By Helena Humphrey, IFRC

“Little by little, men dressed in white suits invaded my dreams,” explains Antoine Kovana Kolié, the former nurse from Conakry turned Safe and Dignified Burial team leader for the Red Cross, recalling the nightmares which began to plague him months after he arrived in Guinea’s forest land, the epicentre of the Ebola epidemic. He rubs his eyes as he remembers the sleepless nights, deprived of the rest that he desperately needed to get through the most testing of days, burying up to 12 bodies a day, young and old alike, struck down by the Ebola virus disease.

“The first nightmare came after a community burial I will never forget,” he says, pausing as he puts into words memories which are clearly difficult to revisit. “The Red Cross had been called because there had been a death from suspected Ebola in a village. When I arrived, I saw a little girl asleep on the ground. But then I realized that she was not sleeping. It was as if the disease had struck her down,” he bangs the table with his hand, “right where she should be playing. That’s when I realized how merciless this disease is. Even an innocent little girl could not escape.”

A little white lie

A husband and father of two children, Antoine’s thoughts turned to his own family, which he had left to fight the epidemic. “I had the choice whether or not to go, but I couldn’t bear to see my own population destroyed. I admit that I didn’t tell my wife what I was going to do. I said I was going to hand out soap and chlorine.” It was a white lie that would not stand up for long. “She worked it out,” he laughs, and when his interrupted sleep made his working days even more challenging, it was Antoine’s wife who was his first confidante. “I had been asking myself, why is this happening? Was it because I was burying the dead when it is traditionally the family’s role? Were their ancestors angry with me?”

It was then that his colleagues at the International Federation of Red Cross and Red Crescent Societies (IFRC), with his wife’s persuasion, convinced Antoine that he needed some time out to get better.

By the time Antoine took a much needed break six months after he had arrived on the ground, he had supervised almost 80 per cent of safe and dignified burials in the region.

Psychosocial support mitigates long term effects

“Psychological stress from carrying out burials is not surprising, and does need dealing with,” explains Babacar Sanoko, clinical psychologist and IFRC’s psychosocial support delegate for the Ebola response in Guinea. “Nightmares are a response to trauma, and the mind’s way of processing difficult things it has witnessed. But if this trauma is not dealt with within three months, it can turn into post-traumatic stress syndrome.” Babacar, as one of the architects of IFRC’s psychosocial support response, has trained Red Cross volunteers in the three main affected countries, so they can train their fellow volunteers to look after the mental well-being of their colleagues and compatriots. To date, over 78,000 people have received psychosocial support. “Whether it is being there for someone who has lost a loved one to Ebola, has a sick family member, or is being monitored after coming into contact with someone who has Ebola, listening is vital to mitigating the long term effects of this outbreak,” explains Babacar, adding that treatment can take different forms.

For Antoine the first port of call was a local, well-known traditional healer in Conakry. “When I walked into his house I saw candles burned to the ground. I could see he had been working all night to prepare for our meeting, but I didn’t know what to expect.” Laid out on the table for Antoine, a bowl of perfumed water filled with leaves. “The healer then just added a few final drops of liquid from various little bottles, swirled the mixture together and told me to wash myself with the water. As I did, he told me to talk about everything that was wrong.”

Better, but no time to sleep easy

Antoine admits he was a little dubious and made a conscious decision to suspend disbelief. “I had to give it a go, so I spoke about whatever came to mind – my nightmares of being surrounded by men dressed in white, that little girl, the bodies we found decomposing by the borders with Sierra Leone and Liberia, unidentified people seeking care, those we had to bury where we found them, in the presence of the authorities.” Five out of seven sessions later, Antoine reports that his sleep is no longer disturbed by visions of men in white suits, and that once he has finished his treatment he plans to return to the forest area and continue his work. “I am too engaged to give up this fight and my body and soul are well again,” he says.

Antoine’s night traumas may have come to an end, but Ebola means that for many, this is not a time to sleep easy. “Like lots of Guineans, I worry. Our schools were closed for many months, there are food shortages, hospitals have been put under such strain by this disease. I know we will banish Ebola from our land, but I also wonder, what then for Guinea?”