The Life of a Liberian Child with Ebola

UNICEF’s Chief of Crisis Communications chronicles six weeks in the life of a 5-year-old on the brink of Ebola.

Additional reporting by Cody Shane Griggers in Monrovia

She called herself the “boss lady” and despite his name, her big brother, Sheriff, 11, didn’t doubt it. Anne Marie had an uncommon feistiness for a five-year-old, especially for one who had just lost her mother to Ebola, or so they said. Her father’s fate was unknown, although the caregivers at Hawa Massaquoi community care center outside Monrovia whispered discreetly that he too had probably succumbed to the deadly disease, like thousands of his fellow Liberians.

The children were on the brink of orphanhood – about to join the 4,000-plus Ebola orphans UNICEF estimates there are now in the three affected countries: Liberia, Sierra Leone and Guinea. In total, WHO estimates that 13,500 have been infected and 5,000 have died, but all agree that the actual figures are at least two or three times higher.

In the chaos and fog of this war against an unseen enemy, the three children – Sheriff, Anne Marie and their baby-sister, Agnes – had been separated from their parents. Their small, tightknit community in Banjor, near Monrovia, had been utterly besieged by Ebola; 20 people had died there in late August alone.

In early September, Anne Marie’s mother, Haja Kromah, was the first in the family to fall ill and was taken to the Ebola Treatment Unit (ETU) run by Medecins Sans Frontieres (MSF, also known as Doctors without Borders) on the outskirts of Monrovia. Soon after, Anne Marie’s father, Solomon Sandee, weakened by high fever and other dreaded signs, took himself off to another Ebola Treatment Unit at JFK Hospital, miles away from his wife. With no one to care for them, the children went along too. They were tested but were not sick, so they were sent to Hawa Massaquoi, the government-run children’s center supported by UNICEF. Ironically, it had once been used for “war orphans” – children who had lost or been separated from their parents during the long and bloody civil war that claimed the lives of many thousands of Liberians. The abandoned barracks of the Liberian Army lay just beyond in the tropical thicket. Now the center was being used for “Ebola orphans” – lost children, shunned children, distressed children.

There it was, Liberia in one center – the country had gone from fighting a real war to a biological war with few foot soldiers.

And there we found the Sandee children in the company of others like themselves. During August and September, UNICEF had helped 700 children find a parent or extended family or placed a child in foster care. There was Anne Marie’s baby sister, Agnes, who had wrapped herself as if in a permanent clutch, clinging to the back of her caregiver Mamie Harris, 33, who loved and cared for her like her own, although she already had six of her own. Even her brother, Sheriff, who tried to pick her up to cuddle her, was pushed away with a firm “no” and a shriek.

Anne Marie was in her element, jabbering away in heavily accented Liberian English, the center of attention. I was with a reporter, Lenny Bernstein, whom she had caught in her sights. We could make out what she said cheekily in response to his questions. “I na understan ya,” she said. “It’s because I’m a big American,” Lenny replied. “I want to go America,” said Anne Marie. Just five years old, with no television and no idea about what that meant, still, she had a line and she was sticking to it.

She toddled off to the playground, still jabbering to herself, evoking giggles from the Hawa staff. She picked up a corner of a cyan-blue UNICEF sticker and stuck it over her mouth. “Why are you doing that?“ I asked. “That’s what the doctors did,” she said. Bored, she dropped the sticker, and another child picked it up and copied her.

“So what do you know about Ebola?” I ventured. “I want Ebola to leave Liberia, so I can go to school,” came the snappy retort deciphered by locals.

We left Hawa knowing the children were at least in good hands: well-fed, well-clothed. They slept in pretty rooms, under mosquito bed-nets, heavy with chlorine-scented air; had regular activities; and had their temperatures tested twice a day. They washed their hands methodically under the vigilant eye of Fatu. But they were troubled, bored, and wanted to go home again – whatever and wherever that may be now in their lost lives.

A few days later came the news that sent ice through my veins – Anne Marie the sassy, Anne Marie the invincible – had Ebola symptoms. The caregiver Fatu had acted fast – the temperature reading on the Thursday night was high. Anne Marie had stomach pains and a rash. The dreaded telltale signs were all there. Anne Marie was isolated in a separate room away from the others overnight. The next day Friday, Fatu was anxious. The ambulance came and took her to the Ebola Treatment Unit at ELWA.

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It was the very day her father, Solomon, was discharged from the ETU. Anne Marie had found and lost her father on the same day.

By Sunday, the worst was confirmed. I phoned the father, who now had his phone back, since he was out. “I’m so sorry,” I said. “How is Anne Marie? Is she being well cared for?” “Hold on,” he said, “I’ll pass you to the mother.” I nearly fell off my chair. So she’s not an orphan. That’s great, but she still has Ebola.

The next day I spoke to Lenny, the reporter. He asked if he should be tested. No, I said. Anne Marie wasn’t showing symptoms when we were there. We didn’t touch her, and there were no body fluids involved.

Solomon had been contacted by MSF, to ask if he or the mother could help care for Anne Marie at the ETU. As survivors, both had a level of resistance; also, they knew what it was like to be on death’s door, and could do what only a parent could. Her mother was still weak and had baby Agnes to care for. So from then on, Solomon spent most days and many nights by Anne Marie’s side, feeding and caring for her.

Every few days, I phoned him and checked on how she was doing. Every few nights, I awoke, willing her in the dark, unsettling hours to be well, convincing myself that her own spirit would get her through. I dug deep into my Irish Catholic roots and prayed; I called upon my journalistic instincts and made up the story in my head but with a little Pollyanna twist. I had created an image of Anne Marie in my head, happy and well. All I needed was the photo and the facts. Another ending didn’t bear thinking about. I had to have something to hold onto after all the horrors I had seen every day for five weeks in Liberia.

The words came first. On Wednesday, October 1, Solomon told me on the phone, “Thank God, Anne Marie is not toileting” (Liberian English for diarrhea, one of the many severe symptoms of Ebola). “They say she can come home soon.”

I had to have proof. So on October 3, my very last day in Liberia, on the way to the airport I passed the Ebola Treatment Unit and called him again. He was home, and so was Anne Marie. I spoke to her. She gurgled happily. I didn’t know, I didn’t care what she said.

It was the voice of an angel, but I wanted the face, the photos, the video of the family. My colleagues in Monrovia obliged. They went to Banjor, to the home of the Sandee family, and filmed the three of them with their survivors’ discharge certificates. The parents had seen the other side but now they had their “new birth certificates,” as they called them. Solomon was trying to get his job and his life back. And Sherriff and baby Agnes had passed the 21 days incubation period, proving they had not contracted Ebola.

Anne Marie embodies so much of Liberia, the Lone Star state that has become synonymous with a virus rather than its resilience, its image in the world a hazmat suit, burial boys, the sick dying an utterly undignified death outside the closed gates of a place of healing, a hospital.

Her giggles, her beautiful beaming face – Anne Marie would be my Ebola poster child. She would be my “boss lady,” daring the world to look at her, look away from the horror, and to imagine there is no Ebola, that Ebola had left Liberia so she could go back to school. It was a look that said: Bring on the future.

Sarah Crowe is the chief of crisis communications for UNICEF, based in New York. UNICEF estimates that at least 3,700 children have lost one or both parents to Ebola in the three affected countries. To watch Sarah Crowe in a panel discussion about Ebola at Women in the World Texas on October 22, click here.