A Year On: How Do We Remember West Africa’s Ebola Victims and Survivors?
By Chernoh Alpha M. Bah
Today – November 7, 2016 – the government of Sierra Leone announced a three-minute national silence to remember the ravages of the regional catastrophe that ravaged West Africa in 2014 and 2015. The Ebola outbreak in West Africa remains one of the most catastrophic human tragedies in the twenty-first century. As government officials in Sierra Leone called for a three-minute national silence, questions around how communities and individuals remember the past and the significance we attach to history and memory become evident. What lessons did we learn from this recent disaster? Are there any measures in place to prevent the recurrence of these kinds of tragedies? While debates around these and many other questions will continue for years, there are many episodes that we must always not forget in our collective thinking as a people.
One such event is the controversy that erupted on April 4, 2015 in Kailahun district in the eastern region of Sierra Leone. It involved a dispute between opposition politician Alex Bonapha and district health officials in Kailahun, regarding the test result of a deceased child.
The child, a nine-month-old baby, died at the Nixon Memorial Hospital in Segbwema on April 3, 2015. A few days before the tragic incident, doctors at the hospital had recommended a blood transfusion for the child. An uncle is said to have donated the blood given to the child. The baby passed away just hours after the blood was transfused. Health officials, who conducted a swab test at the Ebola Management Center in Kailahun, later claimed that the child died a victim the Ebla virus. Officials from the National Ebola Response Center (NERC) in Freetown recommended that Kailahun district be closed down and the family of the deceased child be quarantined. Kailahun was the initial site of the outbreak a year before and had gone almost two months without a single reported infection at the time of the child’s death.
Alex Bonapha, the district council chairman in the area, instantly challenged the validity of the child’s Ebola test result and protested against the NERC’s decision to re-quarantine the district. Bonapha asserted that the child’s test result shed doubt on the whole Ebola management system.
“We are strongly contesting the validity of the one case today in Kailahun,” Bonapha said in a statement issued in response to the child’s test result. “For a person to be infected, he or she has to come in contact with an already infected person or must have touched the vomits, urine, saliva, excreta or the sweat of an infected person,” he also stated, arguing that the deceased child was not exposed to any of these required risks of infection.
According to Bonapha, all members of the child’s family, including the mother who was breastfeeding the child and the uncle who reportedly donated the blood that was given to the child, were Ebola negative and never infected before the child’s death.
“All the family members of the late child including the mother are very healthy and alive. If the child got (Ebola) from the mother, the mother would first have manifested symptoms before transmission, but this was not the case. The child could not have got the virus through breastfeeding because the mother is neither an Ebola survivor, nor has she up to now manifested any signs or symptoms. The uncle of the child who donated his blood has stayed in Segbwema for over nine weeks without leaving the town and he is also not a survivor,” he argued in his widely circulated protest statement.
Bonapha then demanded that frontline responders to the outbreak in Sierra Leone (the National Ebola Response Center (NERC), the World Health Organization (WHO), and UNICEF) explain how the test result of the child turned out to be Ebola positive when the child was not exposed to any of the conditions that cause the infection.
“My suspicion is that either the swab result was interchanged, or the blood that was donated for the child was reserved in the blood bank (while) another from the same blood group, as the one donated by the uncle, was used on the child,” he stated.
Bonapha’s protest was more than a political action from an opposition council chairman fighting to protect his constituents from the harsh disease quarantine measures enforced by troops of central government officials in Freetown. His protest raised a fundamental question about the outbreak: what was the actual transmission mode of the virus?
A fierce debate erupted between Alex Bonapha and the district health officials. The health officials received support from ruling party propagandists.
Government propagandists tried to dismiss Bonapha’s statement and position on the matter, calling it inflammatory and inciting. As council chairman, Alex Bonapha had been at the center of controversy with officials of the Koroma administration and he remained one of the strongest opposition critics of the central government’s response to the outbreak. Responding to Bonapha, Sylvia Olayinka Blyden, a former presidential assistant and owner of the pro-Koroma Awareness Times newspaper, stated that the child’s test result could either be the result of the mother or the uncle being asymptomatic carriers of the Ebola virus.
“The child’s swab test should be re-run or if the corpse is already buried, for the body to be exhumed and another swab test be collected and re-run,” Blyden suggested, but stated that the child’s “mother and entire family must in the interim be subjected to twenty-one days quarantine.”
The controversy over the child’s death now threatened the credibility of the entire Ebola response effort. Kailahun district itself had gone from being a leading Ebola hotspot, with nearly eighty infections per week in June 2014, to exhibiting zero cases for a consecutive period of over one hundred days before the controversial diagnoses of the deceased child. But despite the sanguinary response of government propagandists, Alex Bonapha still insisted that the result did not reflect the deceased child’s Ebola status. The arguments eventually forced the United Nations agencies involved in the Ebola response efforts and the country’s National Ebola Response Center (NERC) to conduct an investigation into the circumstances of the child’s death and the test result.
An investigation team, made up of representatives from the Sierra Leone health ministry, WHO, and the United States Center for Disease Control (CDC), was then constituted in Freetown and dispatched to Kailahun to undertake the investigation. The investigation team later discovered that there was strong basis for Alex Bonapha’s protest: they found no evidence that there was an ongoing Ebola transmission in Kailahun and that the child in question was not an Ebola case.
“The sample in question is not from the child,” the team tacitly stated in its report.
NERC officials in Freetown later called the controversy surrounding the child “a mere mistake,” which they blamed on a lower ranking Ebola health worker. Alex Bonapha, the council chairman who raised the sensitive question, appeared to have scored a significant political victory against his opponents.
“We want NERC to offer a public apology as a way of restoring confidence with the people of the district. Many people are now afraid to go to the hospital,” Bonapha told the Politico newspaper in Freetown.
The government propagandists, who called Bonapha’s protest “immature and inflammatory,” immediately changed the focus of the discussion. They quickly subsumed Bonapha’s protest and replaced the matter with praises for the joint investigators.
The Sierra Leone Telegraph praised what it called, “The encouragingly unprecedented speed with which the ministry of health, NERC and the international health agencies in the country responded to the community’s call for answers.”
The controversial matter regarding the child’s test result was closed. But underneath the torrent of accusations and counter-accusations between the politicians and health officials there still remains a fundamental question: was the child’s test result a real mistake? Many people wondered how many of such “mis- takes” may have occurred during the outbreak. The question as to how the said “mistake” actually happened was never exhausted. Alex Bonapha and the child’s family members never pursued the matter any further.
But an examination of these contentious episodes – from the death of Emile Ouamouno in Meliandou to Mammie Lebbie’s survival story in Koindu – unravels a trail of undocumented testimonies of clinical wrongdoings, questionable scientific claims, and misleading media reports on the outbreak’s origin and modes of transmission. Underneath these questionable stories lie the un-discussed predicaments of the outbreak’s many victims. All across the Mano River countries in West Africa today, communities harbor telling stories that are much more contentious and frightening. In their totality, these stories not only cast severe doubts over the origin of the outbreak and its modes of transmission, but like the so-called mistaken test result of the Kailahun child of April 2015, they tell real-time stories of suspicious deaths, of hundreds of doubtful infections, of strange and unknown disease treatment methods, and of many other ethical issues involving medical experts practicing beyond the parameters of informed consent. These chilling accounts of the victims, of the families of the deceased, of the survivors – real firsthand accounts from true eye-witnesses – have been largely dismissed by scientists and political leaders, oftentimes regarded as “conspiracy theory” in the western and African medias. But these subsumed and suppressed firsthand accounts contain cold and sad recollections of events that are too frightening, too rampant, and too commonplace to be ignored. They cannot be swept under the rug. As incredible as they sound, as unbelievable as scientists and journalists want them to appear, they form an important part of evidence in any genuine effort geared towards a real understanding of the motives and outcomes of the 2014 West African tragedy.
The story of the 2014 outbreak, its questionable origin and modes of transmission, and how certain individuals and organizations profited from the disaster and deaths that occurred in West Africa, must be looked into in the interest of justice, peace, and human dignity. A clear path towards recovery must begin with uncovering the truth: an independent investigation that employs the services of forensics and victim testimonies has to be considered as part of a genuine healing process and as a bulwark for preventing the recurrence of crimes against humanity and genocide.
On July 11, 2005, in a message marking the tenth anniversary of the Srebrenica genocide, Kofi Annan, then secretary general of the United Nations, attempted to address a crucial aspect in international justice: the extent to which international powers can be morally and physically held responsible for either directly or indirectly fomenting, condoning, or failing to prevent the escalation of events with a potential to destroy humanity and global peace.
“It is undeniable that blame lies, first and foremost, with those who planned and carried out the massacre, or who assisted them, or who harbored and are harboring them still. But we cannot evade our own share of responsibility,” Kofi Annan stated. He noted that the human catastrophe in Srebrenica would have been avoided had the United Nations acted swiftly to prevent the events that developed into the massacre. “We can say, and it is true, that great nations failed to respond adequately,” Annan admitted, acknowledging that, “the tragedy of Srebrenica will haunt our history forever.”
Kofi Annan suggested that to address crimes of the past, the world should ensure that systematic slaughter does not reoccur anywhere in the present or future. This entails that the actors can be guilty not just for committing genocide, but also for allowing it to happen.
“The world must equip itself to act collectively against genocide, ethnic cleansing and crimes against humanity,” Annan emphasized.
It is obvious that efforts to draw up historical comparisons between the Srebrenica massacre and the human catastrophe of the Mano River countries in 2014 might raise arguments about the similarity of the events with regards to their unique geographic and socio-political contexts. Nevertheless, there exists within the parameters of the historical cases of genocide and the spirit of international criminal justice a common applicable procedure and trajectory for determining crimes against humanity and genocide. In the case of the 2014 West African out- break, such a determination can start with an investigation (within the realms of the applicability of the Nuremberg Code and its possible violation) into the historical events that created both the conditions for the outbreak and its agency of transmission. This could be a first step to uncover and confront what Kofi Annan calls, “the full truth about what happened” in the West African countries of Sierra Leone, Liberia, and Guinea. A process of reconciling the past with the present in the interest of a peaceful future must start with a genuine process of justice. Without justice, there will be no peace for the families of the victims. Without trust, the requisites for national economic development and collective social progress can never be attained.
**Excerpt from Bah, Chernoh Alpha M (2015). The Ebola Outbreak in West Africa: Corporate Gangsters, Multinationals & Rogue Politicians. Africanist Press: Philadelphia. pp111-120.