By Chernoh Alpha M. Bah
Almost ten year ago, on April 4, 2015, a serious controversy erupted in Kailahun district in the eastern region of Sierra Leone. It involved a dispute between an opposition politician Alex Bonapha and district health officials in Kailahun, regarding the test result of a deceased child.
The child, a 9 month-old baby, had died at the Nixon Memorial Hospital in Segbwema on April 3, 2015. A few days before the tragic incident, doctors at the hospital had recommended a blood transfusion for the child. An uncle of the child is said to have donated the blood given to the child. The baby passed away just hours after the blood was transfused. Health officials, who conducted a swab test at the Ebola Management Center in Kailahun, later claimed that the child died a victim of the Ebla virus. Officials from the National Ebola Response Center (NERC) in Freetown, the capital of Sierra Leone, recommended that Kailahun district be closed down and the family of the deceased child be quarantined.
Kailahun was the initial site of the Ebola outbreak a year before this incident and had gone almost two months without a single reported infection at the time of the child’s death. Alex Bonapha, the then district council chairman in the area, instantly challenged the validity of the child’s Ebola test result and protested against the NERC’s decision to re-quarantine the district. Bonapha asserted that the child’s test result shed doubt on the whole Ebola management response in Sierra Leone.
“We are strongly contesting the validity of the one case today in Kailahun,” Bonapha said in a statement issued in response to the child’s test result. “For a person to be infected, he or she has to come in contact with an already infected person or must have touched the vomits, urine, saliva, excreta or the sweat of an infected person,” he also stated, arguing that the deceased child was not exposed to any of these required risks of infection.
According to Bonapha, all members of the child’s family, including the mother who was breastfeeding the child and the uncle who reportedly donated the blood that was given to the child, were Ebola negative and they had never been infected before the child’s death.
“All the family members of the late child including the mother are very healthy and alive. If the child got (Ebola) from the mother, the mother would first have manifested symptoms before transmission, but this was not the case. The child could not have got the virus through breastfeeding because the mother is neither an Ebola survivor, nor has she up to now manifested any signs or symptoms. The uncle of the child who donated his blood has stayed in Segbwema for over nine weeks without leaving the town and he is also not a survivor,” he argued in a widely circulated protest statement at the time.
Bonapha then demanded that frontline responders to the Ebola outbreak in Sierra Leone who included Sierra Leone’s National Ebola Response Center (NERC), the World Health Organization (WHO), and UNICEF, should explain how the test result of the child turned out to be Ebola positive when the child was not exposed to any of the conditions that cause the infection.
“My suspicion is that either the swab result was interchanged, or the blood that was donated for the child was reserved in the blood bank (while) another from the same blood group, as the one donated by the uncle, was used on the child,” he stated.
Bonapha’s protest was more than a political action from an opposition local council chairman fighting to protect his constituents from the harsh disease quarantine measures enforced by officials and law enforcement agencies of the central government in Freetown. His protest raised a fundamental question about the Ebola outbreak: what was the actual transmission mode of the Ebola virus in West Africa?
A fierce debate erupted between Alex Bonapha and the district health officials in Kailahun. The health officials received support from ruling party propagandists, mostly loyalists of the Ernest Bai Koroma regime at the time.
Government propagandists tried to dismiss Bonapha’s statement and position on the disputed result of the child, calling it inflammatory and inciting. As council chairman, Alex Bonapha had been at the center of controversy with officials of the Koroma regime on several occasions, and before this controversial incident, he was already considered one of the strongest opposition critics of the central government’s response to the Ebola outbreak. Responding to Bonapha, one of Koroma’s spokespersons stated that the child’s test result could either be the result of the mother or the uncle being asymptomatic carriers of the Ebola virus.
“The child’s swab test should be re-run or if the corpse is already buried, for the body to be exhumed and another swab test be collected and re-run,” government spokespersons suggested, and insisted that the child’s “mother and entire family must in the interim be subjected to twenty-one days quarantine.”
The controversy over the child’s death threatened the credibility of the entire Ebola response effort in Sierra Leone. Kailahun district itself had gone from being a leading Ebola hotspot, with nearly eighty infections per week in June 2014, to exhibiting zero cases for a consecutive period of over one hundred days before the controversial diagnoses of the deceased child. But despite the sanguinary response of government propagandists, Alex Bonapha continuously insisted that the test result did not reflect the deceased child’s Ebola status. The arguments eventually forced the United Nations agencies involved in the Ebola response efforts and the country’s National Ebola Response Center (NERC) to investigate the circumstances of the child’s death and the test result.
An investigation team, made up of representatives from the Sierra Leone health ministry, WHO, and the United States Center for Disease Control (CDC), was then constituted in Freetown and dispatched to Kailahun to undertake the investigation. The investigation team later discovered that there was strong basis for Alex Bonapha’s protest: they found no evidence that there was an ongoing Ebola transmission in Kailahun and that the child in question was not an Ebola case.
“The sample in question is not from the child,” the investigation team tacitly stated in its report.
NERC officials in Freetown later called the controversy surrounding the child “a mere mistake,” which they blamed on a lower ranking Ebola health worker. Alex Bonapha, the council chairman who raised the sensitive question, appeared to have scored a significant political victory against his political opponents.
“We want NERC to offer a public apology as a way of restoring confidence with the people of the district. Many people are now afraid to go to the hospital,” Bonapha told a localnewspaper in Freetown.
The government spokespersons, who called Bonapha’s protest “immature and inflammatory,” immediately changed the focus of the discussion. They quickly subsumed Bonapha’s protest and replaced the matter with praises for the joint investigators. One Sierra Leonean-run newspaperpraised what it called, “the encouragingly unprecedented speed with which the ministry of health, NERC and the international health agencies in the country responded to the community’s call for answers.”
Following these arguments, the controversial matter regarding the child’s test result was closed and forgotten. But underneath the torrent of accusations and counteraccusations between the politicians and health officials there remained a lingering, fundamental question: was the child’s test result a real mistake?
Many people wondered how many of such “mistakes” may have occurred during the outbreak. The question as to how the said “mistake” actually happened was never exhausted. Alex Bonapha and the child’s family members never pursued the matter any further.
However, the Kailahun incident of April 2015 was neither a coincidental case nor a unique occurrence. It is one example in the thousands of cases that the troops of aid agencies and many in the media, stamped below the surface in their inundated media coverage of the outbreak and its victims. In the very same district of Kailahun, there also existed the story of Mammie Lebbie, a 39-year old peasant woman in a village called Sokoma near the southeastern border with Guinea. Mammie Lebbie was a daughter-in-law to Mendinor, the traditional healer whom officials initially considered the index case in Sierra Leone.
Mammie Lebbie was supposedly diagnosed with Ebola at the Koindu Community Health Center on May 24, 2014, after she and other women are said to have participated in the funeral rites of Mendinor. When Lebbie became ill, an Ebola swab collector and contact tracer named Mohamed Lamin (who was stationed at the Koindu Community Health Center) reportedly collected her urine and stool specimen, which were taken to the Kenema Government Hospital’s Lassa Fever Ward. On that day, a medical doctor named Mohamed Kanneh reportedly administered ten intravenous fluids to Lebbie, who had arrived at the Koindu health center in a weak and dehydrated condition after walking a distance of two miles from her village.
Meanwhile, laboratory workers at the Kenema Government Hospital’s Lassa Fever Ward confirmed the following day that Mammie Lebbie’s urine samples tested positive for the Ebola virus. They requested that she and all the other patients (a total of ten) at the Koindu Health Center should be relocated to the Kenema Government Hospital’s Lassa Fever Ward, which had been transformed into the new Ebola Holding Center. This was on May 25, 2014, the very day the government of Sierra Leone officially announced the presence of the Ebola outbreak in the country. The test result of Lebbie then became the first supposed laboratory confirmed infection of the Ebola outbreak in Sierra Leone.
But when report of the test result was conveyed to Mammie Lebbie and she was told of plans to relocate her to the Ebola isolation ward in Kenema, she and other patients reportedly fled from the clinic. They fled the night before an ambulance team from Kenema arrived in Koindu to transfer them. On May 26, 2014, health officials and local authorities in the area declared Mammie Lebbie a “wanted Ebola patient” and a search for her arrest was launched in Kailahun. She eventually fled to Guinea and was arrested by health officials at a local clinic in the Gueckedou area where she attempted to seek medical care. Health officials were deciding to repatriate her to Kenema when she re-escaped and then fled back to Sierra Leone.
When she arrived at her village, her husband, a 49-year old man named Tamba Lebbie, immediately took her to an abandoned farmhouse in the bush where she remained in hiding for more than a month. She resurfaced towards the end of June 2014. By this time, Mammie Lebbie had fully recovered from her ailment without any treatment.
Mammie Lebbie returned to Sokoma with both her husband and six children. In January 2015, a group of journalists who heard about her story met with Lebbie to interview her and also arranged for another Ebola test to be conducted. The test result came back negative. Lebbie was then issued a survivor’s certificate and identified as the first Ebola survivor in Sierra Leone.
But the journalists and the health officials ignored the fact that Mammie Lebbie was never treated for Ebola after she reportedly tested positive for the virus in May 2024. She had been on the run since the initial diagnosis. None of her family members, including her husband who was in direct contact with her during her days in hiding, were infected or fell ill. She had recovered from the supposed Ebola virus with no professional treatment, and the family members who cared for her were also not infected despite taking no preventive measures.
Health officials ignored the most significant aspects that characterized Lebbie’s story and status as a so-called Ebola survivor. In fact, a few weeks after she was officially identified as Sierra Leone’s first survivor, her story was re-invented: she became a poster for the possibility of survival from Ebola when one seeks medical care immediately after infection. Most unfortunately, the journalists who assisted in the identification of Lebbie as Sierra Leone’s first Ebola survivor never questioned the circumstances of her survival. The journalists also failed to question whether her supposed test result, which was used by national officials to announce the presence of the Ebola virus in Sierra Leone, was actually clinically accurate.
Mammie Lebbie’s story also remained an unresolved puzzle: the absence of an independent clinical verification of her test results, the absence of a medical or scientific justification of the circumstances of her survival, and the fact that her unprotected husband and six children were not infected remained a critical component of the evidence against both the origin and transmission narratives of the Ebola outbreak in West Africa.
Lebbie’s puzzling story equally mirrors the controversial circumstances surrounding the identification of Emile Ouamouno of Miliandou as the index case of the Ebola outbreak in West Africa.
The report of German scientists, led by Fabian Leendertz, which supposedly identified the cause of the outbreak and its primary infection, omitted significant aspects of the child who they called “patient zero” of the outbreak. The evidence which identified Emile Ouamouno as the first Ebola victim in West Africa was also not based on clinical tests: no laboratory examination was carried out on the child’s remains or any of his specimen to determine his actual cause of death. Available medical records of the child at the community health clinic in Meliandou only state that the child was diagnosed with acute malaria in December 2013. Local health workers at the time believed malaria may have been the actual cause of his death.
Malaria is indeed an endemic disease in southern Guinea and is the leading cause of infant deaths in the region. Other vital records available on Emile Ouamouno at the Meliandou health clinic also confirmed that the child was eighteen months old at the time of his death. This contradicts information provided by German scientists who identified Emile as two-years-old. The age discrepancy also challenges the logic of the child’s supposed ability to participate in the activities of hunting and grilling of the “insectivorous bats” circumstantially identified by Leendertz and team as the infection source of the Ebola virus. Additionally, if Leendertz’s circumstantial scenario were accurate, wouldn’t it be natural to consider that the child might have participated in the bat-hunting activity with other older children?
Unfortunately, the Robert Koch Institute’s report provided no information of other children who may have been playmates to eighteen-month-old Emile and who likely would have also participated in the activity of “child bat hunting” that killed Emile and eventually sparked the deadly disaster in the region.
Also ignored by scientists and journalists were the circumstances that surrounded the death of Emile’s mother and the survival of his father. Emile’s immediate senior sister died around the same time as him. Emile’s mother was eight months pregnant at the time of her children’s death. The mother reportedly fell ill a few days after the funeral of the two children. A doctor at the community health clinic in the village who treated Emile also diagnosed the mother with malaria. The doctor prescribed ten anti-malaria injections. She complained of severe hip pains the very night she commenced the treatment prescribed by the doctor. The hip pains later developed into severe bleeding, and in the middle of the night the woman eventually miscarried and died in a pool of blood. The circumstances of the woman’s death, an eight month old pregnant woman receiving anti-malarial injections, suffering severe hip pains followed by profuse bleeding, then having a miscarriage and eventually dying, makes her a potential statistic of the high incidences of maternal deaths prevalent in the region.
Significantly, the German scientists who identified Emile Ouamouno as the outbreak’s primary victim, provided no explanation on the local doctor who treated both Emile Ouamouno and his mother and how he was able to avoid infection. They also failed to explain why Etienne Ouamouno, the child’s father who took care of all the so-called index cases of the outbreak (the child and his sister and mother), was not infected and did not report a fever or suffer any illness throughout the outbreak. They also failed to explain how the child’s other siblings (Victorienne 8 years old, Sergio 7 years old, Marie 6 years old, and Kanih 18 months old) were never infected, despite the fact that the outbreak, which spread across international borders and killed thousands, allegedly erupted in their household.
An examination of these contentious cases and episodes – from the death of Emile Ouamouno in Meliandou to Mammie Lebbie’s survival story in Koindu – unravels a trail of undocumented testimonies of clinical wrongdoings, questionable scientific claims, and misleading media reports on the origin of the Ebola outbreak in West Africa and its modes of transmission. Underneath these questionable stories lie the un-discussed predicaments of the outbreak’s many victims in West Africa.
Across the Mano River countries in West Africa today, communities still harbor telling stories that are much more contentious and frightening. In their totality, these stories not only cast severe doubts over the origin of the Ebola outbreak and its modes of transmission, but like the so-called mistaken test result of the Kailahun child of April 2015, they tell real-time stories of suspicious deaths, of hundreds of doubtful infections, of strange and unknown disease treatment methods, and of many other ethical issues involving medical experts practicing beyond the parameters of informed consent. These chilling accounts of the victims, of the families of the deceased, of the survivors – real firsthand accounts from true eye-witnesses – have been largely dismissed by scientists, journalists, academics, and political leaders, oftentimes regarded as “conspiracy theory” in the media and academic conversations.
But these subsumed and suppressed firsthand accounts contain cold and sad recollections of events that are too frightening, too rampant, and too commonplace to be ignored. As incredible as they sound, as unbelievable as politicians and journalists want them to appear, they form an important part of evidence in any genuine effort geared towards a real understanding of the motives and outcomes of the 2014 West African Ebola tragedy, and its relationship to global pandemics like the COVID 19 outbreak.
The story of the 2014 Ebola outbreak, its questionable origin and modes of transmission, and how certain individuals and organizations profited from the disaster and deaths that occurred in West Africa, must be looked into in the interest of justice, peace, and human dignity. A clear path towards recovery must begin with uncovering the truth: an independent investigation that incorporates victim testimonies has to be considered as part of a genuine healing process and as a bulwark for preventing the recurrence of crimes against humanity and largescale injustice.
A process of reconciling the past with the present in the interest of a peaceful future must start with a genuine process of restorative justice. Without justice, there will be no peace for the families of the Ebola victims and survivors.
Chernoh Alpha M. Bah is author of The Ebola Outbreak in West Africa: Corporate Gangsters, Multinationals, and Rogue Politicians (2015) and the upcoming book, Democracy Betrayed: Corruption, Dictatorship, and Authoritarianism in Sierra Leone.
