Ebola Still Takes Mental Toll on West Africa’s ‘Burial Boys’ – Wall Street Journal

“They didn’t tell us at the end of this job, you people will get crazy,” said

Matthew Kruah,

a companion in his daily drinking and drug abuse who buried his father during his own time on the graveyard crews.

Ebola killed some 11,000 West Africans, but it also left survivors to grieve in an area with very few mental-health professionals, and where few can afford to see one in any case.

Liberia has just one psychiatrist for a population of four million, according to the health ministry. Sierra Leone, home to seven million, also has only one. The mental-health wing of the Liberian health ministry has just two staffers on payroll.

It is an unsettling postscript to an epidemic that, for all its horrors, was meant to leave behind an army of newly trained health workers. Instead, large numbers of that crew are too shaken to work.

Matthew Kruah stands in front of his friend's home in Unification Town, Liberia, on Feb. 5, 2016.

“They all lost somebody close to them,” said

Janice Cooper,

project lead for the nonprofit Carter Center’s mental-health program in Liberia, which is looking to put hospital staff through basic mental-health crash courses.

Even before Ebola, Liberia and Sierra Leone numbered among the world’s most traumatized nations, both recovering from civil war. Fourteen years of conflict in Liberia left 250,000 dead and many survivors homeless. A 2011 study in Liberia’s Nimba County found 40% of its 500,000 people exhibited symptoms of post-traumatic stress disorder.

Many fought in the war as child soldiers, including Messrs. Dingay and Kruah. The two left school early, leaving them barely literate.

When work burying Ebola victims became available, the two saw it as possibly their only chance to secure a salaried job. They frittered away the money as quickly as it came.

“We were thinking, after this job, we can die, too,” said Mr. Dingay. “So we just spend the money.”

A year later, Mr. Kruah finds it difficult to eat or focus. Mr. Dingay said he can’t shake the image of his daughter in the days before she died.

Neighbors, repulsed by the unusual, macabre trade they plied, have turned “burial boys” into an insult.

“That’s that burial team,” teased a man pushing a wheelbarrow past the porch where they spent a recent afternoon.

“Go away!” one of the burial men shot back.

Liberia—its economy wrecked, its government broke and its people exhausted— can hardly attend to these wounds. Virtually no clinic in the country stocks antidepressants. Liberia’s only mental-health pharmacist,

Joseph Quoi,

has never found a reliable source, so he often runs out. “Mental health has fallen by the wayside,” he said.

Anthony Dingay crosses a river to the sand mine where he works.

There are just 72 hospital beds in Liberia reserved for mental-health patients. About 160 hospital staff have psychosocial training, such as how to spot problems like PTSD. As the hospital system collapsed here last year, half turned to roles that don’t use those skills. Many are probably traumatized as well.

“This is just abnormal,” said

Angie Tarr-Nyakoon,

the director of the government’s mental-health unit. “How are we going to handle it?”

The answer, for many Liberians: self-medication with alcohol and heroin. The government has no capacity to treat addiction. There are only 15 beds for addicts in a country where bars frequently start selling beer and liquor before noon.

From August 2014 to the following March, Messrs. Dingay and Kruah spent days lumbering into the homes of neighbors they knew, to lift their remains up from the blood, sweat and vomit in which they died. Sometime after burying their 50th body in the September heat, they began drinking after work.

Soon they were drinking before work, too. Often, they were drunk, they said, while they put on their elaborate, head-to-toe biohazard suits—a meticulous process, in which a single slip-up can allow the Ebola virus to penetrate. Mr. Dingay wonders if he missed a step and somehow carried the virus home.

In October, his daughter died. “Some people started saying I’m playing with this virus so I’m the one that gave it to her,” he said. “I dream about her. When I’m sitting, eating, I can picture her face.”

A few months later, the two men traded their homes for the churchyard. The pastor tries to cure them with daily prayer. That is about the only place for them to go, their burial-team supervisor,

John D. Johnson,


“I really want to see them doing better,” said Mr. Johnson, who admits to his own problems: “If I don’t drink, I will have some kind of sleepless night.”

Ebola Still Takes Mental Toll on West Africa’s ‘Burial Boys’ – Wall Street Journal

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