This piece was in The Telegraph at the height of the Ebola outbreak in Sierra Leone. People knock aid agencies, but by simply organising efficient burials, the charity below probably saved many lives. Thanks to Will Wintercross for the pictures and Morris Marah for showing us round his native Sierra Leone.
NAMED after a long-forgotten tribal ruler of Sierra Leone, the King Tom cemetery hides behind flaking grey walls in the suburbs of northern Freetown. For years, it has fought a losing battle for space with the neighbouring municipal refuse dump, from which piles of rubbish overflow on to the rows of overgrown headstones. Now, though, the tide is in reverse – as the cemetery overflows with the casualties of Sierra Leone’s Ebola crisis. Since the outbreak spiralled out of control last summer, an average of 50 bodies have been laid to rest here every day by boiler-suited health workers. Such is the pace of new arrivals that the plots are marked only by tiny plywood sticks, each with a name scrawled in red marker pen.
Already they occupy a space the size of a football pitch, and in one corner, bulldozers are clearing sections of the city tip to make room for more.
Toiled over by a team of exhausted, sweating gravediggers that has expanded from four to nearly 100, the graveyard’s rich red soil has become the ultimate “Ground Zero” in Sierra Leone’s battle against Ebola. As part of efforts to stop the spread of the virus, King Tom is where every single person who has died in Freetown now ends up, whether they were killed by the virus or not.
Exactly how many of the 4,400 corpses laid to rest here since August are victims of Ebola is impossible to say, as the city’s overwhelmed authorities lack the time to analyse every death. But the ministry of health “burial squads” that now act as roving undertakers in Freetown take no chances. Each body arrives in a hermetically sealed white plastic bag, which the squads then stagger with across the cemetery’s uneven ground, laying them in one of dozens of newly dug pits.
The most unsettling sight of all, however, is the bags that require hardly any effort to carry at all. When The Telegraph visited the cemetery last week, a procession of three burial workers picked their way through the graves, each with a tiny, knapsack-sized bag cradled in their arms. Edward Conteh, aged 3, Amna Kabbah Dumbaya, aged four months, and Mamayo Sesay, aged two weeks, were buried in a section specially set aside for children. It is also by far the fastest-growing section.
In the first five days of January alone, 156 children under five were buried there, according to Fiona McLysaght, country director for the charity Concern Worldwide, which is supervising the burial operation.
“The number of children we are burying every week is absolutely staggering,” said Ms McLysaght, whose charity’s work is being funded by Britain’s £232.5 million Ebola aid package to Sierra Leone. “It is an appalling situation, although we believe they are mainly non-Ebola cases that are related to the secondary health-care crisis.”
The “secondary health care crisis” is aid agency-speak for how the virus has also crippled the country’s war-ravaged health service, killing at least 110 medics and forcing many hospitals to shut. Malaria-ridden Sierra Leone already had one of the world’s highest infant mortality rates anyway. Now, even more newborns than before will never see a first birthday, let alone a fifth.
Among the charities addressing this wider tragedy is the Masanga Mentor Ebola Initiative, one of charities supported by The Telegraph’s Christmas Charity Appeal which runs to the end of the month. Its work includes training community health workers in basic – and infection-free – surgical techniques so they can step in where doctors are not available.
A glance at the cemetery’s handwritten registry book, which is kept on a table underneath a mango tree, shows how the very young are suffering disproportionately. Of the day’s 37 entries so far, 22 were aged 10 or under. Among them were five entries in a row marked “stillborn”. In the early days of the outbreak, burying so many youngsters at once used to make the chief gravedigger cry. Now it is routine.
Once the undertakers have finished their rounds for the day, they put all their bio hazard suits into a burn pit (Will Wintercross/The Telegraph)
Not since the brutal civil war of the 1990s has Sierra Leone witnessed such apocalyptic scenes, to which the graveyard, which resembles a tropical version of Highgate Cemetery, offers a suitably eerie backdrop. Crumbling statues of angels, half-swallowed by bush, stare out over the new arrivals. Palls of black smoke rise up from bonfires of the burial teams’ disposable uniforms.
At one end, a giant, leafless cotton tree sticks bare grey fingers up at the sky. At the other, where the rubbish dump is being cleared back, a mass grave containing the bodies of 70 civil war victims was found recently under a pile of refuse. Not surprisingly in a country where belief in witchcraft still abounds, the place gives many locals the spooks.
One man who is not in the least intimidated, however, is Andrew Kondoh, a burly, jovial 34-year-old who works as its “Burial Welfare Supervisor”. When interviewed for the post a few months ago, his employers warned him that the job would need someone who was “comfortable around dead bodies”. Given his experiences during the civil war, they could not have picked a better candidate.
During that time, Mr Kondoh was living in the eastern city of Kenema, which became a major battleground because of its rich diamond deposits. The alley next to his family home adjoined an abandoned mortuary, outside which scores of people murdered and mutilated by militiamen from the Revolutionary United Front were routinely dumped. Knowing there was no way the mortuary would reopen, he took it on himself to fence the piles off and stop them becoming a public health hazard.
“It wasn’t easy – the smell was dreadful, and when I tried to stop people using the alleyway as a shortcut, they would abuse me,” said Mr Kondoh. “Even my father gave me several strokes of the cane, because he couldn’t understand why I was doing it if the government didn’t pay me. But someone had to volunteer, and I am not squeamish.
“I hoped never to see dead bodies like this in Sierra Leone again, but at least this time you don’t see their faces, as they come already sealed in the plastic bags.”
Still, aspects of the job are very tough. Because of the fear of infection, Mr Kondoh no longer sleeps in the same bed as his wife, who has also sent their children off to live with her sister. For the same reason, some of the gravediggers and burial workers have been threatened with eviction from their homes by anxious landlords.
Tensions also run high when the burial teams turn up at houses to take away bodies. For many Sierra Leoneans, the corpses of the recently departed are seen as a means of getting in touch with the souls of long-dead relatives, and are of immense spiritual value.
When things occasionally turn nasty – vehicles are sometimes pelted with rocks or chased by angry mobs – it is Mr Kondoh’s job to soothe things over. He comforts the bereaved by telling them that the bodies are at least being laid to rest in a respectful fashion, and that they can observe the burial if they wish, albeit from a distance.
In a sense, they are lucky to have a burial all. Such is the risk from infected corpses that in neighbouring Liberia, they are now routinely cremated. Sierra Leone has chosen not to for fear of alienating the public even further. As Sidi Yayah Tunis, a government spokesman, told The Telegraph: “Do you want a riot on your hands?”
Nonetheless, such is the paranoia that still surrounds Ebola that being buried in King Tom’s carries as much social stigma as ending up in a pauper’s grave. While public health officials politely refer to it as the “medical cemetery”, everyone around Freetown now knows it simply as the “Ebola Graveyard”.
“Recently the family of a prominent person had a big row with us because they didn’t want their loved one being buried here,” said Mr Kondoh. “We had tell them that rules were rules.”
Others, he said, complain that the densely-packed graves are too close to each other together, which meant that “angels have no space to sit at the deceased’s graveside”. Worst of all, some turn up to find their loved ones have simply vanished in the system. A number of the grave sticks are simply marked “Unknown”.
Sierra Leone is now the worst-infected of all the West African nations hit by the Ebola epidemic, with 3,062 of the 8,429 deaths across west Africa so far. Yet while the death rate is slowing, the superstitions that allowed Ebola to thrive in the first place continue.
Wearing black bin liners to protect their feet, the sole group of mourners at King Tom during The Telegraph’s visit were the family of Adama Faroh, 22, from the nearby town of Hastings. They brandished a certificate issued by an Ebola treatment centre, showing that she had been discharged just a few days earlier after testing negative for the virus. Their explanation of how she then died was rather less reassuring.
“When she came back from the centre she was covered in boils, and her feet were swollen,” said her brother, Alvin Ahmed, 24. “We think a spell was put on her by a friend of hers, with whom she had an argument at a wedding a while back. When she finally died, she was shouting out that friend’s name.”
Like many young Sierra Leonean men, Mr Ahmed sports a fashionable haircut and clothes that would not be out of place in Hoxton or Hackney. Yet he mentions his faith in the ancient powers of witchcraft as matter-of-factly as he states his sister’s age – a sign that health education campaigns here still have much to do. He did, however, declare himself satisfied with the burial arrangements. “People spoke politely to us and told us to have courage,” he said.
Also impressed is Philip Du Toit, an expat businessman from Botswana, whose excavation firm has been hired to clear the rubbish dump. His bulldozers are normally used for his ventures in Sierra Leone’s diamond business, a trade not known for attracting the sentimental. Yet he is nothing short of evangelical in his praise of Britain’s charities and government for stopping a bad situation becoming even worse.
“Otherwise, we would be just dumping bodies anywhere,” he said. “They have helped us deal with this very hard situation and give it a dignified end.”
The plan now is to eventually rebuild the cemetery entirely, although so many new graves have been packed in that there will not be room for individual headstones. Instead, there will be long stone slabs with the names chiselled on, along with a central memorial to the great Ebola outbreak of 2014.
By the time it is built, the epidemic itself will also hopefully have been finally laid to rest. The question on everyone’s minds is just how much bigger King Tom will have grown by then.