Armies of student volunteers are key to Sierra Leone's fight against Ebola

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Marco Werman: I’m Marco Werman and this is The World. It happened just before we went on air on April 15th, 2013--two bombings near the finish line of the Boston Marathon. Today, almost two years later, the trial of the surviving suspect got underway here in Boston. We’ll talk about what happened on day one later on The World, but let’s start with an update on a very different kind of tragedy--Ebola. We’ve been hearing recently that the outbreak in West Africa has been waning. That is good news, but the crisis is far from over. New York Times correspondent Sheri Fink has just returned from Sierra Leone, where she witnessed a new flare up of Ebola. It began near a wharf in Freetown, known as Tamba Kula. Sheri Fink described the area for us..


Sheri Fink: You’ve got your reclaimed wood shacks with the corrugated roofs, people living in really tight proximity, garbage everywhere, there had just been a block of toilets put in by Oxfam just a few months ago, but otherwise people have kind of been “making due” with the sea. I should point out the proximity of the settlement to the fanciest hotels in town. Where all the public health workers are staying at the Radisson and other hotels that have this beautiful, beautiful ocean view, these little informal settlements, or slums, whatever you want to call them, are in the in-between areas along the shore. These wooden fishing boats that go out to sea, they came in and one of the boats returned early because several crew members were sick, including the captain.


Werman: These are fishermen, is that right?


Fink: These are fishermen who go out to sea and spend a week or two fishing mostly snapper.


Werman: Is there any idea of how men at sea contracted the disease?


Fink: They’re not sure. It could be that the men, when they’re out fishing they do stop at little islands and they meet with fishermen from other places, and then of course there are other coastal areas where the fishermen stop that include some areas that were hotspots at that time for Ebola.


Werman: How did this neighborhood of Tamba Kula know that these men might be sick with Ebola and how did they deal with it?


Fink: The men came back from sea early, they were sick on the boat, and then some of the men voluntarily went to get looked at at a health facility and that’s how these first cases were detected. Then the health officials and these teams of volunteer students and public health officials both from Sierra Leone and the US CDC and some British organizations, they started to go out to systematically go through these fishing communities along the coast and they found more and more cases.


Werman: So it went further. One patient that was taken away from these wharfs in Tamba Kula by his wife, this led to 42 other cases in a time when things seemed to be heading towards zero.


Fink: This is something that I witnessed. I was spending time with the teams going out in Tamba Kula, trying to detect any other people who were getting sick, getting them right away to treatment facilities, and then I heard from somebody with the International Medical Corps, a nonprofit that has a treatment center in Makeni, which is about three hours from the capital, he said “You know, we’ve got all these cases now that trace back to Tamba Kula, to this one young man.” Well, he got sick in Tamba Kula, his wife and mother were involved in bringing him back to his home village. I went to this community and spent about a week there, this little village called Rosanda, where just person after person was getting sick all of last week, every day the ambulances bumping down these dirt roads to pick up children and women and men who had been sick, and all from this one individual who had left this area of Tamba Kula and gotten away under cover of night. I spoke with the mother and she said “We saw this as a traditional problem, not as a medical problem,” and they sought a traditional healer who then got sick and died. I spoke with some scientists about “How do you get down to zero? Is this common in these outbreaks that you have these bumps in the road?” they’re now calling it the “Bumpy Road to Zero,” and they were saying “Yeah, sometimes problems that were hidden when you had a raging outbreak become clearer when you’re down to just a few cases.” So, here we saw maritime spread, which isn’t something that we really talked about before, the difficulty of controlling wooden fishing boats going out. So, now there’s a big effort to catalog those boats and mark down who’s going out, where they go, when they come back, and testing them, maybe even putting handwashing stations on little wooden fishing boats--that’s one effort that I heard being discussed.


Werman: In this one episode, you were talking about the people who were walking through the slums trying to track down the new cases, and you said many of them are student volunteers. What did they say motivated them in what must be a pretty darn risky job?


Fink: There’s a lot of concern now amongst some of the public health officials about “Well, if we do open schools, what’s going to happen to all of these wonderful volunteers? They’re going to be carrying their school books back to school rather than hitting the streets every day with these prevention messages.” But what seemed to motivate them--it’s almost like you get the same story from everyone you ask--”This is my country, I’m doing this not for money,” a lot of them haven’t been paid anything, “I’m doing this to try to get Ebola out of my country.” They’re so passionate and they’re so inspiring. You think reporting on Ebola is all doom-and-gloom but when you see these young people just incredibly capable and incredibly passionate about what they’re doing, it’s really something positive.


Werman: Sheri Fink with the New York Times, just back from Sierra Leone. Thank you very much for your time Sheri.