In Magazine Wharf, one of Freetown’s largest slums, rivers of stinking mud and debris tumble from the central market, down a steep hill crammed with precarious wood- and tin-built dwellings. The homes continue all the way down to the sea, where there is a small fishing port.
Roughly 3,500 people live here, housed in narrow alleyways where women crouch over fires, smoking fish next to children washing in buckets. Pigs and chickens wander freely.
Families are squashed in so tightly that the cacophony of children, laughter and shouting is deafening.
It is unsurprising that the Ebola virus spread through these tiny streets. The first recorded case here was a 28-year-old man in October last year, the last as recent as August. Magazine Wharf is where Ebola lingered longest in Sierra Leone’s capital.
“It began in this house,” said brigadier Charlie Herbert, pointing to a wonky, wooden two-room structure that houses a family of seven.
“We had to quarantine the house. Then the whole street,” said the second in command of the taskforce for Ebola, the UK’s cross-government response in Sierra Leone, which combines support from the Department for International Development (DfID), the Ministry of Defence and the Foreign and Commonwealth Office.
Herbert’s task was to contain the spread by enforcing the quarantine but also to prevent public disorder. Remarkably, he says the situation only once “turned ugly”. A second near-crisis was averted in the early, chaos-strewn days of the outbreak, when two women from the Wharf escaped from a treatment centre.
“We had to find them – and fast – which was one thing,” said Herbert. “But when we saw the government-run treatment centre we realised we had a big problem. People could go freely in and out. It was a death trap. We were able to feed back to DfID and between us we were able to install fences and get the situation under control within hours.”
The success of this teamwork between DfID and the military was in part due to the defence ministry’s long-term presence in the country, training army and police. This meant they were already trusted. The MoD’s mandate was strictly one of logistical support, but recently their involvement has become project-led with the creation of a 36-bed “field hospital in a box”. The hospital, which will form the new frontline response to any future outbreaks, can be deployed and operational anywhere in Sierra Leone within 48 hours. Officially handed over to the country’s military in a ceremony and dress rehearsal for local dignitaries last month, the hospital is a highly unusual project in that it is DfID funded but was conceived and led by the military.
With the UK preparing to close all but two of its six Ebola treatment centres, set up at a cost of £200m, the new hospital will remain Britain’s longest-lasting legacy on the ground.
The hospital essentially consists of little more than a series of tents with iron beds, a rudimentary mortuary, a small fleet of ambulances, and basic medical equipment. But for patients, the difference between survival or death is often about rapid diagnosis and receiving IV fluids early enough.
The centre represents good value for money, costing only £200,000. That’s something of which Major James Fisher, who has led the construction, is proud. “The military know how to keep costs low. For example, the hand-washing facilities are literally just buckets with a tap inserted,” he explained.
DfID has said the hospital is “a vital weapon”, one that can be used to “help swiftly isolate, contain and treat outbreaks of the disease”. They don’t think the joint model is one that will necessarily be replicated again, citing it as a unique response to a unique crisis.
For Herbert, a veteran of three Iraq and two Afghan tours, the mission has been a special one. “I can’t begin to tell you how refreshing it is to walk around in this uniform and not have people trying to blow me up,” he jokes. As if to endorse his point, two little girls run up to him and fling themselves at his legs. “This is Jennah,” he smiles down at a four-year-old in a pink dress. “She lost both parents.” Jennah has been rendered mute by trauma.
Jennah’s 21-year-old half-sister, Fatima, explains she has had to drop out of school to care for Jennah and another sister, aged eight. “I wanted to be a nurse but my mum used to do everything for us. So now I have to do what my mum did and do everything for my sisters.”
Sergeant Sulaiman Kamara, a young British army officer from Sierra Leone, translates in Creole for Fatima. He promises to bring a child psychologist to visit Jennah.
Kamara said it had “been a life-changing mission for all of us. To be able to use our skills to save lives was something I will never forget”.
The outgoing team has decided to set up its own charity, Magazine Wharf Kids, to provide long-term financial and educational support for families like Jennah and Fatima.
Later that day, at a graveyard housing more than 6,000 bodies, Kamara can’t stop his tears from flowing. “This was a different type of frontline. But it was definitely a war.”
