The 2013 Ebola epidemic in West Africa devastated local economies, decimated the population and left thousands with lifelong scars.  In the first of a series of articles on Bread and Water for Africa UK’s work, Jonny Hellman sheds some light on the situation in West Africa after Ebola and talks about the work the organisation is doing to support local communities which are pulling together to rebuild their lives.



The 2013 Ebola epidemic in West Africa – with 11,316 deaths from 28,639 cases in 10 countries – was by far the most widespread and devastating outbreak of this deadly disease. Despite the region being declared Ebola-free in 2016, millions of people across Liberia, Sierra Leone and Guinea – the three most affected countries – continue to suffer unimaginable hardship.

What is Ebola?

Ebola Virus Disease, commonly known as Ebola, is a viral haemorrhagic fever which causes severe illness and is often fatal. Symptoms typically include a fever, sore throat, muscular pain and headaches, followed by vomiting, diarrhoea, rash, decreased liver and kidney function and, in some cases, internal and external bleeding. Although Ebola is less contagious than the common cold or seasonal flu – only spread by direct contact with an infected person – it is a lethal and terrifying infectious disease.
Image of the ebola virus under a microscope

Photo: The Ebola virus under a microscope. Credit: Centers for Disease Control

Before the 2013 outbreak the WHO had documented 1,716 cases in 24 outbreaks of Ebola since it surfaced in 1976 – usually in remote villages in tropical regions of sub-Saharan Africa: Gabon, Uganda, Sudan, the Republic of the Congo and the Democratic Republic of the Congo.

The West Africa outbreak began in December 2013 in the village of Meliandou, Guéckédou Prefecture, Guinea, where a one year old boy was retrospectively identified as patient zero. Unlike previous Ebola epidemics which had been restricted to rural villages, this one quickly spread to neighbouring villages and reached Guinea’s capital Conakry – a city of 2 million people – by late May 2014.

By this time it had also spread to Liberia and Sierra Leone, and by July the situation was out of control. It was not until January 2015 that the number of new cases was on a downward trend. August 2015 was the first month without any new cases, and in January 2016 the WHO declared the outbreak over.
A map of West Africa showing which areas were most affected by the Ebola outbreak

Map showing the worst-affected areas. Credit: Centers for Disease Control

The headline figures from the outbreak – 11,316 deaths from 28,639 cases – simply do not reflect the scale of the devastation which Ebola brought to Guinea, Liberia and Sierra Leone. Statistics from the US Centers for Disease Control (CDC) paint a bleak picture. Some 881 healthcare staff in West Africa were infected with the disease, and 513 died. Over 17,300 children lost one or both parents to Ebola. An estimated 10,600 additional deaths were caused by conditions such as HIV, TB and Malaria – because of how Ebola had overwhelmed the health system. Healthcare systems in these three countries – already weak before the crisis – were left completely shattered.

 

Countries left devastated by the crisis

Despite the outbreak being declared over at the start of 2016, life has still not returned to normal for millions of people in Guinea, Liberia and Sierra Leone. Of those who survived the infection – over 17,000 – many suffer from lingering health problems, collectively referred to as ‘Post-Ebola Syndrome’ by healthcare professionals. Its symptoms include: joint, muscle, and chest pain; neurological complications such as anxiety attacks and difficulties with memory; vision problems such as blurred vision and inflammation; as well as a number of other symptoms. Many Ebola survivors will suffer from post-Ebola syndrome for the rest of their lives.

In addition, many survivors face severe social stigma and are ostracised by their communities – largely as a result of a lack of information and understanding of Ebola. As one survivor told a journalist writing for The Atlantic, “Life after Ebola is worse than the Ebola virus itself”.

The economic damage wrought by Ebola has meant that millions of people in West Africa, who were not directly affected, are also struggling with the aftermath. The outbreak led to schools and businesses closing, reduced cross-border trade and foreign investment, as well as cancelled flights and the collapse of the tourism industry.
Graph illustrating the economic impact of the Ebola outbreak on Guinea, Sierra Leone and Liberia

This resulted in a combined GDP loss of US$2.2 billion in Guinea, Liberia and Sierra Leone. While for developed economies, this figure is a drop in the ocean, for these West African states, it was nothing short of catastrophic. Economic growth, which had been strong prior to the outbreak, was halted in its tracks. Countries already struggling to feed their people found themselves with more people in food insecurity and on the verge of starvation, so people continue to eat bush meat – the cause of the outbreak in the first place.

Weak and underfunded healthcare systems were left more vulnerable than before the crisis, for as international aid workers returned home, these countries were once again left to fend for themselves, with only a doctor or two for every 100,000 people. Small, isolated outbreaks have continued to occur, and another major outbreak could be just around the corner.

 

Supporting local organisations to rebuild

In the face of such a hopeless situation, initiatives run by local NGOs with BWAUK’s support have had an immensely positive impact.

Since 2005, BWAUK has supported two local organisations in Sierra Leone: the Faith Healing Development Organisation (FHDO) and the Ndegbormei Development Organisation which both run clinics in rural areas. During the Ebola crisis we supported FHDO to set up a team to distribute emergency food supplies and cash payments to 600 households, comprising very poor families, widows and orphans in a number of villages and in the capital, Freetown.

During the Ebola outbreak, BWAUK also gave support to the Glocal Forum Yala Africa (GFYA) which approached households in the fishing community in the Aberdeen area of Freetown, one of the Ebola ‘hotspots’.

 The quarantine zone in Freetown, Sierra Leone in 2015

Photo: The quarantine zone in Aberdeen, Freetown, Sierra Leone in 2015

GFYA trained young community leaders to go to quarantined areas of the city to distribute essential emergency food and hygiene products, as well as providing the population with vital information about the disease and how to avoid contamination.  They also spoke up for survivors' rights and raised awareness against stigma in order to help Ebola survivors reintegrate into the community. At a time where fear of national and international health authorities led to so many people hiding their dead and sick loved ones by fear of seeing them disappear forever, this type of community approach was essential in the fight against Ebola.

Since 2005, BWAUK has supported GFYA with the We Are the Future (WAF) kindergarten and elementary school in Aberdeen, Freetown, Sierra Leone. WAF provides a number of services to the community, including early childhood education, training in skills such as agriculture and nutrition, and raising awareness of issues like HIV/AIDS and gender equality. The project is supporting 230 children in 2017 and over 2000 have passed through the centre since its inception in 2005.

One element of WAF which BWAUK has been keen to support is the Kids Kitchen Garden, set up in response to the chronic food shortages since Ebola. The garden grows fresh food and vegetables, which is used to provide a healthy, nutritious meal to each child at the school. For many of these children, whose parents are too poor to provide for them, it’s their only meal of the day. The guarantee of a daily meal allows more children to stay in school rather than drop out in order to work to feed themselves.

The Kids Kitchen Garden is, in many ways, the perfect example of an efficient, self-sustainable development project which can be replicated across the region. In the short term, the Kids Kitchen Garden is improving the nutritional status of 230 students, benefitting not just them but their families as well. In the medium term, the project will improve the students’ overall physical condition, making them less likely to get ill or drop out of school. Long term, the project will have a positive socio-economic impact across the wider region by improving literacy and healthy food habits.

We are currently looking at other local schools where the proven success of the Kids Kitchen Garden could be repeated, but we can only do so with your help. By making a donation to our Square Meal Appeal today, you will be transforming countless lives.