A doctor and a diplomat talk life on the frontline of the Ebola epidemic

Dr Oliver Johnson

My time in Sierra Leone didn’t begin with the Ebola outbreak, as it did for so many international responders, but as a medical student several years before. Having fallen in love with the small and vibrant west African nation, I had returned after graduating to set up a partnership between King’s College London and Connaught Hospital, the main hospital of Freetown, Sierra Leone’s capital city.

Like the rest of the country’s health workers, I wasn’t at all prepared for an outbreak of this deadly and mysterious viral haemorrhagic fever. What first seemed like a remote curiosity rapidly transformed into an imminent threat, as the disease marched steadily towards Freetown from the east of the country, after crossing the border from neighbouring Guinea.

Freetown had become my home

Each day, more stories came in of Ebola decimating whole families and villages. It proved particularly deadly to our fellow health workers, who lacked the resources and the training to protect themselves. But I never felt any doubt about staying and standing shoulder-to-shoulder with colleagues at the hospital. Freetown had become my home.

Up to that point, I hadn’t been doing clinical work in Sierra Leone, as my role focused on policy and management. That all changed one Saturday in July 2014 when I stumbled across a desperate situation inside the hospital’s main gates, where a collapsed Ebola patient was in desperate need of care. So I suited up in a claustrophobic white protective suit for the first time, my face smothered by the goggles and mask under the sweltering tropical sun. Over the next several months, alongside my work to set up a Freetown command centre and advise on the British response, I would help care for hundreds of Ebola patients in our small and dilapidated unit at the hospital, faced with growing queues of the sick and the dying outside the main gates and constant crises that ranged from protests to water shortages.

The challenge we faced was unprecedented and none of us knew how bad it might get.

When we eventually got the outbreak under control, I knew I had to write about my experiences. I felt a duty to record and honour the extraordinary courage and sacrifice of so many national and international colleagues I had worked alongside.

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Getting to Zero: A Doctor and a Diplomat on the Ebola Frontline by Oliver Johnson and Sinead Walsh is out now (Zed Books, £12.99)

Sinead Walsh, Diplomat

I had been in Freetown for three years when Ebola struck, running the Irish Embassy and aid programme, which meant focusing on issues ranging from child nutrition to violence against women to elections.

Having worked in east Africa previously, I had heard of Ebola, but it was always far from me and seemed remote and unreal, with stories of people bleeding to death as if they were in a horror film. But then in May 2014 the disease arrived at our doorstep in Sierra Leone and became our new reality.

Fear was everywhere. Many people who could afford a plane ticket left. Then the airlines started cancelling their flights to Sierra Leone and the panic ratcheted up further. Those of us who chose to stay tried to help in whatever way we could. Most of us had no idea what to do. An Ebola epidemic of this scale had never happened before; even the global experts were at a loss. But we had to do something and so we did.

The world must learn lessons from what happened in west Africa

My role in those early days was mostly trying to raise the alarm at national and international levels and to rally people in Freetown around a plan. This was more difficult than you might think. In the summer of 2014, a lot of the key people in Freetown and in places like Geneva, London and New York didn’t seem to really understand how bad things were and were not providing the resources the country needed. By August, the number of people contracting Ebola was doubling every few weeks. We were losing the battle. We were doing what we could but, as one responder said, it was like trying to bail out a leaky rowboat with teaspoons.

Eventually the world woke up and the response turned around. It took enormous effort and the sacrifice of many. Sierra Leoneans took the lead and the British government played an important role.

We got there in the end, but we took far too long, and thousands of people died and suffered unnecessarily. At least 3,956 people died directly of Ebola in Sierra Leone, but this figure doesn’t include the thousands of people who died when Ebola largely shut down the health system. It also doesn’t account for the tens of thousands of people who lost their livelihoods when Ebola had a negative effect on the economy, or the 1.8 million children who lost a year of schooling, some never to go back. 

We can’t let this kind of tragedy happen again. The world must learn lessons from what happened in west Africa. This is why we wrote our book.

Image: Shutterstock