Surviving Ebola in Liberia: 10 stories of pain and hope

Josephine Karwah lost her mother, father and sister Salomé. Her child was born dead, in the street, on the way to the hospital. No one wanted to help a mother who had contracted Ebola, the lethal virus that claimed the lives of entire families. Sitting in front of the small clinic she now runs in Monrovia, the capital of Liberia, Karwah picks up her phone and opens a WhatApp group. It has 81 members, all of whom suffered from Ebola except for one, a doctor who sometimes offers medical advice. The rest share their pain and sometimes, happiness. Ten years have passed since the virus decimated their country, but the group remains in contact. The majority of them still experience physical consequences from the disease: pain in their joints, problems with their eyesight. The group is called All Survivors. Here in Monrovia, the sea is once again playing tricks and has risen up to West Point, the city’s largest shanty town, where the streets are so narrow one has to walk sideways. After it recedes, it leaves a blanket of sand, plastic, and dirt on top of which young children play and slightly older kids prepare fish. It’s Sunday, and there is no market.

In 1970, Liberia was one of the richest countries in Africa. Today, it is one of the poorest and among the most corrupt. Liberia is the only African state that was never ruled by a colonial regime and is the oldest government on the continent, having declared its independence in 1847. Two of its presidents have been assassinated and it’s undergone two civil wars, the last of which ended in 2003 and left more than 100,000 dead. At least 40,000 minors were forced to become soldiers. Today, 5.4 million people live in the country, where restaurants are run by the Lebanese and highways are built by the Chinese. Tourism is non-existent. On Transparency International’s corruption perceptions index, Liberia is 145th among the 180 countries analyzed, with 25 out of 100 points. Several studies locate it among the 20 poorest and least-developed nations in the world. Despite a favorable climate and good soil for crop production, it has suffered from food insecurity due to extreme poverty and endemic inefficiency. It’s been dependent on aid from the United States for years, and has watched Donald Trump’s return to the White House with no small measure of concern. In 2018, during his first presidential term, Trump ended special immigration status for Liberians, giving them a year to leave the country.

The Ebola virus was detected for the first time in 1976 near the Ebola River in the Democratic Republic of the Congo, and led to at least 40 outbreaks. The worst of these started in a village near Conakry, the capital of Guinea, in December 2013 and rapidly spread throughout Liberia and Sierra Leone. The virus killed 11,300 people in Liberia, Sierra Leone, and Guinea, including 500 health professionals. It seemed to disappear in June 2016, leaving behind some 17,000 survivors.

The primary sources of contagion, according to nurse Luis Encinas, were funeral rites, care providers and health centers where there were no adequate protective measures enforced at the beginning of the outbreak, in addition to large gathering places such as markets and churches. “The number of infections multiplied because there were not enough ambulances and potential patients had to be transported in unsafe conditions, such as on motorbikes, that did not allow for safe distancing, or in private vehicles that were not properly disinfected afterwards. Doctors Without Borders (MSF) sounded the alarm, but international warnings were not issued until many months later, when thousands were already dead,” he adds.

Years of war that preceded the outbreaks had created healthcare deserts in Liberia. A study by the University of Washington revealed that up to 67% of essential primary care in the country evaporated during and immediately following the epidemic. On June 9, 2016, the World Health Organization declared the end of Liberia’s outbreak. Though the capital had been the worst hit, every one of the country’s 15 counties had registered cases. Thousands survived. Many had sought care in the Ebola treatment center that MSF had built in Monrovia. These are some of their stories.

1. Josephine Karwah: “We had to bury her at night”

Josephine Karwah is an Ebola survivor. She returned home in September 2014, one of the few pregnant people who had been able to defeat the virus. “The neighbors didn’t even want to see me, I was traumatized,” she remembers. When she went into labor, she decided to go to a health center, but wasn’t able to find anyone who would bring her there. “I had my son in the street. No one wanted to help me, even though I had a certificate saying I had been cured. In the end, some women formed a circle around me. My baby was born dead. I returned to my house on foot with him wrapped in a towel.” Karwah lost her parents to Ebola, as well as her nephews and her uncle. Then Salomé, her beloved baby sister, also died. Salomé had worked as a nurse in their parents’ clinic, located an hour by car from Monrovia. She had beaten the virus and located the strength to return to the clinic where she’d watched their parents die, offering her services as a care provider and mental health counselor.

Time found Karwah’s triple role as survivor, health worker and advocate so astounding, it put her on the magazine’s cover. She was named the publication’s person of the year in 2014. Three years later, in February 2017, Salomé died. Three days had passed since she’d given birth to her fourth child, Salomon, when she began to feel poorly. Her husband James immediately brought her to the hospital. She was foaming at the mouth and when they discovered she was an Ebola survivor, no one would attend her. “It took them 45 minutes to admit her, while she was bleeding to death,” Josephine says on the way to the cemetery where her sister is buried. “There were irregularities. And after her death, the case became politicized. The government opened an investigation. The medication my sister needed was not available, that was the conclusion of the investigation. Nobody wanted to touch her or dress her for the funeral, even though her autopsy has been negative for Ebola. We had to bury her at night.”

Karwah breaks down in tears. There has been so much pain, too many ugly stares. Like Salomé, she is a nurse and runs the clinic their parents founded before they died, Karwah’s Memorial Healthcare Center. On a press tour in Amsterdam during which she shared what had happened to her, she received treatment for her eye problems, but she says she continues to lose more of her vision every day. “The stigma continues. Recently I attended a wedding and someone recorded me. You can hear in the video how they refer to me as the Ebola nurse,” she says. Josephine and Salomé's parents are not here, in this small cemetery on the highway to the airport. Like the rest of those who died during the hardest months of the Ebola epidemic, they were cremated. Facing criticism, U.S. agencies bought property on which to bury the dead. Today, their parents’ ashes are there, mixed with those of hundreds of others, along with the corpses of those who were able to be buried. A few miles away at Karwah’s parents’ clinic, a pregnant woman waits to be attended. It’s noon and the sun bakes the building’s aging walls. On them hang posters with recommendations about how to fight Covid and avoid another disease, Lassa fever. Not a single poster addresses Ebola.

2. Zaizay Mulbah: “They told me we wouldn’t live more than five years, but now I’m stronger than ever”

Zaizay Mulbah, 44, was born in Monrovia’s Congo Town neighborhood. He was a very healthy young man, but one day, he found that his eyes appeared to be full of blood. He couldn’t believe it, but he tested positive. He stayed at an in-patient clinic for two weeks, was cured and wanted to help other patients to overcome the virus as part of the MSF psychological support team. He shared his story to demonstrate that Ebola was not a death sentence. “I myself would not be alive if I hadn’t received this kind of support,” he says. Previously, Mulbah participated in Prevail, a research project developed by the United States in collaboration with the Liberian government. “I went every week, then every month and then every trimester. They took my blood, checked my eyes. I also worked there for eight years doing follow-up with other patients,” he says. “What had we learned from Ebola when Covid came? Hygiene protocols. But the Liberian health system is so fragile that if a new disease comes, the disaster will be worse,” he warns.

Today he works as a driver for a state agency that administers petroleum in the central area of Monrovia. He has a spouse and three children. He starts work at 5 a.m. and gets off at 9 p.m., for $350 a month. His wife doesn’t work. He says that physically, he’s better than ever. Today he’s part of the coaching staff of the national volleyball team, a sport of whose federation his father was once president. “They told me we wouldn’t live more than five years, but today I’m stronger than ever,” he says.

3. Musu Kennedy: “It has taken me years to recover from Ebola. I am not afraid”

Ten years without thinking about it, a voluntary memory erasure. Her recollections are so terrifying that Musu Kennedy can’t even cry when she shows a photo in which she appears surrounded by doctors dressed in protective suits at Elwa-3, the center that held up to 250 beds and had been set up by MSF in Monrovia to treat people infected with Ebola.

It was November 2014 and the number of patients and victims had risen into the thousands. In Liberia, 10,212 cases had been confirmed, with 4,573 dead. Kennedy was taking care of 11-year-old Siah as though she was her own daughter. Siah was a unique patient, and Kennedy decided to stay in that hellscape for a few more days after she was declared cured, to care for Siah. The two left together, both negative, and headed to their respective homes. They never saw each other again. “If you find her, tell her that I miss her. I stayed with her back then because she was so young, her parents had died. I knew it, but she didn’t: she never stopped asking for her mother,” says 41-year-old Kennedy, a mother of three children who are now 24, 23 and 13 years old.

Kennedy is now a grandmother, living with her granddaughter in a home to which a skinny dog welcomes visitors, stretching without getting up from a pillow printed with the anime character Doraemon. Talking about Ebola is horrible for Kennedy. She believes that it’s the virus’ fault that she hasn’t been able to have more children. “I began to bleed, I lost my appetite and things started to appear on my skin. When I came home, only my husband supported me.” For the last few months, they’ve lived in a small house near the main highway of the Liberian capital. Kennedy is Christian and her life is the church, she goes every day. “My husband is the pastor, I direct the choir and I’m the mother of the church, I take care of the sick,” she says. She begins to sing in a powerful voice: “What is so hard that God cannot do it for me?” She says that today, she is especially happy. She feels blessed by the visit. “It’s taken me years to recover from Ebola. I am not afraid,” she says.

4. Comfort Paye: “I would like it if the government built medical centers”

Comfort Paye says she was born in 1972. “So, I am 53 years old,” she says in a faint voice. “And yes, I am an Ebola survivor.” While one of her young grandsons plays with a tub of water and another runs around, sucking on the plug of a mobile phone, Paye tells her story. First her sister was infected and died. Then, the baby, and finally, Paye found herself in an isolation center. She took medication and days later was finally able to go home. That’s where another nightmare began: she received word that she had to move. “They discriminated against me and branded me an Ebola victim,” she says.

And now? “Now everyone has forgotten it,” she says. But not her. Paye’s arms and legs still hurt, though she doesn’t go to the doctor because she doesn’t have the money for consultations or medicine. Although she still appears to possess certain fortitude, Paye swears that before the virus, she was a stronger woman. “Not anymore. I would like it if the government built medical centers,” she says. While she speaks, her three grandkids careen about and her husband listens from behind her. Is there a lot of sexism in the community? Paye delivers her answer with her eyes downcast. “Men have more rights,” she says. “If the man makes a decision in a meeting at home, that is the final decision.”

The three children pose proudly for the camera alongside their grandmother. Silence reigns in her community, located 40 minutes by car from downtown Monrovia. It’s mealtime, but no food has been prepared.

5. Beatrice Yardolo: “I was the last survivor of Ebola in Liberia. The government gave me an envelope with $200”

Beatrice Yardolo was an English teacher for 15 years. She was born and raised in Loyee Town, some 233 miles north of Monrovia. Initially, she wanted to be a nurse, but that dream was never fulfilled, in part due to the civil war that ravaged Liberia for nearly two decades until 2003, and in part due to a lack of money.

This morning, like all other mornings since she beat Ebola, her joints hurt. Her aching hands hold two photos, each of a child that the virus took from her, Elaisha and Steve. Her niece Amanda was the first to be infected and die. Then her daughter got sick as well. Little by little, she herself began to feel poorly, experiencing diarrhea and vomiting. Yardolo was admitted to the treatment center between February and March of 2015. “I was the last patient at the center, I was alone and scared,” she remembers.

It’s easier to flee the weapons of war than this invisible enemy

Beatrice Yardolo, survivor

Yardolo was officially the last survivor of the country’s massive outbreak. Like so many others, despite being cured, she later experienced painful rejection from her community. When she returned home, she slept by herself in an isolated room. The neighbors wouldn’t let her touch the water supply. Then the country’s president at the time, Ellen Johnson Sirleaf, appeared at her house. “She gave me an envelope with $200. She was here less than an hour and left,” she says. Yardolo is now 69 and insists that she continues to experience a lot of pain in her hands and legs. “This mortal disease has caused so many problems for families. It’s easier to flee the weapons of war than this invisible enemy,” she says.

6. Jackson Slown: “I experienced a lot of discrimination and lost my job”

“Physically, I’m OK, but I’ve lost my memory. When I got the disease, I was a security guard. Later, I experienced a lot of discrimination and lost my job.” The 58-year-old Jackson Slown also lost his wife to Ebola. He got the disease first. She brought him to the Ebola treatment unit and after she went home, she discovered that she too had been infected. By the time she went back to the center for treatment, it was too late. They brought her straight to the area for the most serious cases. “In fact, we were together in the same place. I thought I recognized her from the patio, and I asked if it was her. A doctor told me it was and that, unfortunately, she had just passed away. I couldn’t even say goodbye,” he says. Slown explains that fear got the best of him when he went home, despite health educators having accompanied him to explain to his community that he was free of the virus and didn’t represent any danger to them. Such was the protocol at the time.

He says the workers hugged him in front of the neighbors and the officials recommended that they burn everything in his home to avoid new infections. “It took a lot for them to accept me,” he says. He remarried in 2017 to a younger woman named Jennet, a 40-year-old who is also an Ebola survivor. To earn a living, Slown grows corn and cassava leaves. He bids goodbye with a final message and a half-smile: “I’m counting on you to let people know that we still need help.”

7. Tony Henry: “We have to learn from history”

Tony Henry, now 49 years old, beat Ebola. Despite that, after being cured he had to leave his home to escape stigma. The father of four children, he was for a time vice-president of a network of Ebola survivors that had 1,668 members. When asked, he’s not shy about his hopes for the future. He wants to build a monument in memory of the victims of the virus, but the Liberian government has ignored his requests, which is why he’s asked non-profits for funding. Henry is a Christian and says he was unafraid even during the worst moments of his illness, because his fate was in the hands of God. He lost his mother and wife and continues to feel pain in his legs.

“Viruses replicate, we don’t know what tomorrow will bring. We have to learn from history. The big difference is that we have a vaccine now, but I’m afraid for the new generations,” he says. The injection interrupts transmission of the virus, which can kill 50% of those it infects, and increases the survival rate for those who were infected before receiving their dose, according to MSF research. Henry points out that the impact of Covid was less severe in Liberia. “We had more experience and had already learned some protocols, like avoiding contact and wearing masks.”

Henry stays in contact with the world through an aging mobile phone. The latest news he read was about the fires in Southern California. He calls Liberia a peaceful country. “It’s easy to live here if you have money, it’s all about having work,” he says.

8. Theophilius Fayieh: “We have to help pay for the education of Ebola orphans”

First it was his friend. Theophilius Fayieh knew it was Ebola, because the man threw up on himself. After accompanying him to the isolation center, Fayieh began to experience his own symptoms. First, he went to the government clinic, where they told him that he was fine. But he knew he was sick. When he arrived on foot to his home, he had a fever of nearly 107 degrees. He tells this story with boundless amounts of energy. Fayieh is an optimist. He beat Ebola, married his girlfriend and became an ambassador for a humanitarian aid organization, International Medical Corps. The immunity he’d acquired even allowed him to assist in births that took place in the center, where no one else dared to touch the placentas of women who had Ebola because they were highly contagious.

“For me, Ebola became an opportunity to work, I was at MSF for seven years,” he says. In 2015, he told his story alongside his wife in a project financed by the European Union, for which they allowed cameras to record their day-to-day lives. Fayieh is now 41 years old and the president of the National Association of Medical Assistants in Liberia. He’s gotten a master’s degree in nutrition and is preparing for a program in public health administration. “We have to help pay for the education of Ebola orphans, because in this country, if you can’t pay for school, you can’t keep going to class. We also have to create programs to fight against diseases like malaria and invest in neo-natal care and pediatrics. Since the MSF pediatric hospital closed two years ago, there’s no free, quality alternative for children. I ask the international community to help build new hospitals.”

9. Watta Jabateh: “I lost my business”

Children of all ages surround Watta Jabateh on a sunny January afternoon in the central area of Monrovia. She emerges from her home barefoot, wearing a black dress. She speaks an English that is hard to understand for foreigners. “Before Ebola visited my family, I worked in an import business,” she says. She traveled to Guinea and Sierra Leone to buy clothes to bring back to Liberia to sell. “When I caught the virus, I lost my business,” she continues. She came home and the 50,000 Liberian dollars ($261) she’d saved up had disappeared.

This was far from the worst thing to befall her during that time. Nine members of her family died, and the neighbors barred her from entering the mosque for months. Like other patients, she says the pain in her eyes and legs caused by Ebola persists.

10. Benetta Coleman: “Around here, nobody knows I’m an Ebola survivor”

Benetta Coleman takes Paracetamol to treat the intense headaches she suffers after having Ebola — when she can find someone to pay for the medicine. Being cured was supposed to mean she could start over, but things haven’t been going well. The 34-year-old earns just $1 a day selling water and ice in the streets of Monrovia. She cares for her eight-year-old daughter, Francia, who is her greatest treasure and whose father is a married man who tried to convince Coleman to get an abortion, and who has never wanted to help them. “They had told me that it was very probable that I wouldn’t be able to have children, so when I became pregnant, I was absolutely sure that I wanted to have my daughter,” she says.

What was it like starting over? “I had lost 15 members of my family to the virus. Soon after I was cured, Atena, an MSF worker, offered me a job. For a few months I worked at Elwa-3 as a social assistant. With the money they paid me, I bought property, but when Ebola was in its final days, MSF handed the center over to the government and I was left without a job or money to develop the land,” Coleman says. Today, she has just one sister, who helps her survive. “Around here,” she says, “no one knows I’m an Ebola survivor.”

She’s one of many patients who had to move because of stigma. Prevail covered her medical expenses for six months. Now Coleman’s main issue is money, as it is for the majority of survivors. The United Nations’ Human Development Index, which measures countries’ progress, has found that Liberians have one of the worst qualities of life in the world: 83.8% of the population lives under the poverty line, which is set at wages of $1.25 a day. “Becoming a mother after the epidemic is the best thing that has happened to me in 10 years,” she says. “My only wish is for someone to help me provide a future for my daughter. I can only put her into school when I get some money.”

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