Q: Can you tell me about your particular role in how you looked at the training of nurses?

JFS: When the numbers of infected cases started increasing, Dr. Khan, together with Tulane University and Metabiota, brought training to Kenema Government Hospital for all medical superintendents and matrons all over the country. We did the training for two days. But my boss, she was a bit older than me, the senior head nurse in charge, said, “No, no, Dr. Khan, I am a bit older, Josephine is a bit younger than me. Let her go and do the training.” That’s how she pushed me into it now, but because it’s my job, I am a nurse, and this is a new disease that has shown face in Sierra Leone, the curiosity made me want to know more. I decided to go for the training.

Q: What about the other nurses?

JFS: Yes, volunteer nurses came onboard. I had twenty-one of them initially. I still have their names in my computer, the twenty-one nurses who volunteered, and they were not on salary.

Q: Volunteer nurses. You volunteered. You got other nurses to volunteer to do this.

JFS: Well, I was on salary, but the government was not paying us extra for what we were doing. Well, the same volunteers, some of them became infected, and started dying like this, [snaps] dying, dying, dying. Before we could say one week, two weeks, three weeks, one month, we’ve lost about eight of them.

Q: Eight of them.

JFS: And so it was scary. And my own people started calling me from Freetown. Leave that environment. Leave the environment. Nurses have started dying. What are you doing there? Leave this environment. And once I did, I switched my number so that l would not receive calls from anybody, because the passion—when you go to the units, before you enter the units, you hear patients crying, “Nurse, nurse, water, water, water,” calling for water, and so that sound was the one that really moved me. I said, if we don’t go and give them water, who will go and give them water? So I started wearing PPE. I said come, let’s wear PPE, and that was the time now I started wearing PPE. Take the nurses together. We go in. We give them water. We mix ORS [oral rehydration salts] in containers, put them in the ward, encourage them to drink. You meet people dying, more than fifteen, sixteen, seventeen. Sometimes I don’t like to recall. It was terrible by day, you know?

WHO was on the ground, but they were not really active. They would just come take photos, go for EOC [environment of care] meetings. That was the time I refused to go to an EOC meeting. I said I will not go to an EOC meeting to explain how many people have died. Other people are still suffering over there.

It was like that, until when Dr. Khan now became infected, and he came to the hospital in the morning and said, “Josephine, I’m not well. I’m not well. I’m not feeling myself. So please make sure you take care of those that are here for now, the patients that are in the ward.” And then he called one of our nurses, Tamba, asking to have treatment at home. Tamba took some drugs, malaria treatment, and went to give him treatment. But the day after they collected the sample, immediately somebody called me from the lab to say, “Oh, my sister, Dr. Khan has been proven positive.” I said, “What? Dr. Khan positive?” She said, “Yes, but we have decided to take him to Kailahun.” I said, “Why to Kailahun? Can’t we manage him here?” They said, “No. The entire team—Metabiota, Tulane University—they have decided—” By then, MSF [Médecins Sans Frontières] had established their own Ebola center in Kailahun district, and we were in Kenema.

They took Dr. Khan to Kailahun. They took him on Wednesday evening. In the morning hours, we sent some nurses there with jelly, coconut jelly. You know jelly? Coconuts, the younger coconut, you know, it has a lot of fruit inside. We call it jelly, it was a supplement we used to give. You know, we just used to give an antibiotic, but for Dr. Kahn we added fluid. We opened two IV lines, set up a drip, and gave the coconut jelly water. The three first survivors from our unit survived with the jelly water, and so it was now part of what we do. We brought some of this jelly and then had two nurses bring the jelly water for Dr. Khan in Kailahun. That was a Thursday. Friday, I went there to see him.

I went to the unit, the MSF Ebola treatment center. I went there, and they made provision for me to go to the visitors’ area. He was sitting in a rubber chair, and the IV fluid was hung on him. The drip was turning. Immediately, he saw me, he started crying. He started crying, and tears were coming from his eyes. And I said, “Doctor, it’s okay. Dr. Khan, it is well. Don’t cry, doctor. Don’t cry.” And I also started crying. Then the white lady that was there, MSF, the white doctor said, “No, don’t cry. If he’s crying, you are crying, so it’s okay, now you’ve said greetings, you can go now.” And so I left. I left on Friday. Saturday, Sunday, Monday, and then he passed away.

[pause] After his death , it was so hard—this was somebody that had been giving us courage, somebody that had been talking to us, you know? And then he lost his life. I am just a nurse. If that man has died with all the expertise in community, hospital protocol, hemorrhagic fevers, he’s the only expert, and now he’s dead.

I said, I’m going to leave this job. I’m going home. I will no longer work here. I’m going home. I went home crying. I cried for the rest of the day. Then, at night again they called me. “Matron, Matron, Nurse So-so is dead.” “I know that nurse. I know that nurse,” I said. “What can I do?” You know? And I said I will not go there, but when they called me, I went there again. I went there.

Q: How did you think about explaining this to the community? Were nurses active in teaching the community about what Ebola was, or how to prevent it, or come in for treatment?

JFS: When the thing started creating serious alarm, I was mainly in the management treatment center, and the social mobilization team, those are the nurses and other health workers, CHOs [community health officers], they used to go out and do sensitization. But the community people were not convinced about Ebola, initially. In fact, one time a mad woman came to the marketplace and started shouting, “There’s no Ebola! There’s no Ebola! These nurses and health workers are liars! I am a nurse!” And she started saying that she’s a nurse. “It’s just cannibalism. I am a nurse. I am a nurse. There is no Ebola. It is just cannibalism they want to do. It is just cannibalism they want to do.” And the whole market went into chaos, and they say, “Oh, you are talking it. We are saying it, that there is no Ebola. A nurse is confessing! Witchcraft! Witchcraft!”

And so the whole village converged to go and burn the hospital, the Kenema Government Hospital. When they came there, we are storming off, we are hiding, finding place to hide ourselves. They said they want to burn down the hospital. They want to kill every nurse—they were saying, “You kill one nurse, we give you one thousand. You kill one—” If anybody kills one nurse, they will give that person one thousand, because we are lying that Ebola is real, and Ebola—somebody has confessed from our group that there is no Ebola. The police, the military now came and dispersed them. They used teargas. It was terrifying.

Q: So what would you do differently? What would you want to do if you were given the power to make new policy? What would you want nurses to do?

JFS: I would start with the policymakers and their failure to recognize what the nurses have done.

If those that are up there can really do some form of capacity-building for our nurses. It’s only now that nurses have started getting masters, first degree. Initially in Sierra Leone it was just nursing assistants, community health nurses, RN [registered nurse], and that’s the end. And that’s the end. Midwifery – not everyone will go for midwifery – and that’s the end. But if you have that capacity, if they can try to build up a new curriculum, improving the nursing standard, you understand, that will help us.

Because of my training I knew what hemorrhagic fevers meant. That’s why I took my own money to make a scrub for myself, to buy boots for myself, to cut my hair, because my hair was long, in dreads. I don’t want to infect myself going into the Ebola units. Sometimes I was in an Ebola treatment center for one hour, and I didn’t know what I would contact, so I decided, let me cut my hair. I called the barber and my hair was cut. I did it because the knowledge is there, that’s why. That’s wanted. If we can improve, build on our capacity, nurses in this country, that’s when we can help for any subsequent outbreak.

And for we nurses, we should not just say, “I’ve done my certificate. I think I’m okay.” If you have the will, you say, “No, I’m going to improve myself.” I started nursing as a nursing aide, nursing assistant, and I’ve gone to this level now with a Master’s in Public Health, because I have the determination. I want to go forward. I want to learn more. I want to know more. I want to know, you know? So for the nurses, now, let them also have that initiative and say now, “Let me try to develop myself.”

The other thing is for policy makers. Let’s say somebody has done something good, to see just a tap on your back. Like me, with all what I went through, nobody recognized me in Sierra Leone. The government didn’t recognize me. My senior authorities, nobody recognized me. Instead, the boss—and I’m going to say it, and it’s on tape, and I am saying it. I told Dr. Shephard, “With all what I did, sacrificing myself and my family, after that, the then-outgoing Chief Nursing Officer, instead of giving me a tap on my back to say, ‘Josephine, thank you for what you have done,’ she took me from where I was and sent me to the most remote area Kailahun District. I had to walk on foot. I had to bike to go to where I am supposed to work.

Instead of her just saying, “Okay, you’ve done more than what we are expecting, now you can go to Freetown, now you can go to a better facility,” she took me to the most remote facility. And I suffered there a lot.” [crying] Our elders, those ahead of us, they should recognize us. As nurses, we are doing a great job, but we are not recognized. We are not recognized. We are not recognized. We are not recognized. Not a single recognition was given to me. It was only when The New York Times came and did a story with me, and then I had also some few guys came from Diaspora Focus [phonetic]—I came with this purposely to show you. [shuffling papers]

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Josephine Finda Sellu was interviewed for Frontline Nurses by Jennifer Dohrn on August 13, 2019 in Freetown, Sierra Leone.

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