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The Psychological Fight After Ebola in Liberia

The story of Mawah town

Resilience


Supporting communities to cope with the mental health impact of Ebola

The Psychological Fight After Ebola in Liberia

Mental health|Community|Coping with grief

Liberia mental health ebola

Men and women from the village of Mawah, deep in the Liberian jungle, slowly trickle into the village hall and find a place to sit. 

The villagers get to their feet and begin to move. Singing and dancing is a way of celebrating life in this relatively small community, before they begin the psychosocial support sessions run by International Medical Corps. 

“God should come and heal the land,” they sing, “The land is sick.”

A traumatised town in the jungle

 

An old man, easily in his 70s kicks off his battered worn out shoes and steps into the middle of the floor, pauses, then begins dancing, releasing what seems like months of built up frustration, anger, sadness – who knows, but he looks so happy.

After a minute or so, he walks over to another man, and where once, they may have shaken hands, they now touch elbows – a new practice used by many West African people to exchange greetings since the Ebola outbreak.

Mawah is a town of around 200 people, made up of beautifully constructed mud houses each with its own small garden. Clothes are drying outside laid on the grass, or neatly hung out to dry on the wooden rooftops.

International Medical Corps psychosocial support sessions were developed for those living in the town of Mawah to help them cope with the devastating impact of Ebola which has taken the lives of 39 friends and family within a single month last year.

The spread of the disease was fast and sudden in Mawah

On September 3, 2014 a young man travelled there from Kakata, a nearby town.

“He was sick,” said Victoria Tagbayoung a 34-year-old midwife living in Mawah. It was Victoria who contacted International Medical Corps to ask them for help in supporting her community through the traumatic events of the past few months.

He was travelling to Bong Mines to see his mother, but he had been brought to Mawah because the town has a doctor who can give Liberian medicine. The doctor asked him how long he had been sick, but before he could answer he had collapsed.

“We didn’t know it was Ebola,” said Victoria. “We just heard it on the radio, but it was not really clear to us at all,” she said.

Some people started rubbing medicine on the man, then they carried him to a house and he slept. The next morning he was vomiting, he had a fever and diarrhoea. He was taken back to Bong Mines, to his mother but within hours, he was dead.

Within a day other people in Mawah started to become sick; within two weeks Ebola took the town’s first victim.

Between September 17 and October 10, a little more than three weeks, 39 people from Mawah died from Ebola; only seven of those infected survived.

Mawah was quarantined for almost two months in order to protect those outside the town, but within, the pain and suffering was great.

A million people quarantined

Liberia mental health ebola

More than a million people across Liberia have been quarantined for some period of time during this epidemic. It has been an essential tool in bringing the outbreak under control. Yet the trauma that has come accompanied these quarantines has become evident months later.

Victoria recalls earlier in the week, visiting one of the burial sites on the outskirts of Mawah.

“I’ve not been there since the burial, four months ago. I can’t, I almost cried just now, but I need to be strong, I need to be a strong woman,” said Victoria. “My oldest sister’s two children died in my presence right here…the husband died, my brother died, his own girls died” she said.

Facing grief together

 

Dr. Friederike Feuchte, International Medical Corps’ Mental Health and Psychosocial Director, was one of the first to be alerted to the trauma faced by many in the town when she visited Mawah in December 2014.

“They were very friendly, very open but you could also feel they were somehow stuck,” said Feuchte.

“There’s a lot of broken relationships because of Ebola, there’s a lot of grieving, there are some conflicts, and people are missing, so the social structure is disrupted,” said Feuchte about the situation in Mawah.

“Re-connecting with each other and rebuilding relationships, building trust and finding a way to move on is something that needs time and needs work,” she said.

“We had this workshop where we basically asked people from different communities, ‘What do you really want for your community to help you move on now?’” she said.

The people in Mawah chose counselling as a tool to try and work through the pain.

And so it began

Meetings that started with a handful of women talking about what they wanted for their community have grown into group counselling sessions each Saturday, led by International Medical Corps psychosocial workers and social workers from Bong and Margibi County. This Saturday around 70 people arrive at the town hall, the focal point for community gatherings and setting for the International Medical Corps meetings.

As benches are organised around the large open room, facing the concrete stage, women who have already arrived start clapping and singing, signifying the start of the session.

Our own relatives were afraid of us, our own people neglected us. Then International Medical Corps came to help,” said one man, standing to make himself heard in front of the crowd.

“If Ebola enters in the home, it will destroy the home,” said another man. “We are learning from you people in case Ebola returns,” he added.

Within one breakout group in a nearby schoolhouse, people begin to share their experiences and worries.

“I am afraid, afraid of Ebola. It will get us and kill us,

“We all in Mawah, we are one family. If it happened to one, it happened to everyone. There is so much hurt in our hearts. Ebola has taken everything away,” said one man.

A different woman said she had fled into the forest from the town when Ebola had struck. “I decided to pack my things, take my children and grandchildren and run away into the forest to pray,” she tells the group.

“Why?” asks Garmai A Cyrus, International Medical Corps’ Psychosocial Officer. “Why did you not stay?”

“I am afraid, afraid of Ebola. It will get us and kill us,” she says. Without saying a word, the rest of the class nod in agreement.

Another woman who spoke of her ordeal said she had been so happy because her children had graduated. Now, Ebola has taken her children, she has nothing. She sat and cried. The class fell silent.

One woman spoke of her anger at the friend of her son for not being able to get to him when he was sick. The child was on one side of the river, and the friend would not transport him back because he was afraid of the risk to himself.

Over the next three hours, there are so many stories, stories that couldn’t even be imagined, stories of absolute gut-wrenching sadness and loss.

But the group sessions are not just a chance to talk about Ebola and its effect on the town, they are about forgiveness and working together as a community to overcome the feelings of loss, fear and guilt and move on.

And then there are women who have turned to drugs as a coping mechanism. Some have started drinking heavily.

Never again

Liberia mental health ebola

Victoria had visited the gravesite of a woman who had lost everything. She had lost children, grandchildren and her husband. With no one left, she turned to drink. “She was not sick, nothing of the kind just quite recently, three weeks ago, she just went in bed and just died, died like that,” Victoria recalled.

“No more,” she said. “We cannot afford to allow this to happen again. That is why International Medical Corps is so important to us, to help us get through and stay alive.”

Hope for the future

“They are forever gone,” she said, speaking about the dead.

But Mawah and its people are still there, trying to come to terms with all that has passed and learn to build a future.

“So you must help our people to recover because some of them are still dying in their hearts.”

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