Ebola outbreak – interview with Daniel James, National team leader, safe and dignified burial teams, Sierra Leone Red Cross Society
Two years following the declaration of an Ebola virus disease outbreak in West Africa, communities and governments in Guinea, Liberia, and Sierra Leone are moving into the recovery phase, determined to make their countries stronger before Ebola decimated families, economies and health care systems.
Through its five pillared response, the IFRC, in support of the three affected National Societies, played a key role in helping to bring the outbreak to an end. Thousands of volunteers were involved in contact tracing, case management, beneficiary communications and social mobilization, psychosocial support, and safe and dignified burials (SDB).
Daniel James was working in the disaster management unit of the Sierra Leone Red Cross Society when the outbreak started. When no one else volunteered to conduct safe and dignified burials (SDB), Daniel put up his hand. He was among the first to be trained on SDB in Kailahun district, the epicentre of the outbreak in the country, and after demonstrating leadership qualities, was promoted to head up the national SDB team for the National Society. He trained others across the country on how to provide SDBs, and took part in more than 500 burials in the first three months of the outbreak alone. He is quite proud of the fact that no member of his teams became infected with Ebola, despite having conducted approximately 50 per cent of all burials in the country.
Daniel talks of the outbreak, his role in it, and his hopes for the future.
TRANSCRIPT:
DANIEL JAMES, NATIONAL TEAM LEADER, SAFE AND DIGNIFIED BURIAL TEAMS, SIERRA LEONE RED CROSS SOCIETY
00:00 - 00:24 When we heard the news that Ebola was in Sierra Leone, the first thing the Red Cross did was to start social mobilization. That was our first activity. The volunteers, all around the branches, were trained and we were doing social mobilization. Educating people with information that Ebola is in the country, it’s in Guinea, it’s in Liberia, and now it’s in Sierra Leone.
How did you get involved in SDB?
00:24 – 00:42 The National Society called a meeting, they asked volunteers to go to Kailahun to start, but nobody wanted to go, so finally, because I work for the Disaster Management department, the Secretary General called me and asked me to take up this responsibility.
00:42 – 01:07 And I willingly answered that I am going. So they were surprised when I say yes I am going because they have asked for volunteers and nobody wants to go. Why is it that it is only me that says I am going to Kailahun to undertake this activity? So I went to Kailahun in July. I was given crash training by MSF and then on the 17 of July, we officially started doing our burials.
01:07 – 01:17 So, going to Kailahun was very frustrating, because when you go to Kailahun, people say you were in Kailahun. They think as soon as you enter Kailahun, you will be infected by Ebola.
01:17 – 01:39 When we went to Kailahun, it was like a ghost town. Nobody was outside. Everybody was just sitting indoors watching how things are going in the district. When I went as well, I was afraid. I was scared. Because when you go to a town and you don’t see anybody to talk with, to interact with, it becomes scary for you.
You weren’t entirely honest with your family about volunteering to conduct safe and dignified burials?
01:39 – 02:20 Going to Kailahun, I didn’t exactly tell my family that I was going to do such an activity. I only said I am going to Kailahun because they know normally we have other activities like trainings and workshops in this district. So, I said I’m going to Kailahun for an activity. I did not tell them that I was going to do this Ebola burial in Kailahun. So, I was there when they heard that I am in Kailahun and doing this Ebola business. In fact, my wife came to the office asking the Secretary General to withdraw me from Kailahun. I called her again and said this is the situation we just have to do it so we can help save our country from this deadly disease in the country.
Daniel spent approximately 3 months in Kailahun district, conducting hundreds of burials.
02:20 - 2:44 We are doing burials in almost all of the district, coming from Kailahun as far as Daru which is almost very close to coming to Freetown area. Because at that time, the government does not have the capacity. People don’t want to do burials. So everybody only depend on the Red Cross. And so we are almost covering almost the whole district of Kailahun and doing burials.
02:44 – 02:53 From July 17 to September when I left for Kenema, I was able to conduct and supervise 520 burials.
02:53 – 03:31 Just to bury 520 people in three months, at normal, it’s not real. But because of the outbreak and people were dying, and people were still dying in Kailahun because nobody believed that it was Ebola and Ebola was real. So nobody thought that they could take the message, so people are just doing what they feel like, they were going to funerals, they were going to burial activities, and when they come back, there is no precaution. They clothe bodies and they come back with their families so at the end of the day you just hear that this person has got Ebola and then he is dead.
Stigma
03:31 – 03:57 When I reach the head office nobody wanted to come closer to me. Everybody was afraid of me. So even the office that I was using, if I opened the door, the office assistant would come and disinfect the door. The table I am using, when I leave there, they would disinfect the table. So in fact, those my good friends that I was talking with together, nobody wanted to talk to me, nobody wanted to come closer to me.
03:57 – 04:22 But, before coming, I already have a preconceived mind that when I come to the office, this is what is going to happen to me. So, it was not more traumatizing to me because I already had the preconceived mind that this would happen, and when I came, exactly what I was thinking, happened. So it was not much more stigma to me because I had already given myself psychological first aid.
Talks about the tremendous accomplishment of not having one SDB member become infected with Ebola, despite having carried about approximately 50 per cent of all burials in the country.
04:22 – 05:01 When I was training them I say, your first mistake is your last mistake. And in this operation, you have to be disciplined. We don’t take jokes, we don’t compromise anything within the activity. When you are in the field you are like in the military ground. You take command, with instructions. You don’t do anything without instructions. So, with that discipline, with that instructions in mind, we were all able to cope and we were all able to follow instructions. That is why, since July, to the last day when they announced Ebola is finished in the country, none of the SDB teams, none of the SDB members got infected with Ebola and we are so happy and I am proud of that.
In October 2014, Daniel became the head of national SDB team for the Red Cross
05:01 – 05:42 Ebola has changed me somehow, one, in terms of discipline. Before this time, health wise or perhaps in hand washing, or human interaction, has not been taken into consideration because we think we are just common, we are friends, we can just shake hands like that, we don’t wash hands. But now, handwashing is part of me. It has not been part of me, but now it is part of me. So that is one way Ebola have changed me. A discipline of handwashing which is also not only for Ebola but for other infections as well like cholera, diarrhoea, other transmittable diseases.
(Note: As of 20 February, Sierra Leone is not Ebola-free, having recorded two new cases in January. If no further cases are detected, transmission linked to this cluster of cases will be declared to have ended on 17 March.)
05:42 – 06:15 The biggest accomplishment for us in this Ebola is that we are able to today say Sierra Leone is Ebola free. Because we know 85 per cent of transmission was through dead bodies. People were going to funerals, were washing, who we are playing, when we are burying the corpses, we are transmitting this Ebola. And when we came in to do burials, we said, ok, stop playing with corpses, let us do it safely for you, and because of our intervention, we are drastically able to cut the chain of transmission.
06:15 – 06:58 The worst part of Ebola is a lot of people have lost their families. As you can see. Just look at the cemetery. People have died, families have gone, children have lost their parents who were taking care of them. Today they have to ask other people to support them in their education, in their survival. Wives are now widows, some husbands are now widowers. Even the country has lost a lot of people like medical doctors who are professionals, who should have led the country in combatting the disease.
How do you think people will react when there is the next disease outbreak, such as cholera, which as symptoms, at the start, which resemble Ebola?
06:58 – 07:26 Because of the experience now, people will not even think of cholera. Straight away their focus will go to Ebola, because even when there was Ebola, there was cholera. But everything was just sticking under Ebola because nobody was focusing on cholera but everybody was focusing about Ebola because Ebola was so dreadful that nobody can make any fun with it. So, if there is an outbreak of cholera now, people will not even think of cholera, but straight away they will link it to Ebola.
Recovery
07:26 – 08:02 We are now in this recovery process. We are going into communities doing sensitization, contact tracing, talking to people, telling them about not only about Ebola now but other transmittable communicable diseases like cholera, like other diseases. And we have programmes like radio in a box. We have television show. We have radio shows. We go to the television, we talk to people, we go to the radio and the radio in a box, we have a drama group that goes around in the communities, do some community theatres on the transmission and prevention and how to take care of our community, how to take care of ourselves.
Talks about the joint project with UNDP which will help reintegrate 800 SDB workers in Sierra Leone (and 400 in Guinea) back into their communities.
08:02 – 08:17 So we are able to get a project from UNDP to make sure we are engaging volunteers for a period of one year. By that time, they will have been reintegrated, their minds are steady and they are engaged and they have something to do.
08:17 – 08:42 And it is divided into four categories: we have the formal education aspect, we have technical vocation, we have skills training and we have business sectors. So, these volunteers will be trained, they are going to train PSS (psychosocial support) people who will talk to them, who will meet them, interview them, do some questionnaires, to see which area each of them can fit into.
08:42 – 08:53 There is a saying that an idle man is the devil’s workshop. And we don’t want their minds to be the devil’s workshop. We want them to be engaged in doing something better for their life.
What goes through your mind now when you enter a cemetery?
08:53 – 09:49 When I entered initially I felt so sad, because just looking at the graves like this one, not because of normal dead but because of an outbreak of a disease, I was not happy when I came in and saw graves like this one. Even though we started doing burials here, I was not happy and I’m still not even feeling good that I am sitting here now talking to you. Because just looking at the number of people who have died, families, children, that have been taking care of their families, who have been people to bring up the country, now they have died. It is like that. But thank god and that is why we are happy that we are able to combat Ebola and we pray that we don’t have a repeated outbreak of Ebola in the country so we don’t have this kind of death and mass burials in the country.
Some people refer to you and your team as heroes. How do you feel about being called a hero?
09:49 - 10:41 Well, I feel very proud. Because I took up the venture. I gave up myself to say, I’m going to do this one, to save my country. Because even when the SG asked me why do you want to go to Kailahun to do these burials when others say they are not going? I said, one, it’s my country. And secondly, the district is my district, and thirdly, I am a volunteer. I have given myself in the Red Cross that I am going to serve humanity. So if I sit back and see how things are going, which I think I have the skill or the capacity to do it and I don’t do it, my conscience, my mind would not be cleared. So, it will be better for me if I take up the chance to go to Kailahun and start this thing so others can come on board. And that is how the other volunteers came on board. They say, if Daniel have done it, then why can’t we?
10:41 – 10:48 So, I feel very proud and even the volunteers would be very proud to be called heroes of Ebola.
What are your plans for the future?
10:48 – 11:23 My next plan is to continue what I was heading for because I did sciences in the school and I did that because I wanted to become a medical doctor. I have done nursing as my first stage. Because of the outbreak of Ebola, I discontinued following what I wanted to do. So now that we have ended Ebola, my next plan is to go back and to take to complete my subjects so I can fulfil the university requirement that will take me to college of medicine.
11:23 ENDS