It started in December 2013. A 2-year-old boy in Guinea was running a fever. He was vomiting. There was blood in his stool.
He was most likely "patient zero" — the first case in the Ebola outbreak that swept across West Africa.
At the time, no one knew what had sickened the child. The disease was not identified until March 22. The next day, the World Health Organization announced this grim news on its website: There was an outbreak of Ebola in Guinea. At that time, there were 49 cases and 29 deaths.
The virus raged throughout the year and into 2015, striking thousands in Guinea as well as neighboring Liberia and Sierra Leone. From April 2014 through January 2015, NPR sent 19 reporters, producers and photographers to cover the epidemic. Several made repeat trips.
A year after the WHO announcement, we asked our correspondents to share a moment from their on-the-scene coverage: a powerful, poignant or hopeful scene they witnessed. Here are their memories.
The first Ebola survivor I met, early in the epidemic, was a Guinean doctor. He was the first to recover from the virus in Conakry — Guinea's capital. I was told that probably makes him the first Ebola survivor in a major city anywhere in the world. Age 30, slight and reserved, the doctor told me that those who cared for him in the isolation unit called him and other Ebola survivors the Lazarus cases — risen from the dead, so to speak. He described the hell of isolation and the fear he felt as he realized he was getting better but was still stuck in a tented ward with other sufferers. Then he started helping them. The doctors and nurses called him a hero.
What struck me most was what he told me about his wife — his eyes welling up with tears. The doctor said what really hurt, after going to hell and back, was the stigma that stuck to him and his family like a painful, ugly rash.
Friends, and even some relatives, stayed away and boycotted their home. Neighbors shunned them. People no longer ate his wife's meals or bought the ginger juice she once sold — because he had Ebola.
I quite understood why he didn't want his name used. But he was determined to share his story to help other survivors and their families.
-- Ofeibea Quist-Arcton
It was an odd feeling, stepping into the family home of someone who had died, someone you felt you knew but had never met.
In a lush, green compound, with heavy rain pitter-pattering noisily on the tin roof of the house in Lungi, I was introduced to a frail, 93-year-old former teacher, the father, the grieving but welcoming mother, big brother C-Ray and sisters Mariama and Aissata — all members of the close-knit family of 39-year-old Dr. Sheik Humar Khan, dubbed Sierra Leone's Ebola doctor.
After caring for about 100 Ebola patients, he himself had succumbed to the virus at the end of July. They were still in shock at their loss. They were hurting.
Out came a stack of family photos — a young Humar with his siblings, and Humar's graduation as a doctor.
The memories came tumbling out of his brother and sisters, who proudly described how they supported their "kid brother," as they called him — the ninth of 10 children — as a boy and through medical school, watching him blossom and sharing his dreams as he rose to become Sierra Leone's leading virologist.
Now he was gone. Another Ebola casualty.
But you still felt his presence in the family home, through his siblings who were determined to keep the spirit and memory of their kid brother alive. They told me they'd just set up a fledgling Dr. Sheik Humar Khan Foundation, to help other young doctors from Sierra Leone.
-- Ofeibea Quist-Arcton
There was a moment in my reporting on the Ebola outbreak when I realized that everything had changed.
During my first trip to eastern Sierra Leone in early July the situation was terrible. There weren't ambulances or clinics to handle all the patients. Nurses in Kenema were on strike after several colleagues died of the disease. People were terrified. But the terror was confined to the east. In the capital, Freetown, life went on pretty much as normal.
A few weeks later, in mid-August, I flew back into Freetown.
As the plane started to descend, a wave of tension pulsed through the passengers. The flight attendants were pulling on rubber gloves and surgical masks. Many of the passengers around me started to do the same. Rain pounded the tarmac as we walked toward the arrival hall. All of a sudden Ebola felt as if it were everywhere. Health officials yelled at us to wash our hands at buckets of chlorine water before we entered the airport. Passengers stepped away from each other. Men in masks tried to take our temperatures with thermometer guns without getting close to us. The touts who usually attack your luggage at the baggage claim backed away from me. Ebola terror had set in. Everyone was suspect. What would happen if you brushed up against someone's arm? Could the virus be suspended in the thick tropical air? Was it hiding in the wads of filthy currency that the money changers slapped against their palms?
The outbreak had jumped from being medical to mental. That panic would radiate out from West Africa and dominate the world for months. Fear of Ebola was spreading faster and farther than the virus itself.
-- Jason Beaubien
The baby's cry echoed through the hallway. It was the pathetic, full-throated, long cry of an infant in distress, with a catch and a gulp for air at the end, on repeat. I was at Redemption Hospital, a free, government-run hospital in Liberia's capital of Monrovia. It was mid-August 2014 — still early in the fight against Ebola. Things would get worse before they got better.
A doctor was showing me how the hospital was coping with the virus. He explained that the baby actually wasn't a baby at all. The child was 4 years old and had a spinal condition that kept him tiny. His mother had left him at the hospital a year ago. He lived here now, in this crib in the hospital hallway.
In the room down the hall lay a dead body. All signs pointed to Ebola, but there was no way to confirm it, just as there had been no way to treat it. A team of body collectors moved the man onto a tarp and carried him outside, leaving a pool of liquid on the floor.
The tiny child in the crib in the hallway continued to cry, without hope of comfort or protection from the infection all around him, a reminder that this hospital faced enormous challenges before Ebola came calling and would continue to long after it had gone.
-- Nicole Beemsterboer
On Aug. 20, residents of Monrovia's largest slum, West Point, awoke to find themselves under quarantine. Cut off from friends, families, livelihoods and markets, they reacted with anger.
In the rioting that followed, 16-year-old Shacki Kamara was fatally shot by Liberian security forces. One bullet shattered his shinbone, leaving a gaping hole through his leg.
As he lay bleeding on the street, officers tried to persuade me he had cut himself on razor wire. Some took photos on their mobile phones, and none lifted a finger to help him. Shacki died the next day.
Shacki's aunt told us she had just sent him out to buy food for the house — he was not even part of the protest. The quarantine was lifted shortly afterward.
-- Tommy Trenchard
We were visiting the office of Dr. Bernice Dahn, Liberia's chief medical officer, interviewing her on the nationwide fight against Ebola. Dahn gave us a good estimate of the macro: X number of people are sick, Y have survived, etc.
But it was Dr. Martha Zarway, who just happened to be waiting for a moment with the officer, who gave us a glimpse into what it meant to be on the front lines.
Zarway, who's 53, runs her own clinics in Monrovia. She lost one of her staff members earlier that month, someone she called a friend. Rumor was, Ebola was to blame. When we asked her if she was still practicing despite this loss, she likened herself to an army general in the fight against the disease. "I usually tell my staff, it's scary, but think about a war. [If] all the soldiers run away, what will happen to the civilians? I'm a doctor, so we can't run away."
-- Sami Yenigun
The thump of the ambulance door being kicked closed is what sticks with me all these months later. We had followed the emergency vehicle to a rural suburb of Freetown, Sierra Leone, to observe a health team in action. It had been dispatched to pick up a possible Ebola patient. When we arrived we found a 14-year-old boy in a yellow T-shirt, slumped into a chair outside a simple house.
His parents lived in the interior of the country, and the boy was staying with a guardian so he could attend one of the better schools in the capital. That man had become concerned when the boy complained of a headache and so he called the Ebola hotline. Instead of the evaluation team he expected to arrive to determine if the boy was, in fact, infected, an ambulance showed up.
After donning their moon suits the health workers nudged the young teen — who was all alone — into the back of the ambulance without ever touching him. And they gave that door a kick.
Soon the boy was deposited at an Ebola holding facility where he was surrounded by infected patients.
A day or two later we realized that the name of the boy did not match the name the dispatchers had given to the health workers. The ambulance had gone to the right place but likely picked up the wrong person. And a boy with what was probably just a headache was now quarantined with highly infectious patients.
I can still hear that kick.
-- Peter Breslow
The markets were empty and littered with trash. Dogs slept in the street. Military vehicles patrolled the abandoned roads, and armed guards ran checkpoints at intersections. This was Freetown in September, during the country's three-day Ebola lockdown — or, as the government called it, a three-day "psycho-educational exercise." Sierra Leoneans were told to stay home to reflect and discuss Ebola with family members, while teams of health workers combed the countryside to educate people and search for new cases.
During the quarantine, I saw a ragtag group of health workers going door to door. They had nothing to give people but bars of soap. I was struck by the stark difference between this poorly organized health campaign and the efficiency of the military in a country where the most well stocked division of government is the one with the AK-47s and camouflage trucks.
Health organizations criticized the quarantine. They said it would make people feel persecuted and erode their trust in the government. The government disagreed and said it would slow the spread of the disease.
In the weeks that followed, Ebola continued to ravage.
-- Anders Kelto
When I first saw 15-year-old James Kollie, he was talking up the ladies on staff at the Ebola treatment center in Lofa, Liberia. Impeccably dressed in a stylish Polo shirt and a fresh pair of jeans, his hair was buzzed short, and he had a hand-beaded necklace around his neck.
From a distance, Kollie seemed just like boys here in the U.S. who wanted to impress girls. But when he told me his story, I realized he was the strongest teenager I had ever met.
Kollie grew up in Monrovia with his mother and sisters. When Ebola swept through the city, his entire family got sick. Eventually, he was left alone in his house with his entire family dead.
He didn't know what to do. The only option was to hop in the back of a pickup truck and ride 12 hours to Lofa, where his estranged father lives.
A few days later, Kollie started showing Ebola symptoms. He went into the treatment center. Fought the virus and was discharged.
Now Kollie was moving on with his life, he told me. He was trying to get to know his father, learn English from the staff running the Ebola clinic and make friends in his new hometown.
Standing next to Kollie felt like standing next to a superhero. The young man was immune to a disease the world feared.
But he had a sadness in his heart that I could feel from all Ebola survivors I met. They were all so thankful to be alive. But they had lost so many loved ones.
-- Michaeleen Doucleff
The lifeless fetus was straddling a nurse's arm at ELWA, a hospital for pregnant women outside Monrovia. We were standing in one of the corridors of the courtyard-shaped hospital, interviewing Dr. John Fankhauser. He's one of the family doctors there.
Fankhauser was talking about the high risk that obstetricians and midwives take when delivering babies. "If a pregnant woman shows up and she's bleeding," he said, "how do they know if she has Ebola or not? And if she does, how do the doctors then protect themselves?"
While he was saying all this, dozens of unemotional women sat on benches, waiting their turn for prenatal care. Outside, lots of rain was coming down. Inside, nervous tension filled the air.
Then a nurse walked by us with the dead baby covered in a white sheet. The sheet slipped off her arm a bit, exposing the skull and 10 little fingers and toes. Minutes later, ELWA's midwife boss, Ester Kolleh, explained what had happened. "Last night we received three ladies," she said. "All of them had stillbirth. Now we have three dead babies in the delivery room."
In her story about "Dangerous Deliveries" in the time of Ebola, NPR's Michaeleen Doucleff wrote, "the three women had gone from hospital to hospital in Monrovia. They were turned away at each one. By the time they made it to ELWA, it was too late for their babies."
-- Rolando Arrieta
It was the week before Thanksgiving when we drove from Monrovia into rural Bong County, past the end of the cell service, to the place where a dirt road turned into a walking path. Down the path was an Ebola hot spot where there had been dozens of cases. We were going there with a handful of epidemiologists and doctors in search of one rumored case.
There was a woman who lived somewhere down the path, and local health officials suspected she had Ebola.
The walk took hours. At each village we came to, the epidemiologists asked about the woman. Keep walking, we were told. She lives farther down the path.
Walking, there was a lot of time to imagine what we'd find when we finally found her. What was the plan? What if she were too sick to walk out to the hospital? What if she had already died?
Finally, we arrived in the last village, her village. That, we were told, is her house. That is her room, behind that door. The men from the town stood in a tense circle in front of the house. She's not here, they insisted. Ebola is not here. No one opened the door.
We stood there until the sun began to dip behind the trees. The consensus among the local health officials was that the woman was hiding nearby, but we had run out of time. It would be getting dark soon.
It felt like we had come all that way for nothing. Hiking out, one African Union epidemiologist, Mutaawe Lubogo, was unsurprised and undaunted. He pointed out we knew more than we had this morning, and the people of the villages we visited now had more information about Ebola.
"This is true epidemiology," said Lubogo. "You walk and walk, and tomorrow you do it again."
-- Rebecca Hersher and Kelly McEvers
The good news was what we weren't seeing. Patients.
It was October, and we had come to the northeastern corner of Liberia, to the place where Ebola first crossed the border with Guinea and exploded in Lofa County. We had taken a helicopter ride over thick jungle followed by hours in a four-wheel-drive vehicle to reach the Ebola care center in Foya District.
Three months earlier, this had been a place of fear, exhaustion and death.
Many people were afraid that the health care workers here were bringing Ebola or taking sick people away to sell their organs. So an NGO had been run out of town, and Ebola ambulances were still sometimes pelted with rocks as they arrived in a village.
Doctors and nurses at the center had battled fatigue and dehydration as they worked long shifts in moon suits that amplified the intense heat. And death had become routine. At the peak of the outbreak, more than 125 people were living in an ever-expanding complex of wood-frame cubicles covered by blue tarps. Most of them died.
But that wasn't the scene that greeted us. We did see an ambulance parked near the compound's main gate when we arrived, but it was just waiting for a call. Health care workers were sitting in the shade in plastic chairs, talking and laughing. On the other side of the orange plastic fencing that separated patients from visitors, we could see row after row of empty cubicles.
In a tent that served as the command center, there was a whiteboard listing the name and status of every person in the care center. On this day, the board had just three names. Soon after, the district would be declared Ebola-free.
-- Jon Hamilton
We spotted her sitting in the tall grass by the side of a road in Sierra Leone: a tiny woman, all skin and bones — except for her belly. She looked about eight months pregnant. Neighbors gathered around to explain. An ambulance had unaccountably dumped her there the day before, in the middle of a rainstorm. No one knew her and they were afraid to get too close. But a man who ran one of the roadside stalls tossed her an umbrella. Someone else bought her a sandwich.
We called out from a distance, asking what was wrong. Her gaze was unfocused, her voice barely above a whisper. But she managed to tell us that she'd been feeling sick and had been taken to a hospital to be tested for Ebola. The test came back negative. Instead of trying to figure out what was ailing her, the hospital told her she'd have to go home. Then hospital workers packed her into the ambulance. The driver had pushed her out here — miles from her neighborhood.
We asked her for a cellphone number, or even just the name, of a family member who could help. She didn't seem to understand. Instead, she reached into her bag for a piece of paper and unfolded it with trembling hands. It was the certificate from the hospital confirming her negative Ebola test. "I don't have Ebola," she said.
We kept our distance because we were nervous. NPR photographer David Gilkey took a photo through his telephoto lens and tried to enlarge it on the screen of his camera. Maybe the piece of paper would tell us her address? But the writing was too blurry to make out. Luckily, we were working with journalist Umaru Fofana, who has to be one of the most well-sourced reporters on the planet. In minutes he managed to track down someone from her neighborhood who figured out who she was and alerted her family. Then Umaru shamed the hospital into sending an ambulance to take her home. I hoped it wouldn't be too late.
-- Nurith Aizenman
Mama Quaye, a gracious elderly widow, has run a restaurant on Ashmun Street in downtown Monrovia for more than 30 years. The low-ceilinged, almost empty premises sits opposite a derelict, windowless building -- a relic of Liberia's civil war that was a bank. It is still pockmarked with holes from bullets and mortar shells.
Mama Quaye lived through 14 years of back-to-back civil wars. She, and other Liberians, compare the Ebola epidemic to the war.
But they say Ebola was worse.
Mama Quaye said the war was the first blow against her thriving restaurant business, but she felt Ebola had finished it off.
Few people were popping in at lunchtime for a meal. She showed us an almost full tray of the staple food, fufu, well into the afternoon. Barely any customers.
But one diner gave her some hope. Alfred T. Karngar, who worked across the road, said Mama Quaye's food is tasty, that he ate there before the Ebola crisis and intended to continue eating at her restaurant.
-- Ofeibea Quist-Arcton
In December, I spent a week with producer Sami Yenigun visiting a remote village in northern Liberia. We wanted to find out what life was like now that that area had officially been declared Ebola free. Though it was free of the virus, what we found was not a happy picture. One of the people I will never forget was a woman named Mamuedeh Kanneh. She is the "chairwoman" of the village of Barkedu. Like most people in Barkedu, she speaks Mandingo, but not much English, so our communication at first was tricky.
When I first started photographing her, she held up some green bananas. I didn't understand what she was trying to tell me. Only later did I realize what she was trying to say: That's all she had to eat. She had been married to the village imam. He had four other wives — she calls them her mates. His son was the one who brought Ebola to the town, so essentially her family was ground zero for this outbreak.
She described, at one point, how she was on the floor crying on one side of the room. She had relatives dying and some dead in the room. No one else in the town would come near. They didn't know it was Ebola but they knew it was some terrifying disease. So she's alone in this house with all these little kids, just crying. And she just describes being semiconscious, not knowing what to do. "Should I care for the living or should I care for the dead?" she asked herself.
But she made it through. She survived. And now she takes care of not only the surviving children in the household but kids who were brought to her from other parts of the village, kids who lost their parents to Ebola.
I don't think many people I know would have the resilience to survive and carry on the way Mamuedeh Kanneh has. For me, she came to represent the whole country of Liberia — what it went through and the way it was able to survive this terrible disease.
-- John W. Poole
The pastor's son rolled up both sleeves, revealing fresh scars on his biceps. Twenty-four-year-old James Khanu Jr. had a terrifying story to tell us.
He'd joined his father and another Baptist pastor on what they considered an unremarkable trip. The men were headed to Forecariah, where they had worked as missionaries in years past. But as they began inspecting a well they had helped drill, a rumor began to swirl.
"They are poisoning the water with Ebola!" Khanu recalled a man shouting.
Villagers swarmed the missionaries and forced them into a house, he said. They beat them with sticks and stones and tied them up with rope. An angry crowd torched their shiny new red vehicle and threatened to burn the pastors alive.
One pastor, a Guinean, slipped away. Khanu and his father, from neighboring Sierra Leone, were held all night and forced to drink fetid water from a well the villagers accused them of infecting with Ebola. They were lucky to escape with their lives the next morning.
The missionaries' visit had nothing to do with Ebola. But the virus has stirred fear and suspicion throughout Guinea — and perhaps the pastors misjudged just how combustible that combination can be.
In this environment, rumors and conspiracy theories can ignite violence where friendships might have flourished before. James Khanu Jr.'s welts tell that story for me.
-- Kevin Leahy
People wanted to shake my hand. That was a shock in the new year. In 2014, when I was on assignment in Guinea — the first country to be hit by Ebola — there was no handshaking in a nation where shaking hands is de rigueur. I quickly learned from Guineans other forms of greeting: raising clasped hands or touching my heart. The no-touching rule was scrupulously observed, and buckets of chlorinated water were everywhere to wash hands and boots.
But all that had changed this year. I was shocked to see people openly shaking hands in the capital and in the countryside. There were friendly laughs and looks of "oh yes, we're not supposed to, are we?" when I didn't stretch out my hand in return and reverted to the elbow bump to say hello. Far fewer buckets of diluted bleach water were visible outside buildings of all sorts — and there were far fewer people using the water to wash their hands.
It looked as if complacency was setting in. But a year after Ebola was first identified in Guinea, there is still cause for concern. In the week ending March 15, there were 95 new cases in Guinea and 21 new infections reported in a single day.
-- Ofeibea Quist-Arcton
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