Wednesday 17 October 2018

'Health workers were dying left, right and centre. It was one of the most difficult things' - Ireland's ambassador to Sierra Leone during the Ebola epidemic

Dr Sinead Walsh (40) was Ireland's ambassador to Sierra Leone during the virus epidemic that killed thousands and spread fear across the continent

Ireland's Ambassador to Sierra Leone, Sinead Walsh pictured at The Department of Foreign Affairs.
Ireland's Ambassador to Sierra Leone, Sinead Walsh pictured at The Department of Foreign Affairs.

I can't entirely explain why, but I always had this idea that I wanted to go to Africa. There was none of that in my family - I grew up in Raheny in Dublin as the youngest of four.

I was a tennis player as a kid and I ended up going to Harvard in the US where I did a degree in literature and French. I went straight to India as a volunteer after college with no real idea what I was doing. From India I went to Rwanda and ran into Concern, who were in the same town as the US NGO I was working for. I joined Concern and my first posting was to the border of Afghanistan and Pakistan in 2002.

Once I completed my masters in development studies in UCD, I headed to South Sudan with Concern. I joined Irish Aid - part of the Department of Foreign Affairs - as a development specialist in 2009. I then went to Sierra Leone and while I was there, the Government upgraded it to embassy status. I became Ambassador to Sierra Leone in 2014 and was based in Freetown for five years.

The two big issues for us were nutrition and women and girls. We would have done a lot of work with teenage girls who had children and were trying to feed their families. There's still a big malnutrition problem there - one in five children die before the age of five and the average life expectancy is 51.

I'd been in Sierra Leone about three years when we started hearing about this mysterious disease. At the time we had a food security crisis. The economy was tanking and we were facing corruption. The country was really suffering and there was a lot of fire-fighting going on.

When I had worked in Rwanda, there had been reports of Ebola in the Congo and I'd heard about it in South Sudan. But it had always been deep in the forest. It was very distant. We would have heard horror stories about it.

It started in Sierra Leone in a remote district called Kailahun. Then it reached the district of Kenema which is like the gateway to the rest of Sierra Leone and the centre of the diamond trade.

When Ebola had occurred in other countries, it had been associated with a lot of bleeding. We didn't see that. The symptoms of Ebola are a lot like those of malaria: fever is a big thing. We had so few resources, and we didn't get big international help in the early days. If we had, what we saw could have been avoided.

I visited Kenema early on and health workers were dying left, right and centre. They didn't have proper protection. This, for me, was one of the most difficult things. We had all these health workers dying and they were still there. They said: "These are my people, this is my country."

The problem with Ebola is that it's so hard to diagnose. If you had 100 people walk into a hospital with symptoms of Ebola, they could have typhoid or malaria. We weren't ready at all for anything like this. All the weaknesses were exposed and we were getting positive cases all the time.

In Sierra Leone 3,956 people died. In the region as a whole 11,310 people died of Ebola with the vast majority in Sierra Leone, Liberia and Guinea. That was only a fraction of the number who died because the health system shut down. Many others died because they couldn't see a doctor or they couldn't get medication. We'll never be able to quantify that.

It was just unprecedented. It had never happened to anyone else. That was what was so absurd - we had all these experts from all over the world and they had never seen anything like this before either.

At the beginning I felt, when the experts come, they'll tell us what to do. They came and said 'let's figure this out together'.

Ebola isn't air-borne. It's transmitted by bodily fluids like blood, sweat and tears. That's why the people really at risk are health workers. Because it's not air-borne, it's possible to keep yourself safe.

It's a ghastly death with Ebola. The whole idea of dignity went out the window. There was so much fear that it was almost dehumanising people. When people were afraid they were saying 'keep that away from me'. People eventually die of dehydration because they lose all these bodily fluids at such a rapid rate.

I remember having a conversation with my mum about it. My parents are pretty calm and if I told them I was fine, they believed I was fine. We were more afraid we'd catch something else and we wouldn't be able to get health care. I asked myself 'is this ever going to be over?' so many times.

At the time a lot of people left or were evacuated. It meant there was a really strong sense of solidarity among those of us who stayed. There weren't many of us left after the summer of 2014. In October, the Irish Army got there and there was a good team effort. That really kept us going.

The response internationally got better. We managed to end the disease but it took too long - it took 21-and-a-half months. Very few international agencies were there before it happened and after it ended. I used to feel like a historian, because I'd be at a meeting and someone would suggest something, and I'd say, "We tried that nine months ago." That is one of the advantages for Ireland having a long-term presence in these countries, you can bring that perspective.

I met Dr Oliver Johnson when he was working in one of the hospitals in Freetown. We met again when things were calming down in 2015. We started chatting and we figured out we had a lot of the same frustrations about what had happened. It dawned on us both that it would be hypocritical if we didn't write that down.

I'd already decided I was going to take a year off after five years in Freetown. I made writing the book on what happened my full-time project.

I'm moving on next to become the EU's Ambassador to South Sudan. It's a country that has huge challenges and is in the middle of a peace process. It's my kind of place and somewhere I feel I could contribute.

Getting to Zero: A Doctor and Diplomat on the Ebola Frontline by Dr Sinead Walsh and Dr Oliver Johnson is published by Zed books and is available in bookshops now. In conversation with Kathy Donaghy

Irish Independent

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