Surviving Ebola in Sierra Leone: A community’s experience during and after the epidemic - A qualitative study
(School of Public Health (UMD) Maryland Institute for Applied Environmental Health (MIAEH) Doctoral Student)
Objectives: The 2014-2016 Ebola epidemic - a complex public health crisis with various sociological, ecological, and environmental drivers - devastated populations throughout West Africa. Due to its high mortality rate and infectious nature, most Ebola research to date has focused on healthcare response and interventions; however, little is known about the experiences of Ebola survivors and communities. This qualitative study aimed to better understand the lived experience of community members, including children, during and after the Ebola epidemic in Sierra Leone. Approach: During June 2016, we conducted three focus group interviews and one in-depth interview with a local nurse in Calaba Town, a rural community outside of Freetown. The vice principal from a local school was present and assisted with Krio (local language) translations when necessary. Interviews were recorded, transcribed, and coded verbatim using a modified constructivist grounded theory methodology. Findings: During the Ebola epidemic, fear, confusion, suffering, loss, and isolation were part of daily life. Children were isolated indoors away from friends, unable to attend school. Instead their days consisted of domestic chores and listening to government-sponsored educational radio programs. Meanwhile, caretakers and parents struggled to provide basic necessities, including food, due to job loss and inability to earn an income. During lockdown periods, families could not even leave homes to fetch water. Health workers were caught between desire to provide service to the public and fear of acquiring Ebola. Sierra Leone was declared Ebola-free in March 2016; however, the struggle for food and the grief stemming from the loss of loved ones continues. Increased food prices post-Ebola and caring for extended family members and orphaned children have amplified these challenges. Conclusions: Following the transgenerational trauma of the recent Civil War, families in Sierra Leone were forced to navigate between fear, confusion, and loss during the Ebola epidemic. Despite nationwide school closures, children continued studies via educational radio programs. Interviews reveal one community’s resilience and desire to overcome the epidemic; however, grief and distress continue. This study highlights the need to tell stories of communities in order to evaluate the long-term psychological, social, and economic consequences of infectious outbreaks.