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The tiny African nation of Sierra Leone with a population of about six million has been at war off and on since the early '90s. Between 1991 and 2002, a civil war raged in the country before U.N. peacekeepers helped restore order. By 2005, a period of calm ensued with peaceful elections taking place and a rebuilding process beginning.
But things changed again on May 24, 2014, when the first case of Ebola, a virus that takes no sides, was reported.
As of October 2015, the Centers for Disease Control and Prevention reported 8,704 laboratory-confirmed cases of Ebola in Sierra Leone resulting in 3,955 deaths. The number of suspected cases is actually closer to 14,000 but not all have been verified in the lab.
Serving on the front lines in this new war is SAMUEL DILITO TURAY, MEd, MPH’11, a policy analyst in the office of the chief of staff in the office of the president. On the weekends, Turay battles the epidemic as part of Hands For Life, an organization he started in 2010.
How Turay found himself in this situation is the luck of the draw, literally. One day in 2005, Turay went to an Internet café to check his mail and met a group of guys playing the Diversity Visa lottery—a chance to get a visa to the U.S.
"I had a good job. I didn’t think I needed to go anywhere. But I thought, let me give it a try," Turay recalled. "I played, and we won as a family."
Despite having a 2003 master's degree in education from Njala University, Turay had a bit of culture shock when he brought his family to the U.S. In Sierra Leone, he had an office, a driver, and a cleaner and a maid at home. Now, he had to start from scratch. About a month into his stay, he wanted to go home but found out that the university where he worked had already replaced him.
Seeing the need to go back to school, Turay desired to study public health with health policy because none of the universities in Sierra Leone offered it. He enrolled in the program at USciences in 2008 and emerged with his MPH in 2011. AMY JESSOP, MPH, PhD, associate professor of health policy and public health, helped Turay secure a job with the African Family Health Organization in Philadelphia as coordinator of health programs' for African and Caribbean immigrants in Philadelphia.
Prior to getting his MPH, Turay went on vacation to Kamakwie, the town where he was born. Again it was a chance encounter that would lead Turay on another track. A trip to a private hospital for allergy medicine, opened his eyes to the appalling fate of sick women and children who didn't have enough money to pay for medicine and care.
"Unable to afford the cost, they turn their back to go home to continue suffering and await the sting of death, which was certain in most cases," he said. On the spot, Turay told the dispensary/ pharmacy staff that he would pay for the medicines of sick women and children. He discussed the proposal with the hospital administrator and got his approval, handing over the local currency equivalent of about $200. This was to continue even when he returned to the U.S.
The country does offer free healthcare for pregnant women and children under 5 years of age, but the services are only available in government-assisted institutions, and the KamaKwie hospital is not one.
After returning to the U.S., Turay shared that experience with ROSEMARIE HALT P'89, MPH'12, a member of the USciences alumni board of directors and a classmate, and Dr. Jessop who suggested he put a proposal together for funding instead of doing it himself.
"I learned of his savings and collection of funds from others, which he sent to his home village of Kamakwie," Dr. Jessop said. "He had set up a system of sending funds to the hospital administrator there that could be used to cover cost of care for maternal/child health medical issues if the family was unable to pay. I wanted to help fund these efforts and believed others would as well. To encourage support, we discussed establishing his efforts as a registered nonprofit entity."
Turay also received support from RUTH SCHEMM, EdD, a recently retired professor of health policy and public health, and CLAUDIA PARVANTA, PhD, chair of the Department of Behavioral and Social Sciences, who would help to set up a crowdfunding page through CrowdRise that has raised over $6,000.
"Samuel is a gifted leader who is dedicated to helping his country," Dr. Schemm said. "He is creative and always trying to find ways to connect people in need to resources."
Out of these efforts, Hands For Life-Sierra Leone was born.
"There was the desire to go back home," Turay said. "What I wanted to do was something that I could not do here. The only place to do it was over there and that was to help people in need access healthcare. The other one was a bit of passion. I wanted to be close to my [extended] family because of my standing within the family structure."
By 2014 and with the help of his MPH, Turay landed in Sierra Leone as a policy analyst in the strategy and policy unit, working with President Ernest Bai Koroma's health advisor.
Turay is part of the mechanism that provides technical support and coordinates activities among the ministries of health and sanitation, social welfare, gender and children affairs, education, and science and technology, and the National Commission for Social Action. His work helps make sure the agenda of the president and government is achieved. He also seeks to improve performance and evaluate outcomes.
"If they have any challenges, we step in to make sure those challenges and bottlenecks are removed," Turay said. "We work with them. We support them with their programs and don’t wait for them to fail."
His position in the government also allows him to forge ahead with Hands For Life. Based in city called Makeni, in Bombali District, of the Northern Province of Sierra Leone, the small registered community-based nonprofit has three part-time staff and a handful of volunteers.
The civil war destroyed numerous healthcare institutions. Over time, some clinics and hospitals around the country were rebuilt and operated by nonprofits that are not sponsored by the government. Therefore, patients do not receive free care. The KamaKwie hospital is owned and operated by the Wesleyan Church of Sierra Leone. The population of over 200,000 receiving care from the hospital does not benefit from the government program. The hospital operates on cost recovery.
Hands For Life—Sierra Leone is trying to fill in some of the gaps.
"If you want to improve on the access, you need to improve on the delivery and manage the costs to make it affordable to the bottom group," Turay said.
But when Ebola hit, everything changed.
"Every other thing was turned off, and we focused our attention on Ebola," both in the country and in Hands For Life. And while Hands For Life can't make an impact with a medical approach, it can take a social approach.
"In absence of vaccines or medicine, the best option is educating the people to break the chain of transmission," Turay said. "Ebola has come to wage war on our tradition, and we need to make our people more resilient to win the war."
Turay explained that in his culture everyone is expected to go and help a sick family member or friend. If someone dies, you want to be with the person. The Ebola outbreak creates a health and social paradox.
In their own guerilla-style war on Ebola, Hands For Life—Sierra Leone staff and volunteers went door-to-door. They spread key messages about what Ebola is, what to do if you have Ebola, and most importantly, what to do to prevent you from getting Ebola.
Turay estimates they reached 300 families/households with direct support and 1,000 or more indirectly. Monies raised by staff, present and past students at USciences, friends, and other sympathizers, and with support from Marc Goldberg, MD, JD, of Healing the Children—NJ, have bought food items and toiletries for quarantined homes and support the social outreach and health education activities.
About one year after the outbreak, just when the county started to think the worst was behind them, five new cases were reported in June 2015.
All the while, Turay is traveling back and forth from Sierra Leone to the U.S. where his wife Fatmata and his three children Thaduba, Sapunka, and Sameh live. Despite family here to help, it's a stressful situation.
"If I am able to put a smile on the face of somebody, that is therapy for my stress," Turay said. "That is the purpose of my life and trigger of my strength to persevere."
Hands For Life—Sierra Leone is evolving again. The group is concentrating its efforts on helping children affected by Ebola continue with their schooling by paying tuition so they can go to school and buying clothes and books and other educational supplies. Turay is searching for committed funding to his cause.
"I am so much grateful to USciences. I consider it a privilege, very lucky, to have found myself here to study," Turay said. "The knowledge I got from here has really helped me. It did not just give me the advantage but has helped me to work better."