| Freetown GVs | Music | 00:00 |
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| SARA: Like many nations in this unstable part of Africa, it's strife that's lifted Sierra Leone out of obscurity and into the world's view. Brutal civil war, thousands of children pressed into service as soldiers, mutilation as a weapon of intimidation. | 00:10 |
| In car with Patrick | Music | 00:31 |
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| SARA: Now that war's over, another has begun but this time the nation has to combat a very different, very deadly scourge - Ebola. | 00:35 |
| Patrick | PATRICK MASSAQUOI: "You know, considering the fact that I am going into an affected area that is currently infected by Ebola, it takes a man, you know, for you to go back". | 00:46 |
| In car | Music | 01:00 |
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| SARA: Our cameraman, Adam Bailes, is travelling with Red Cross worker, Patrick Massaquoi who's returning to the Ebola battle zone despite the risk and the worries of his family. PATRICK MASSAQUOI: "You know when you are back from this affected area, | 01:02 |
| Patrick | friends stigmatise you, even when I went there for the first time, when I came back and my wife said, I mean since you are coming from that place you have to stay far off, you know, for 21 days. I have to really convince her, I have to show her pictures on the videos, that... even though we are involved in that, we are highly protected, you know?" | 01:19 |
| Car on road | SARA: They're heading south-east towards the borders of Guinea and Liberia. | 01:49 |
| Roadblock |
| 01:55 |
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| Through the roadblocks and a long pot-holed stretch of road, it's a 12 hour drive to the town of Kailahun and an Ebola coordination facility on the front line of this African emergency. | 02:02 |
| In car | Once Foreign Correspondent's crew is through, this and other checkpoints will be closed to media as a national crackdown intensifies. | 02:16 |
| Village houses | DR RICHARD BROOME: [Adviser, International Red Cross] "The environments in which people are living is absolutely a critical part of the effectiveness of the spread of this outbreak. | 02:28 |
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| People are living in very basic housing with poor access to water, no ability to isolate themselves. There's very poor access to healthcare as well. But then there are all these cultural issues as well, such as a healthy mistrust of government, especially in some of these countries that have had very severe civil wars for many years. | 02:35 |
| Broome. Super: | There's a lot of beliefs in black magic and I suppose traditional beliefs, so people often explain things through witchcraft and curses - and all those things come together I suppose with a disease like Ebola to result in these explosive outbreaks". | 03:00 |
| Cars on muddy road/Dodo town | Music | 03:20 |
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| SARA: Dodo is a town of about 3000 midway between Freetown and Kailahun. | 03:34 |
| Red Cross workers suit up | A large crowd's gathered. A Red Cross Dead Body Management Team has just arrived and they're suiting up in the middle of the main street. | 03:40 |
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| RED CROSS WORKER: "They want to see... they want to see what we are doing". SARA: They've been alerted a middle aged man has died in his bed overnight. | 03:53 |
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| MAN FROM VILLAGE: "He's fifty five years old, married with one wife and a child, a boy child. He has been a farmer and he also collects palm nuts from the palm tree". | 04:03 |
| Red Cross workers suit up. Crowd watches | SARA: The Sierra Leonean government has decreed that any inexplicable death must be dealt with by designated authorities. Traditional community funerals are not allowed. | 04:23 |
| Red Cross worker | RED CROSS WORKER: "We are now going to the house and get the... well... just the body management team, | 04:36 |
| Body Management Team enter house and spray | and they will proceed with the burial". SARA: So while the circumstances of this man's death are unclear, his body is being handled as if he had died of Ebola. A sample will either confirm or eliminate Ebola as a cause, | 04:42 |
| Team remove body | but the body will be sealed in plastic, doused with chlorine and taken away for burial. It's disturbing and confusing for the town's people. Dodo hasn't experienced an Ebola death or any infections during this outbreak and they don't want their town stigmatised. | 05:07 |
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| MAN FROM VILLAGE: "Since no, have not got any person die of Ebola." MAN: No cases? MAN FROM VILLAGE: No cases of Ebola. | 05:31 |
| Body Management Team spray corpse | SARA: The new emergency procedures are also causing a little consternation for local leaders here. | 05:35 |
| Village Leader | VILLAGE LEADER: "I am asking if he died of Ebola. That is my concern". RED CROSS WORKER: "We are not | 05:44 |
| Red Cross Worker with Village Leader | saying that the cause of the death of this old man now is as a result of Ebola - but what normally this is... is probable case.... probable case... it might be, it might not be". VILLAGE LEADER: "Okay". | 05:50 |
| Corpse on to truck | RED CROSS WORKER: "That is why government have said we should be doing the burial". VILLAGE LEADER: "Well I know | 06:03 |
| Village Leader with Red Cross Team | that is the procedure that we should not do the burial on our own, but because of the convoy, the way it looks... so fearful that this is a new thing... for the community people - so the majority may have that in mind and be doubtful - is this man not affected by Ebola also? | 06:07 |
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| MAN: Thank you very much. Very happy. VILLAGE LEADER: So no problem". RED CROSS WORKER: "So you feel more informed?" VILLAGE LEADER: "Yeah, yeah. I'm better informed." | 06:23 |
| Corpse on truck | DR RICHARD BROOME: "One of the real problems with Ebola is that the most infectious | 06:30 |
| Team wash up | risk is a dead body of someone who's died from Ebola. Now that's a real challenge again in places like Sierra Leone because | 06:36 |
| Corpse on truck | often people would be dying in communities and they would be having traditional funerals | 06:43 |
| Crowd watches | and I guess there are few better ways of spreading | 06:47 |
| Broome | Ebola than a lot of the traditional funeral practices that go on in these remote parts of West Africa". | 06:50 |
| Broome in radio studio |
| 06:56 |
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| SARA: Australian Doctor Richard Broome recently spent a month in Sierra Leone helping to streamline the Red Cross response to the Ebola outbreak. | 07:09 |
| Stills. Broome addressing villagers | He's seen firsthand the emergency collide with customary practices. | 07:18 |
| Still. Red Cross car on road | DR RICHARD BROOME: "For the Muslim funeral, for example, it's traditional to wash the body prior to burial | 07:24 |
| Broome | and again so that would put a number of people at risk and then for some of the more tribal or remote areas there would be very traditional burial practices, such as wakes, where lots of people might come into contact with the dead body". | 07:30 |
| Red Cross convoy on road in rain | Music | 07:42 |
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| SARA: It's the wet season. Roads turn to quagmire and can become more difficult and dangerous. But locals find a way to get from one place to another and out where national borders are porous, mobility is making the transmission of Ebola all the more difficult to contain. | 07:46 |
| Kailahun GVs | Music | 08:04 |
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| SARA: Kailahun is a market town of around thirty thousand people at the centre of a region of almost half a million. The commerce here makes it a magnet for people from neighbouring Guinea and Liberia. | 08:09 |
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| Music | 08:23 |
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| SARA: In this outbreak, the central focus of the fight against Ebola is here... | 08:27 |
| Crisis coordination centre | Foreign Correspondent has been granted special access to this crisis coordination centre where patients are being tested and quarantined. | 08:33 |
| Doctors in meeting | It's run by MSF with help from the International Red Cross and the World Health Organisation. | 08:44 |
| Doctor looks at whiteboard | Music | 08:50 |
| Hugo | MALCOLM HUGO: "The squares on the board represent the... gives us the information on admissions, discharges, deaths". | 08:5 |
| Doctor writes on board | SARA: It's where we find Australian psychologist Malcolm Hugo. MALCOLM HUGO: [Psychologist, Medecins Sans Frontieres] "Okay in the last week and a half | 09:01 |
| Hugo. Super: | to two weeks there's been a significant increase in the number of cases coming here and also a significant increase in the number of confirmed cases. | 09:07 |
| Medical team at work | People are scared. I guess the kind of suddenness, the suddenness of the epidemic and the catastrophic impact it's had on small communities where whole families have virtually been wiped out and for surviving members, whether it be a psychological or psychosocial response available to them. | 09:16 |
| Hugo | And, I mean, culture's obviously important, but sometimes these people tend to be neglected by their communities because of the stigma attached to it". | 09:40 |
| Hugo walks around centre | SARA: Malcolm's retired from his Adelaide practice and for the past decade has undertaken at least one international crisis assignment a year. | 09:48 |
| Series of stills of Hugo on assignment | MALCOLM HUGO: "I've worked with one Ebola outbreak in Uganda in 2007. I've done two missions in the West Bank. I've worked in MDRTB, a drug resistant tuberculosis program | 09:59 |
| GFX Hugo contained in stills frame | in Khadija, which is part of Georgia. I spent six months in Baghdad last year. | 10:13 |
| Hugo with body collectors | I was in the Philippines following the typhoon over Christmas. I was in Haiti after the earthquake. I was in Aceh after the tsunami in 2004". | 10:20 |
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| "You've come to pick up some bodies?" MAN: "Yes, yeah". MALCOLM HUGO: "How many will you be picking up?" MAN: "Nine". MALCOLM HUGO: "Nine. | 10:36 |
| Body removal | A busy day... okay". | 10:45 |
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| SARA: Far from here there's an intense effort to develop a vaccine. | 10:58 |
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| The death rate for this strain is slightly lower than those of previous outbreaks, but most people admitted to this facility can expect to die. That makes Malcolm Hugo's work here vitally important. | 11:05 |
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| MALCOLM HUGO: "I really think grieving and the faith, the way people respond to the death of loved ones, it's pretty universal. | 11:21 |
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| Obviously people are really upset and particularly when they can't do the things that they traditionally do when somebody dies". | 11:31 |
| Nurse takes woman's temperature | NURSE: "We are taking their temperature... | 11:46 |
| Nurses | whether they have a fever - at least if it starts at 37.5 or more, that will give us a clue about them". | 12:03 |
| Patients | SARA: In this outbreak there's been confusion in communities about symptoms. They've been told a high temperature is one sign, but earlier health alerts also cited bleeding as another. | 12:14 |
| Nurse reads woman's temperature | As it transpires, bleeding is not an indicator with this strain - but many people acting on the earlier advice, assumed they were okay and didn't present for testing". | 12:28 |
| Patients | MALCOLM HUGO: "It's difficult to give bad news to patients and I think some of the nurses understandably avoid doing this by just saying to patients, oh you're going to be moved to a different section, rather than telling them why they're being moved to a different section, that they need to be isolated from the negative cases. | 12:44 |
| Hugo | Also they're concerned about the reactions that they're going to get. Understandably patients are going to be distressed when they hear this news or in some cases they get a bit angry, so I guess it's just human nature to try and avoid that conflict". | 13:04 |
| Hugo throws drink to patient/Patients | SARA: It's here in a relatively open space cordoned off by a plastic fence - a make shift buffer zone - that infected patients wait for Ebola's crippling onset. They're given some pain relief and told to keep up their water intake. They can only hope to survive its three week attack phase. | 13:19 |
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| DR RICHARD BROOME: "It seems that in Sierra Leone at the moment the mortality rate is somewhere in the order of 60% and it's a virus that spreads through contact with people's body fluids. | 13:54 |
| Broome. Super: | Essentially, the virus is one that just overwhelms your body's immune system and ability to cope and as a result your organs begin to fail, your blood vessels become leaky. So it's really just overwhelming... an overwhelming of your body by the virus". | 14:05 |
| Patients/Medical staff | Music | 14:24 |
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| SARA: For many still reeling from civil war, fear of Ebola is eclipsed by a fear of authority, suspicion and superstition have been keeping people away. | 14:31 |
| Crisis centres shots | MALCOLM HUGO: "Particularly when I first came here, lots of rumours about the activities here. There were rumours that body parts were being taken or MSF were injecting people and | 14:45 |
| Hugo | I've certainly met people that have come here, patients that have come here that were in fear of ah... we were going to take all the blood out of them - a whole range of things".
| 14:59 |
| Nurses scrubbing boots/washing clothes | SARA: Despite the almost agricultural appearance of these facilities, safety protocols are strictly observed and policed. Everything that's spent time near or within the isolation zone is scrubbed and sterilised, and yet among the more than 1400 deaths so far in this outbreak, many have been among the volunteers and medical staff dealing with it. Across West Africa, about 170 have been infected. More than 80 have died. | 15:07 |
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| Music | 15:57 |
| Kenema GVs |
| 16:05 |
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| SARA: The busy, colourful city of Kenema is Sierra Leone's third largest and about three hour's drive from Kailahun, depending on the rain. It's home to a large government hospital - the scene of the nation's single biggest loss of medical staff to Ebola. 20 health workers died after contracting the virus. | 16:09 |
| Construction of new centre. Amanda walks | On the outskirts of the city, Amanda McClelland is overseeing the rapid construction of another Ebola coordination centre to take some of the pressure off Kailahun. | 16:34 |
| Amanda with Red Cross members |
| 16:49 |
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| AMANDA MCCLELLAND: [Emergency Health Officer, IRC] "The pressure and the speed that we need to move in the Ebola is | 16:59 |
| Amanda at construction site. Super: | something that we haven't felt before. Every day we waste, the epidemic continues to spread and is not under control so it's an unusual situation and extremely concerning". | 17:03 |
| Construction site | SARA: Amanda's a Queenslander who's leading the Red Cross response to Ebola in Sierra Leone. She's a nurse and tropical diseases expert and like any other medical professional, she's worried about Sierra Leone's capacity to cope with and contain Ebola. AMANDA MCCLELLAND: "We've seen health workers make mistakes. | 17:13 |
| Amanda | A lady was full term pregnant, presented, was... seemed to be miscarrying. They took her to the maternity ward... they were taking care of a full term miscarriage, and half way through they realised actually she was an Ebola patient and she was positive. Now that one mistake, we've got ten to fifteen health workers that are possibly contaminated from that one case". | 17:33 |
| Construction site | SARA: The race is on to get this new Ebola clinic up and running but it will take several months. | 17:54 |
| Patients at Kailahun crisis centre | It's a devastating death rate but 4 in 10 are surviving. Back at the Kailahun crisis centre, these teenagers have endured the normally lethal 21 day cycle of the virus and have just been cleared to leave the isolation ward. | 18:06 |
| Hugo | MALCOLM HUGO: "She had Ebola. Her husband died here". | 18:27 |
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| SARA: They've survived but they'll head back to their homes and into another ordeal. | 18:32 |
| Washing boots/Red Cross workers | MALCOLM HUGO: "There's still a lot of misunderstanding about Ebola in the community even though we have health educators, people still believe that because patients have been here, | 18:40 |
| Car on muddy road | that they.... when they go home they may be contagious. | 18:54 |
| Hugo | There has been cases where people when they've gone home have been marginalised within the community and there's been quite a stigma involved so we just go home to make sure, yeah". | 18:59 |
| Patients behind fence | SARA: Twenty per cent of the patients in Kailahun are under the age of 15. They're brought here because they're infected or the family members caring for them are infected. They can be difficult to handle. MALCOLM HUGO: "The baby was positive and has been an inpatient for over three weeks. It was about two weeks | 19:10 |
| Hugo | ago the baby actually crawled under the fencing here and walked out into the middle of our compound and I've never seen people scatter so quickly and she was just standing there with her hands on her hips, yeah, a little two year old feeling quite powerful with the impact she had on all the people here. But somebody quickly suited up and picked her up and returned her to the compound". | 19:31 |
| Ambulance at crisis centre
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| 19:57 |
| Lansanna. Mush and Abu care for Lansanna | SARA: That child is Lansanna. She's now being cared for by one of the health workers at the MSF clinic, Mush Tiah and Mush's husband, Abu Bakar Sesay at their home in Kailahun. | 20:01 |
| Mush | MUSH TAH: "So when I go to the containment centre where I can see babies that have lost their mother, lost their family, I can volunteer to take them because I can feel their hurting where a baby is left at this age... when they have lost their mother". SARA: Lansanna came to the emergency centre with her parents. | 20:17 |
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| Her mother died, her father fights on. Ebola has claimed 17 members of her family. | 20:40 |
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| MUSH TAH: "Some babies have got no mothers, some families have all died, so it's very disheartening. Even now at this time, children do not go to school. So I mean, it's very disheartening that this Ebola has come to us here". | 20:48 |
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| AMANDA MCCLELLAND: "Some communities that we've worked with, they've lost 30 or 40% of their population. Some of these places are quite small and how do those communities then undertake agriculture in the future? | 21:08 |
| Amanda | What happens when the adult population has you know been killed by Ebola and only the children are left? Then we're seeing what we call almost Ebola orphans where
| 21:23 |
| Baby | whole families have died and only the young children are left. So the impacts of this epidemic will be long term in these countries". | 21:31 |
| Red Cross worker in suit sprays house |
| 21:41 |
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| DR RICHARD BROOME: "I think the psychology is an enormous part of an Ebola outbreak and not just for the people who are sick themselves, but also for the communities where they've come from. | 21:47 |
| Woman under umbrella/Men in suits | Making sure that they understand the nature of the illness in that person and that once they've recovered, that they're not going to, you know, be able to transmit the disease. | 22:01 |
| Body removal/Crowd watches | The people who've recovered, one of the really important things is getting.... they can almost become ambassadors for the disease. They are the people who can give people most hope and use them as symbols of you know, | 22:09 |
| Broome | success in this Ebola outbreak to try and change the overall psychology I think and people's view of Ebola". | 22:23 |
| Workers douse body in chlorine/Removing body | Music | 22:30 |
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| MALCOLM HUGO: "Yesterday we had 10 deaths which is a bit of a record for us. | 22:48 |
| Burial of body
| Music | 22:51 |
| Hugo | MALCOLM HUGO: I'd estimate at around the 35-40 mark within the last week so it's been a difficult week for most people. | 22:58 |
| Burial of body | I think the big concern is what's going to happen to the people here. It's the first time in Sierra Leone that they've had this sort of experience, so it's a very new and frightening experience for people". | 23:04 |
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| Music | 23:27 |
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| Further Information To find out how you can help, or if you wish to donate, see the Australian Red Cross Ebola Outbreak 2014 Appeal |
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| Credits: | Narrator: Sally Sara Camera: Adam Bailes Editor: Nick Brenner Producers: Suzanne Smith Vivien Altman Adam Bailes Executive Producer: Steve Taylor Additional footage: International Red Cross. | 23:55 |