ANJALI RAO: Ashley, good to see you back safely. You were one of the last reporters allowed into the hardest-hit areas. How did your remarkable journey begin?
ASHLEY HAMER, VIDEO JOURNALIST: Well, I flew straight into Freetown and immediately left the next morning to drive twelve hours into the epicentre of Sierra Leone's Ebola outbreak, into the district of Kailahun, which is a border region in the very east of the country.
It is the middle of the rainy season in Sierra Leone at the moment which means the parts of the road that are not paved are often totally impassable and certainly in Kailahun there are 470,000 people scattered across remote villages and it is very difficult to logistically get people and supplies, medical personnel and medical equipment, around the region because it's so difficult to operate on those roads.
ANJALI RAO: Was there anyone on the road checking the health and movement of people?
ASHLEY HAMER: The government had just declared an increased state of emergency, which meant that they had deployed the military and police to various checkpoints across the country.
MAN (Translation): We are spending today here so people can come and get preventive measures.
SOLDIER (Translation): In order to wash their hands with chlorine. You see?
REPORTER: Why?
SOLDIER (Translation): I'm even asking kids to come and do so because the sickness doesn't choose. Either big, small, no, the sickness will come anywhere, for any person whatsoever. So that's why I have ordered them to come and do it.
ASHLEY HAMER: Halfway through our drive to Kailahun, we stopped at Kenema, which is another big Sierra Leonean town, and the site of the Kenema government hospital, which was one of the first hospitals to start taking Ebola patients, because it was formerly a centre for Lassa fever, which is also a very deadly disease. MSF and the Red Cross tell me that hospital is a death trap. I went there to see what it was like, and it was chaotic to say the least.
I wandered in and nobody checked me at all. Patients are potentially wandering in and out. There's a dirty screening tent on the right hand side as soon as you come in, where nurses in degrees of personal protective, but inadequate personal protective, equipment are interviewing potential Ebola patients, sick patients, about their symptoms.
NURSE: We are doing screening - taking patient histories, past and present histories. If they have Ebola we send them to the Ebola ward. Because in some cases, some have symptoms of Ebola - headache vomiting, diarrhoea - and if you have this we send you to the Ebola ward.
ASHLEY HAMER: You have no idea whether the people that you are come into contact with there have Ebola. When I arrived, I overheard a doctor in the background tell me, "Don't touch the walls". The place is potentially completely contaminated, and yet, at the same time, there's a maternity ward, they are trying to treat malaria, they are trying to treat typhoid, as well as having this Ebola isolation unit there.
REPORTER: How many patients are in the hospital now?
NURSE: Here? Now? Plenty! I can't recall it now.
REPORTER: Do they have Ebola?
NURSE: Yes! Some are getting Ebola, some are not. We have some that we admitted today.
REPORTER: I understand that some nurses have died here?
NURSE: Yes.
REPORTER: Can you tell me how many?
NURSE: Well, we are now close to 20.
ASHLEY HAMER: You simply cannot have people wandering in and out with potential Ebola symptoms at the same time as patients who might not have Ebola at all and I got the impression that the nurse just didn't really know what she was doing.
ANJALI RAO: It's a dramatic death toll amongst the nursing staff. If they are struggling, it's hard to imagine the situation for the villagers. How do they get information about this disease?
ASHLEY HAMER: There are teams, local teams, of volunteers who are going out into the rural communities and telling people about symptoms, telling people how to prevent the disease, and telling people what to do if they believe themselves or a relative may have contracted Ebola.
VOLUNTEER: We have these charts which we use to display to the people and tell them what to do and what not to do. You see? Now like this one we get the other infection through somebody who has been infected. Like if I'm infected, if I touch the person or if somebody touches me, then the disease will be infecting him too.
ASHLEY HAMER: The problem is that this is a vast area with a very large and dispersed population and there are simply not enough people on the ground who are trained to be able to cover the population and genuinely educate people, help people to understand in their own local context, what this disease is and how to prevent it.
ANJALI RAO: Now, I understand that funerals are a risk for everyone concerned. Why is that?
ASHLEY HAMER: Ebola is transmitted by physical contact with an infected person and a deceased person somebody who has tied from Ebola - is at their most contagious immediately after death. I went out with the Red Cross dead body management team, who are deployed to local communities whenever a death in the community is reported. The government has ordered that all deaths in the communities need to be reported, at which point the dead body management team are deployed to safely deal with that dead body.
They have to bury it in the correct, disinfected, safe way and they must swab the body, because it is impossible to tell whether somebody has died of Ebola just by looking at them.
DEAD BODY WORKER (Translation): We will still pay the same last respects to the loved one who has died. Okay? The only difference will be that you won't be able to wash them like you wash them normally, okay?
ASHLEY HAMER: The dead body management team made a very big show of dressing up openly in their personal protective outfits so everybody could see what was going on. As you can see they dressed me in some protective gear to be able to stand outside the house and film the process of them going inside and protecting the body.
They then went inside, dealt with the body, and brought the body out. It was a very distressing thing to see. The relatives were - the emotion was raw amongst the relatives, who were right there watching the dead body management team extract the corpse of their relative and bring it out into the front compound.
REPORTER: Is it always a big gathering like this? Does the whole village always come out to see?
DEAD BODY WORKER: Always.. Always people come out to really see exactly what we are doing and how we are doing it, because the perception used to be different. They were claiming that when this exercise was being done, we were taking some parts from the corpse to do rituals. So this is why now we open the window wide, and they can stand afar, and see what is happening inside.
REPORTER: When you turn up in a village, you go to a village to do a burial, and people are angry with you, or they are afraid, how does that make you feel?
DEAD BODY WORKER: Well, I feel uncomfortable because while I'm doing the right thing, people are trying to be ungrateful for my efforts so I feel uncomfortable. Yes even as I'm speaking to you we're I'm staying in my communities people are afraid of me when they hear that I'm working with the dead body management. So they are afraid of me. So we cannot eat - we cannot share eating together.
ANJALI RAO: Well, this was obviously a dangerous assignment. There are very few journalists reporting from there. Did you feel at any point that you may be exposed to the disease?
ASHLEY HAMER: I never felt that I was at risk of physical harm, certainly not. There was no risk of public disorder. But, there's no doubt that the paranoia that comes over you, when you realise you are in the middle of a serious disease outbreak - you cannot see it coming. It makes you distrust people. It makes you so aware of everything that you are touching - every footstep that you take, every person who is near you. That gave me a bit of a sense of what the local people are feeling to be told that they are living in the midst of this highly deadly virus, and not knowing where it's coming from and how it can be contracted.
MAN: this sickness is a killer disease, it's going to kill all of your families. We are totally afraid, this is the main point.
ANJALI RAO: Did you get any sense of order at all? Is anyone taking control of the situation, or at least trying to?
ASHLEY HAMER: Médecins Sans Frontières or Doctors Without Borders are the experts in the field out there. They have established in June the biggest ever Ebola treatment centre. It's an 80-patient treatment facility outside Kailahun town centre. It feels extremely ordered and the planning that has gone into the construction of the place, which was only established in June, has been absolutely meticulous.
ANJALI RAO: It must be an eerie feeling to be only 2m away from somebody infected with this horrible disease. What did you feel when you were talking to the patients?
ASHLEY HAMER: It is an unnerving feeling to stare into the eyes of somebody who you know is sick with Ebola. You are divided by a plastic fence. They are in the high risk zone and you are in the low risk zone. But because Ebola is transmitted by very close contact with an infected person, physical contact and the sharing of bodily fluids, it is safe to be able to talk to somebody like that. And I met patients who were feeling OK - they were feeling strong. They had been there a couple of weeks, and they were, I hope, on the mend.
REPORTER: You are dancing! That's good!
MAN: Let's go dancing!
REPORTER: You are getting stronger!
MAN: Yeah!
ASHLEY HAMER: I met a young mother called Hawa Idrissa who was extremely feisty.
HAWA IDRISSA: I will not feel happy, because I want to go home to my daughter. I want to see her now.
REPORTER: How old is your daughter?
HAWA IDRISSA: One year.
REPORTER: But she's OK? No Ebola?
HAWA IDRISSA: No Ebola. No more Ebola! Only I have Ebola.
ASHLEY HAMER: I left my number with her, and the day before I left, she called me herself to tell me that she had been discharged and she had gone back to her village. It was fantastic to hear that news.
MALCOLM HUGO, MSF PSYCHOLOGIST: Step by step, very slowly, getting back to talking with friends...
ASHLEY HAMER: There is an Australian psychologist working out there called Malcolm Hugo, from Adelaide, and he is the main MSF psychologist, counselling people who are operating or sick in the treatment facility.
MALCOLM HUGO: As you can imagine, they are in a pretty terrifying situation. They're in a life-threatening situation, and they are surrounded by death and a lot of suffering. So there's obviously some psychological effects.
ASHLEY HAMER: He introduced me to a young lad of 18, who was one of the survivors - a chap called Lahai, who was extremely relieved to be going home finally.
REPORTER: And how many family members? You have mum, you have dad?
LAHAI: My father and my mother they are there.
REPORTER: They are waiting for you?
LAHAI: Now!
REPORTER: What will you say to them when you see them?
LAHAI: I'll teach them about Ebola. How to prevent it themselves.
REPORTER: You are lucky, you are strong.
LAHAI: Yeah, yeah, I'm very strong.
ASHLEY HAMER: I witnessed a discharge counselling session between Malcolm and Lahai, and then I accompanied Lahai back to his village to meet his mother. Lahai was extremely proud of the certificate of negative status that he had been given, which is issued by MSF for every survivor, because it is very important for local communities - in order to be able to accept the infected person back into the community, they need proof that that person is no longer contagious.
MAN: No more Ebola.
ASHLEY HAMER: And we had to do this to prove to them that it was OK, and that the person could be brought back into the community sail.
ANJALI RAO: Ashley, well done on an assignment that not too many would be keen to undertake.
Ashley Hamer there in London. And Doctors Without Borders predicts it will be at least another six months before we see an improvement in the infection rates. Well, there is a blog from Ashley On our website describing her confronting journey across Sierra Leone. Plus, you can read more background on the ebola virus and past outbreaks at SBS.com.au/dateline. And Ashley is on twitter right now so you can talk to on twit right now so you can talk to her about her remarkable journey. Just use the Twitter handle @AshleyHamer.
Reporter/Camera
ASHLEY HAMER
Producer
CALLISTE WEITENBERG
Editor
WAYNE LOVE
Graphics
MICHAEL BROWN