James and his siblings pass their quarantine in a UNICEF-supported OICC, under the care of survivors like OICC manager Alfred Pujeh (left).

Surviving together, in Ebola-hit Sierra Leone

UNICEF’s Observational Interim Care Centres provide new hope for children under quarantine and a new mission for the Ebola survivors who serve in them.

FREETOWN, Sierra Leone, 3 March 2015 – Picturesque mountains and lush greenery adorn the fields surrounding the Observational Interim Care Centre (OICC) in which James Kamara* and his six siblings pass day 18 of their quarantine. A soft breeze flows through the bright yellow building, carrying the laughter of children.

These children are under supervision for having potentially come into contact with Ebola. Here, they pass their quarantine playing with carers who interact with the children without the benefit of partitions or personal protective equipment (PPE) suits. The reason? All 12 of the staff here are, themselves, Ebola survivors.

Care for vulnerable children

James, who is 13 years old, lost his father, uncle and three brothers to Ebola. The emotional scars are fresh.

“Ebola has affected the lives of children in my community, especially my household,” James says. “We have lost our relatives, and we couldn’t play freely anymore. We felt discriminated against because other people didn’t allow us to get close to them. They even refused to help us fetch water.”

To help care for children like James, the Sierra Leone Ministry of Social Welfare, Gender and Children’s Affairs (MSWGCA), with support from UNICEF, has established OICCs.

The purpose of the OICCs is to provide care and protection for children who have been in close contact with a parent, caregiver or a relative infected with the Ebola virus, who do not exhibit symptoms and who do not have any other family members available to look after them. The OICCs care for 20–25 children at a time. The children stay for a surveillance period of 21 days. They are monitored so that any sign of Ebola can be detected early and, in the event that symptoms develop, they can be referred immediately for appropriate care.

Teams also seek to trace extended families or identify a caregiver with whom the child can be placed at the end of the quarantine period. If a solution is not found, then Interim Care Centres (ICCs) can be a safe place for children awaiting a longer-term outcome.

The OICC is guided by the principle that family preservation and reintegration must be the first priority at all times. If it is not possible, then kinship care or foster care can be options.

A supportive – and protective – environment

“We are cared for well at the centre,” says James. “Our caregivers feed us well and talk to us when we feel sad.”

Fourteen OICCs are currently in operation, covering 12 districts, with a total capacity of 275 beds. Since the start of the emergency, 407 children have been cared for at UNICEF-supported OICCs.

“’Contact children’ need special care and support during this quarantine period,” says Matthew Dalling, UNICEF Child Protection Chief. “Imagine if you were a child whose loved ones died, you are discriminated against and living in fear of getting sick or dying?

“The OICCs help prevent unnecessary infection risks while promoting a safe and protective environment, minimizing abuse risks, reducing trauma and promoting resiliency among Ebola-affected children,” he continues. “[E]xposed children used to accompany their symptomatic caregivers for treatment, putting them at a high risk of contracting Ebola. The OICCs have taken away this unnecessary risk.”

Ebola develops more rapidly and with a worse outcome in children, especially among children under 5, who are not able to communicate their symptoms. Most OICCs are located within close proximity to an Ebola Treatment Centre or Holding Centre to facilitate rapid transfer of children displaying symptoms.

A ‘family’ of survivors

Alfred Pujeh manages the OICC in which James and his siblings have resided these three weeks. He lost 11 family members and is, himself, a survivor of Ebola. He has considerable empathy for the children under his care.

Alfred answered the call for survivors to take part in eradicating Ebola. He considers his work and the work of other survivors who act as nurses, caregivers, cooks, cleaners and security personnel to be important in helping to contain the virus.

“If it were not for this centre, we will lose more children to Ebola,” he says. “Once, we had four children from the same family. Two of them tested positive. We immediately isolated them and so the two remaining children were not infected.”

Kadie Panda, a caregiver at the centre, lost nine family members to the disease. She, herself, contracted Ebola while looking after for her sick mother, who eventually passed away. Kadie cares for the children in the centre in the same loving way she cares for her own.

Every morning, she checks all the children for symptoms of Ebola and alerts the nurse if any of them become sick. She bathes and feeds them, and observes their interaction with other children to see if they need comfort and attention.

“When I see children who are sad, I tell them: Don’t allow yourself to get depressed and get sick. We have gone through this same situation, and we survived. We will care for you and advocate for your needs to be taken care of,” Kadie says.

Time to go home

In three days, James and his brothers and sisters will be brought back to their village. James is excited to go home and says he misses his family, and he misses helping out on the farm. He has big dreams for his future, and so he is also looking forward to going back to school.

“I want to go back to school because education is important and it could help you achieve your dreams,” he says.

And what are his dreams? “I want to become president of Sierra Leone. If I become president, I will rule the country well, educate every child and care for children without parents.”

*Names of the children have been changed to protect their identities.

By Marge Francia
UNICEF Sierra Leone