Ebola orphans now face stigma, stress

Of the hundreds of children in Sierra Leone who have lost parents to Ebola, the vast majority have lost both their mother and their father.

Among them is eight-year-old Lamin Borbor, who sits alone beneath the shade of a large, tin-roofed gazebo, playing with a small toy car, outside the Interim Care Centre (ICC) in a quiet neighbourhood of eastern Sierra Leone's Kailahun town.

Borbor is one of more than a dozen orphaned or separated children between the ages of six months and 18 years staying at the ICC, while the Ministry of Social Welfare, Gender and Children's Affairs (MSWGCA), alongside aid agencies, work to trace their families or find alternative family-based care.

"I was brought here because I had nobody to take care of me," Borbor told IRIN. "My parents died of the Ebola virus. but I have no fear [because] the people are taking good care of me at the centre."

Nationwide, more than 3,400 children have been directly affected by the virus, including at least 89 children who have lost one parent and more than 795 who have lost both parents to Ebola, according to the MSWGCA/UNICEF-led Family Tracing and Reunification (FTR) network. There are no accurate figures for the number of separated children, a spokesperson for FTR said.

"Thousands of children have already been affected by the Ebola outbreak, and many children have lost parents and family members, and are now left without appropriate care," said Krista Armstrong, a humanitarian information and communications officer with Save the Children. "And because of the nature of the virus, orphaned children are also at risk of being ostracized from their communities at the most vulnerable time in their lives."

While many West African countries, including Sierra Leone, generally have a strong social network that supports children during times of hardship and need, some of these orphans are facing stigmatization and even rejection.

Many of the children are also experiencing severe stress and fear after having watched the death of a loved one, or perhaps from even having survived the virus themselves.

"When I'm lonely I'll start to think about my mother and sister, and it's very hard for me," said 17-year-old Bridgette Alpha, whose mother, a nurse, and older sister, died from Ebola. Her father died four years ago. "I'm always in constant fear. I'm afraid to sleep at night," she said.

Authorities say they are doing everything possible to reunite these children with relatives, but that isn't always possible.

"It can be hard sometimes to trace their roots," said Amy Richmond, a child protection specialist with Save the Children. "There are children that go into the ETUs [Ebola Treatment Units], who survive and come out, but now they are in big cities, hours from their village, and their parents have passed [away] and they don't actually know where they came from or are afraid to talk."

The latest data from a 12 November FTR survey found that at least 520 children have now received psychosocial support services in Sierra Leone and 200 have been either reunited with their families or placed in foster care, in accordance with the international Guidelines for the Alternative Care of Children.

For those children whose families can't be immediately located, they are temporarily sent to an ICC, such as the one in Kailahun, where trained caregivers provide them with a safe place to stay, along with psychosocial support, until they can be reunited with their extended families.

"The centre is really good and I'm always having good encouragement," Alpha said. "If I'm sad, the caretakers will call me and talk with me."

For the moment, this ICC, which is run by the government and funded by partners such as Save the Children and UNICEF, is the only one of its kind in Kailahun. A second ICC for children affected by Ebola opened earlier this month in Port Loko.

Some children stay just a few days at the ICC, others a few weeks.

"Life in the centre is quite different from what I am used to," said 14-year-old Fatu Falma, who lost her father and grandmother to Ebola. Her mother is still sick in the treatment centre. "But I eat good food. and the people talk to me very nicely. I normally spend most of my day playing with the toys and games with the other children here."

Under surveillance

Like many of the children who have been in contact with an Ebola case, but are not showing any symptoms of the virus, Falma is under a 21-day surveillance. Caregivers - many of whom are survivors themselves - check the temperatures of the children each morning and monitor them closely for the first signs of sickness. They also give them the attention and affection that many others are too afraid to.

"I want to be with someone like my mother who can take care of me but she's very sick. I don't know if I can see her again"

Fanta Lavaly is one such volunteer. She has been working in the Kailahun ICC since she recovered from Ebola in September.

"It's not easy for these young kids to lose their loved ones so early," she said. Most of them saw their parents die. Others are too young to know. But for all of them, seeing someone that cares for them, plays with them and talks with them, is all they need."

To help regain a sense of normalcy and routine, the centre offers the children a space to play and coordinates recreational and social activities.

"Particularly the toys, they can help distract them and not think too much about their lost families," said Sailfulai Bah, the coordinator of Sierra Leone's Ministry of Social Welfare in Kailahun District. "It can help reduce their frustrations and also have a positive psychological impact."

Bah said they are now looking to employ teachers to give lessons during the day to the school-aged children.

If, and when, a child's extended family are located and they are declared Ebola negative, aid agencies help to reintegrate the children into their new homes and communities. Families are debriefed on how to work with and care for a child who has experienced a distressing event, like Ebola.

Those children that are sent to live with extended families are given social welfare assistance and provided with reintegration kits, including household items, such as a mattress, bedding, small food items, clothes and dishes to help ease the burden of taking in an extra child during, what is for many families now, an already difficult time.

No international adoption - for now

For now, international adoption is not being considered as an option for those children whose families can't be located, according to Matthew Dalling, a chief child protection officer for UNICEF in Sierra Leone.

"The Ministry doesn't have the capacity to do [international] adoption investigations and it's a risky endeavour," he said. "So right now we're focusing our efforts on family tracing and foster care."

For those children at the ICC who need a place to stay longer-term, while waiting for foster care placement or local adoption, Plan International is now constructing a boarding home in Kailahun.

The children, however, while very appreciative of such centres, say they just want to go home.

"I like the centre because everything here makes me feel not so lonely," said 11-year-old Augustine Turay, whose father died from Ebola and whose mother is being treated for the virus. "But I want to see my friends and other relatives I used to play with. And I want to be with someone like my mother who can take care of me. but she's very sick. I don't know if I can see her again."