia. In neighboring Guinea, new cases are still occurring.
Need to reform health system
Patrick Turay, medical director at the Holy Spirit Hospital in Makeni, the largest city in Northern Province, sees no reason to rejoice over Sierra Leone's new Ebola free status. "We still haven't got our priorities right," he told DW. "We need to overhaul our healthcare delivery system." Any fresh infection could have devastating consequences, he warned.
The Holy Spirit Hospital is a private hospital run by the Catholic church. Wards and examination rooms are clean and well equipped. Safety precautions are observed, unlike in other hospitals and health centers where staff have become careless and fail to measure the temperature of every visitor.
This is why Turay insists that Sierra Leone must learn from the Ebola crisis. At the top of his list is the wish for more trained staff. "There are more Sierra Leonean doctors working in the US than in their own country," he said. Also, anyone wanting to come to Makeni has to be ready to live in the provinces which has little attraction for people used to city life in the capital Freetown.
No farewell, no grave
Since 2014, the country has undergone the painful experience of learning just how important a good health system is for rural areas. Someone who knows this only too well is Momoh Sesay, a tall, serious young man. When he talks about Ebola, he tries to sound as detached as possible. "First my mother suffered from headaches. Then she started vomiting. We took her to hospital. She received treatment but she died," he says.
A friend who was in the same hospital and survived broke the news to Momoh by phone, the only way of maintaining contact with the outside word. Momoh's village of Manoh was badly hit and was put under quarantine. Neither he nor his siblings were able to say goodbye to their mother. There is no grave.
Grief is mixed with fear of what the future may bring. The children are now orphans and have no income. They do have an uncle and aunt who help them out occasionally. Today, many thousands of children in Sierra Leone are growing up without parents.
Life must go on
Asked whether he will celebrate the official end of Ebola, Momoh Sesay swallows hard and says nothing. He has to fight to hold back his tears.
Gisela Schneider, a doctor who runs health projects in Sierra Leone and Liberia for German aid organizations Bread for the World and Diakonie Katastrophenhilfe, says for the population at large, the Ebola countdown is important. "After eighteen months of a terrible disease, this is definitely something to celebrate. People have suffered tremendously but they have also achieved a great deal," she says. Scheider also calls for the creation of a robust health system and warns against just carrying on as before.
The death of his mother means life can never be the same for Momoh Sesay. From one day to the next he suddenly had to take on responsibility for his siblings. He is often sad but is also determined to fight for his family. The first step is to get a good education. "I'd like someone to teach me how to use a computer," he says. "Then I would like to go to college and study bookkeeping."