A Return to Liberia in Ebola Time

Why did I go back? I initially came to Liberia in May 2011, and then left in 2013 for Sierra Leone, to work as a program adviser for all education projects for the Forum for African Women Educationalists and as a consultant on the USAID Advancing Youth Project.

At the beginning of October, I went back to Liberia to help initiate a project, Playing to Live! The inception for this project was a video posted on Facebook of a Liberian boy, Mamee, interned in an Ebola treatment unit, who was dancing to a Nigerian rap song. The boy had watched his mother and siblings die of Ebola. He reportedly developed symptoms within days of coming to the unit. Still, he became famous among the patients and doctors because he danced all the time, whenever music was on. He survived his outbreak, and as he recovered, he continued to dance and play. Alexis Decosimo, a specialist in art therapy and public health, approached me about starting Playing to Live! to work with orphaned and vulnerable children affected by Ebola, like Mamee. We would apply art and play therapy to stem the emotional and psychological trauma that children experience, particularly in quarantine.

Alexis and I met in Monrovia in 2011. Like so many of my international development cohort, there is something remarkable about this humbling country that touches a person, the effect of which becomes fixed. So when we all first heard that Ebola spread to the country in the spring, we were alarmed.

The Ebola outbreak in Liberia spread first into Lofa, once one of the most devastated places in the 14-year civil war. The first time I entered Lofa in 2012 on a work assignment, it was a sharp contrast of wartime relics, the bullet pockmarked buildings that stood across the street from the new Reconstruction Era landmarks, like the Total gas station and rebuilt cement homes with metal roofs that shined in the brilliant sun. Motorcycle taxi drivers, mostly young men, waited for passengers to go to market, many of whom knew the drivers when they were child soldiers carrying AK-47s on their thin backs. But yet, 10 years later, wartime was a memory and the country was well on the road to slowly rehabilitating and moving on from the painful memories of the past. Lofa seemed a place very symbolic of most of Liberia. A place of real hope. Then came Ebola. Within months, entire villages were gone, most families affected, and the survivors fleeing into other villages, carrying the new “curse” with them.

As Ebola spread throughout the country that we adored, a sorrow seeded in many of us who had worked there. Development workers started being evacuated by their international organizations as a caution when Ebola spiked. Some objected to the forced evacuation, pleading to stay on the ground to work. For many of our Liberian friends and colleagues, it was too late; people who I worked alongside with in the bush and in Monrovia started burying fathers, daughters, and aunts.

When I arrived in Monrovia last week, though people moved about as usual, I saw the differences immediately: stations set up by Doctors Without Borders and USAID, hazmat suits, and the ominous smell of bleach. Parents yelled at their kids not to touch one another. “We in Ebola time, ya’ear!” I heard. Schools were closed. A Liberian friend said it best: “Childhood been reduced. It like wartime ’gain, when the childrens must fear.”

There is a mounting issue of children affected by Ebola — orphaned, abandoned due to stigma, ostracized, and left vulnerable. It is hard to determine the exact statistics on the ground but nearly 2000 children have lost at least one parent due to Ebola.

Any child who is exposed but shows no symptoms (Ebola-suspected) has to endure a 21-day-long quarantine in order to determine if she or he is Ebola-negative. Up until now, Ebola-suspected cases have mainly been quarantined in their homes, abandoned by families and communities to the streets, or sent to Ebola treatment units, meant only for Ebola-positive cases. The quarantine can be a living hell for children. At treatment units, children wait day after day in the hot white tents, unsure if or when they may fall sick, sitting for hours alone, watching the horror and death around them. Estimates show 60 percent will not make it. Those children who are released experience high levels of trauma unlike what we have seen in typical emergency response situations.

The Ministry of Health, with support from its international health partners, is establishing protocols to respond to child protection and children’s wellbeing. This includes opening Interim Care Centers (ICCs) and home care for children with Ebola-suspected cases to complete their 21-day quarantine instead of leaving them in treatment units — or on the streets. The first official ministerial ICC opened in Monrovia this week.

So what is Playing to Learn! doing? We are collaborating with ChildFund-Liberia, and in guidance with the Ministry of Health and the Ministry of Gender, to develop a curriculum for children in ICCs affected by Ebola, particularly Ebola-suspected cases. Additional project support comes from Good360 and the More than Me Foundation. In the next months, our project will train caregivers who are Ebola survivors on psychosocial support for affected children and on predesigned, safe activities that use art and play to therapeutically enhance the quality of life for the children. Public health research shows that children who are fighting off diseases and emotional trauma often have a better chance of recovery and survival when they engage in child-centered activities as part of their treatment.

We must safeguard children from the psychosocial trauma that Ebola can reap — even in the midst of this growing crisis.

To learn more about our project or support its efforts, follow us on Facebook.

— Jessi Hanson, Ed.M.'07, a graduate of the International Education Policy Program, will serve as the program manager for Playing to Live! In 2013, she moved back to the United States to become the performance monitoring manager at VaxTrac in Washington, D.C.