Tim Cunningham – Sierra Leone – February 2015
Fires slowly rip through fields desecrating the lowest brush. They singe the branches of the mango trees closest to the ground, creating swaths of smoldering ash following the direction of the wind. Every day, a new fire leaps from field to field. Then it seems like in short time bright green sprouts with small leaves proliferate the scorched earth, moving everything from black and grey to green.
We turn off of the main road that heads towards Freetown, an unmarked road, like most. Patchy and full of holes with a subtle downhill gradient, just enough that in front of us opens a horizon humid and hazed with palm trees as far as we can see. Immediately to our right and left hardy undergrowth flanks the trail springing from the new ash. The road is red.
About one half of a mile down there is a tin shelter, perhaps eight feet by eight feet with an upward tilting roof that opens onto a cleared field, not black like most burned land, but red, clay, full of gravel and large stones. Beyond the field, facing this shelter is another structure, a skeleton of wood decorated with laundry drying in the sun. Around it, 28 young men talking quietly.
We have arrived at the Port Loko New Cemetery; today it is rudaceous with 522 mounds and 10 or 20 open pits, deep rectangular graves. In front of many of the mounds sits a wooden post with a crosspiece plank, black with white paint: A name or “unknown,” and age or blank space, the name of a village, a site number.
Mr. Sesay (his name is changed here; all forthcoming names are changed too to respect privacy) has invited us to come to his work place. He built the tin structure for a viewing area in which family members can stand at a safe distance to watch their loved ones laid to rest with distant dignity. At death, the body is most contagious with Ebola and yet in this place funeral rites, for time immemorial, have consisted of caring for, cleaning and closely honoring the decedent. Mr. Sesay and his team of 28 gravediggers and burial teams try to bridge the gap between culture and contagion.
He claims he was the first man in Port Loko District to wear Personal Protective Equipment (PPE) when this epidemic was first named. His corps of 28 young men, some ex-soldiers, most of them previously jobless, all strong, free volunteered to this work. The first person they placed in the ground was a police officer. His body lies at “site 1,” his maker reads “unknown,” based at the roots of a large mango tree.
When we, four nurses from the Maforki ETU, descended our vehicles to step on this sacred land, Mr. Sesay and the 28 gravediggers quickly approached us saying we were welcome, but with a pressurized tone that another agenda was in place. Mr. Sesay encourages us to take photographs as do the gravediggers. “That way people can know,” he says. A gravedigger then speaks up from the crowd and iterates, “You are free to walk wherever you like. We need to speak with you when you are done.”
And the crowd steps back.
Mr. Sesay asks: “So, who are you here for?” We don’t respond. We may be here for ourselves. Since December 25th more than 100 patients have died in our facility, most from Ebola.
One of our nurses asks to see the site where a patient named Hawa lies. She was 8 years old and this particular nurse helped admit her when she cried out to her headman, “Mr. Bangura! I will die! I will die!” He comforted her, speaking her own language, Temne, calmed her and daily brought her treats during her rapid decline. He had planned to set up financial support for her to get her through school when she was discharged. Hawa, like many of our pediatric patients stole our hearts with her ferocity, her constant attempts to pull out her IV cannulas, her refusal to drink and eat when we told her (but her love to eat when we turned our backs). Even as she got more sick, she still fought us with what strength she had, comforted only by this nurse Cheedy, whom she trusted the most.
When Cheedy asked to see where she was, Mr. Sesay pulled out a meticulous document, a matrix of names, dates and site numbers and took us directly to her home in the earth. Then names flooded our minds and we walked the coarse stone graveyard, each name provoking vivid memories covering the spectrum from joy and laughter to loss and the gnawing feeling of complete failure.
We visit Hassan next, a boy who was 1 and ½ years old when he died. He had days of looking like he could die at any minute and then his last day was his best. He was beginning to recover, we thought. He looked better, stronger, his skin took on a healthy tone and then the next day he stopped breathing in his father’s arms. Frequently, we have seen this trajectory with children; they look horrible and we fight to resuscitate them, they take a turn for the better, they often eat, sit up and play. They have their “best day” and all too often, it is their last.
Hassan’s gravesite is mammoth compared to the size of his body. All graves are uniform in length, depth and width. This one-year old fought like a grown man though, fought like an adult, fought like the strongest of our fighters and therefore he fills a grown man’s grave.
More visits, more sites, a sea of names. We walk for I don’t know how long.
And then the cadre of gravediggers approaches us again; perhaps we have spent enough time in near silence. The critical mass of burly young men present their spokesperson who I will call Ali. Ali appears younger than the others and is energetic. He speaks like a politician, vehement and focused. His speech sounds well-rehearsed.
There is a discourse that I have heard at the ETU and in all of the communities I have visited in the Port Loko and Kambia districts. It has shifted from, “How do we contain this disease and end Ebola?” to “What will we do now?”
Ali spoke about how he and his colleagues came to this work, one of the most important fronts in the fight against Ebola, jobless, but wanting to serve their country. They have all experienced the war that ravaged their homeland, a “seen war” confused by enemies, politics and power and now they see themselves at the front line of an “unseen war” with a known enemy unquestionably evil. And they know this war is ending soon and they are fearful.
Ali eloquently describes how NGOs came after the “seen war” and provided work and assistance rebuilding. He talks about how, over time the NGOs left and then there were no more jobs. He and his compatriots are concerned that once the Ebola war is over, NGOs will again leave and then leave an all too familiar swath of joblessness, “Will you all leave us again? Who will remain and help?”
Ali’s team is proud of the work they have done. They no longer have to volunteer as they have been hired by a large NGO and been given tools to continue to provide safe and dignified burials. Through their work, this disease is closer to being contained. He rallies his group at the end of his speech with words of hopefulness and ideas of rebuilding his country, springing forth from the damaged earth. He asked again what we could do to help.
We respond as best we can, that we don’t know what the future will bring. Tearfully, we thank him for his work caring for the bodies of patients we loved. And we also tell him that we can commit to sharing his story. We can promise that we will tell about the work of the gravediggers, their bravery and their commitment to their country to rebuild after this second war. Ali is happy and thanks us; he and his team pose for a photograph, explicitly asking us to share it with their story.
There is nothing else to say. And we are ready to leave.
Mr. Sesay asks again that we share photos and stories of the graveyard.
The four of us walk back to our car parked on the opposite diagonal of this field. We walk from site 1 to site 522, each taking a different line of the grid in order to walk alone and have yet another “one last goodbye.”
As if my path was predetermined, I glance at a marker while exiting the space and see the name of the first child who died in our hands, I will call him “Issa.” He had a “good” death: good in that his body was clean, he wore the most colorful lappas as bed sheets and he was not alone. He had been sick for days and when we found him while doing our morning rounds he lay listless with agonal breathing and in his own bodily fluids. We cleaned him, lifted him to a bed, and rolled him in a position where his breathing seemed a bit less painful and he shortly succumbed to Ebola. Issa was 9 years old.
At the foot of his grave, amidst this field of rubble, was a tall green sprout. It stood just a foot high off the ground with stalwart blades soon to be leaves. It had pushed its way through the dry stone, despite lack of rain and pounding sun.
Clinics and hospitals are slowly reopening here. Schools are slated to start by the end of March. The need is great: for health care workers, for teachers, for community servants able to make this place fertile again. The fires are subsiding.