Augustine Kargbo

Augustine B. Kargbo

Q: This is Sam Robson. It is March 20th, 2017, and I am here in the city of Magburaka at the District Health Medical Team office, and I'm pleased to be joined by Augustine Babar Kargbo. [laughter] I'm sorry if that was terrible.

KARGBO: No, it's no problem.

Q: This interview is part of our CDC Ebola Response Oral History Project, and I'm pleased to be talking with Augustine about his own experiences fighting back against the worst Ebola outbreak in history, as of now. Thank you so much for joining me, Augustine.

KARGBO: You're most welcome.

Q: Would you mind saying, "my name is," and then pronouncing your full name?

KARGBO: My name is Augustine Babar Kargbo. I'm a Sierra Leonean in the Northern Province, Tonkolili District. I'm working with the District Health Management 00:01:00Team in Tonkolili.

Q: Can you tell me more about your current position, just a little bit?

KARGBO: My current position for now, I'm working with the community health workers, the CHWs, in the Tonkolili District. I'm the focal person working with them.

Q: If you were to tell someone in just a few sentences what it was that you did during the Ebola response, what would you say?

KARGBO: During the time of the Ebola, we set up a committee in the districts because we saw that Tonkolili is bounded with seven other districts, and Tonkolili is in the middle. So anything that happened within the nearby districts, it affected us. That is why we sought to get out with my then-former 00:02:00DMO [district medical officer], Dr. Osaio Kamara, to make sure that we track down people that are sick in the community so that we can remove them earlier and test them, and if we find them positive, make sure to quarantine them or separate them from their families so that the virus will not continue to kill their family. We set up an operation that we called Chase the Virus, Operation Chase the Virus. By that time--

Q: Can I interrupt you for just a second? I'm sorry. I think that is really good for an initial summary. Would you mind if we back up a little bit and I ask you about growing up and your childhood and that? So, where and when were you born?

KARGBO: I was born in Magburaka in Tonkolili District, 6 January 1976, in 00:03:00Magburaka Government Hospital. I started my primary education in Magburaka with a Catholic primary school. I pursued my secondary schooling, government secondary school for boys, Magburaka. Thereafter, I went to the College of Medicine where I [studied] pharmacology, and I was given a certificate as a pharmacist technician, and I thought it fit because during that time I was in 00:04:00the store, working at the district medical stores. So I thought I needed to capacitate myself. I followed my studies in the [University of] Makeni, doing logistic management and procurement. That is the diploma. I was there for two years. Thereafter, I came back for some time to work in the DHMT [District Health Medical Team].

When this Ebola outbreak started in this part of our country, at that time, we did not have a lot of equipment like vehicles, IPC [infection prevention and 00:05:00control], a lot of things. Everything was low down there. Can you imagine at that time, we only had one ambulance in the North running from Tonkolili, Kambia, Port Loko and Bombali [Districts]? We only had one ambulance. But through the support of other partners, we managed to have another vehicle. But we still had a lot of cases from the communities, so eventually, that is why our DMO, Dr. Osaio, thought that we needed to go to the community to look for the suspected [cases] and to really talk with them, and if there are any suspected, we isolate those people and have them tested. If they prove positive, we need to take measures like quarantining the place. So that was why we launched the 00:06:00Operation Chase the Virus in Tonkolili District.

Q: Up to that point, what had been your role in the Ebola response?

KARGBO: I was the head of contact tracing. Any area where we have a positive result, in any community, I have my men that we usually send for them to quarantine and monitor the people for the next twenty-one days. But I'm also organizing this Operation Chase the Virus because we have people in the communities, we have our contact tracers in the communities, so I tend to--when they call that there is a suspected person here, we usually go there. And it was really not easy by that time because we don't have a lot of logistics. In fact, 00:07:00during that time, Masanga [Hospital] gave us one ambulance that we were using, and we mostly used that ambulance to remove patients. But the problem lies in the areas where the ambulance cannot reach, motorbikes cannot reach. So what we do is we use our motorbikes, we wear PPE [personal protective equipment], go there, and remove them. Sometimes we have them back in our bikes to remove them, to access them to the ambulance, and having them conveyed to the hospital, and there, start the testing. If they are found positive, we do our investigation there and have them quarantined and continue to monitor the communities. But it's really not easy because as a worker of the District Health Management Team and a worker of the MOHS [Ministry of Health and Sanitation], we are here to 00:08:00save lives, so we need to give ourselves to make sure that we save the lives of the people in their community. A lot of things happened because--it's really not easy because at that time, we are not too afraid about Ebola; not a lot of trainings, just discussions, and it was terrible that they are calling up and down.

During that time, again, we started to have another support, where we received some vehicles, and we continued. I think it is a matter of time when NERC [National Ebola Response Center] came in and started working with us. I believe the office transferred to Masokory there for the response. But it's really not easy for we and the DHMT because logistics are not provided on time, and 00:09:00logistics are only provided on time when they are available there. So, we try to manage our [unclear] resources to make sure that we don't have a lot of contacts. That is why Tonkolili is bounded with seven other districts. We tried at least to minimize the contacted Ebola persons. Even I think we have a lot of survivors, because why we have a lot of survivors is because we don't allow people to move from their community to come. We meet them. If we know that they are meeting the case definition, we mount a quarantine and try to remove the people there, especially those who are sick, to a nearby hospital and have them 00:10:00tested. We usually use our DHMT vehicle, the DMO vehicle, and one ambulance that we received from MSF [Medecins Sans Frontieres] to even do some active surveillance within that period. That is why mostly, when we move to the community, we move by seven or eight o'clock during the night because by that time, most of them should have come back home. So we do house-to-house inspections, and if we find that you have any one sign or two signs, we will make sure that we move you out there and have you in the government hospital. We have your blood tested and--no, we have your blood sampled and we send the sample to Kailahun for testing. If it's proved positive, we continue to do our investigation within the community and make sure that we talk with the people 00:11:00around there, especially the contact tracers in the community so that they will continue to monitor these people. This is our way we make sure we manage Ebola, until the time when NERC came in and have them [unclear], continuing to support the program.

Q: I'm wondering if we can start back toward the beginning of your response work again. Could you take me through your process of building your team of contact tracers, of training them to do the job?

KARGBO: For the contact tracing, we have them based in their community. You must be in your community because at the end of the day, you know the population in your community, you as a contact tracer, you know the population in your community. You know visitors that are visiting the community, you know the people that I have to see because if I'm living in a certain community, I know I 00:12:00don't see a person two or three days and we know there is something wrong. So that is why we involve most of the contact tracers, people who find themselves in their communities. So we give them phones that we supported through UNFPA [United Nations Population Fund]. We give them phones so at any time they suspect a sick person or any other disease condition, they try to call us immediately. In fact, at any time that they call, by that time we don't have a bike, we don't have vehicles, we are using bikes, motorbikes. We only go with a vehicle or ambulance when we know that there is a suspected case there. But during that time, we have bikes until the advent of CDC, that they continue to support us. Sometimes we all go to the field to make sure we monitor, do some case finding so that at the end of the day we will track them, all those people 00:13:00we think have contacted the disease.

Q: Can you tell me about one or two of your contact tracers who you supervised? Just describe them a little bit?

KARGBO: In fact, I have a contact tracer, Mabakoh. In fact, he too got the virus. Contracted the virus. Unfortunately, he died. Really, to become a contact tracer is a challenge during the time of Ebola. In fact, I even have one of my contact tracers by the name of Edward Kamara who was beaten because he was given information in the community. So we have a lot of challenges. Why you see the Ebola--we have a lot of suspected cases and even confirmed survivors in this 00:14:00part of Kuniki Sanda Chiefdom. During the time of Ebola, there were a lot of denials there. They are, in fact, beating our contact tracers. So people are afraid to give us reports. By then, unless when we have people tested [and when positive, we try to remove those suspects in that community.] During that time when we go there, we meet--one or two persons died. [The chief house, one house--in Masokory], there was even denial as a chief. We removed about five suspected cases there. In fact, even the other one that I moved, I went there during the night with Dr. Osaio. I used the PPE. I went right in their bedrooms trying to remove the contacted person there. But, yes, we have denial. That is 00:15:00why. We managed to work with our contact tracer. In fact, I will be describing the house of any suspected community or any house suspected. Most times, they have some things they have to identify. So when the call us, they identify things that okay, we are going to so-and-so area, just look where there is a blue or red [unclear] or there is a big stone. Those are the things that we used to identify, so when we go there, we will not even call the contact tracer. We go there direct. That is why most times, when we are traveling, we wait until around seven to eight, when we know that people come back because when they know that we are doing this Operation Chase the Virus, during the day, they find themselves in their farms being there till seven, eight o'clock after they get back home. Since we know that during that time they get back home, we most times 00:16:00launch our operation during the night to have them tracked because that time, we will meet them right in their bedroom. And have them checked up, and if that convinces us to remove them, we will remove them [unclear]. After testing, if we see it is negative, we will not [unclear]. But if this person is negative, we will always monitor you again for the next twenty-one days. [unclear] That is why you see in Tonkolili District we tried to control this crisis, because our surveillance was so active and we made sure that we reached people. We don't allow the people to come back.

I think that is the era when I too contracted the disease. Although I contracted, I think--two ways that I [unclear]. Either I contracted the disease from the ambulance driver because--we had four ambulances drivers at that time, we had three laboratory guys. We lost two laboratory guys and one ambulance driver, and two of them contracted the disease but managed to survive. So I 00:17:00don't know if the time when we are doing our Operation Chase the Virus, sometimes we sit down together in the ambulance. A lot of things, because if we really want to move in any location, if we don't have surveillance logistics, we have to make sure that we use the logistics that we have. Usually one ambulance, all of us we are there. When we track them down, we allow the ambulance to convey them to the hospital. Thereafter, we follow back and make sure that we put things in place. This is how we have been working with the response despite limited resources, limited phones, limited logistics, but we still managed to have this thing come down.

Q: When you only have one ambulance--

KARGBO: Yeah, in fact, during that time, only one ambulance in the North, not for Tonkolili District.

Q: For several districts, like four districts you mentioned.

KARGBO: Four districts, yeah: [Tonkolili], Bombali, Port Loko, and Kambia. That ambulance was provided by MRC [Medical Research Center].

Q: How do you prioritize where you send the ambulance? [crosstalk]

KARGBO: How you prioritize is based on the influence that we have, the contact that we have. That is why we, during that time, we have the hospital as the holding center. We have a lot of them removed from their community, especially when we know that these are suspected. We have them in the hospital and have them remove their blood samples and have them tested. At the end of the day, if you prove positive, we make sure that we send you immediately. That is why you see we have a lot of survivors. And if you prove negative, we will send you to another ward and you will be there for the next twenty-one days to make sure that you don't have the virus. Really, we put things in place, but it's really not easy. I only realized [note: was paid] maybe four hundred thousand [leones] 00:19:00per month during my time as a coordinator of contact tracing, give you four hundred thousand. But we are not looking for the money. This is our country, we need to fight. We need to sacrifice our life. If we had been looking for money, it's a problem. But we managed to sacrifice ourselves, sacrifice our lives to control this outbreak. It's not easy.

Q: So I assume that sometimes there were real shortages of money.

KARGBO: Yeah. You know, there is no money. DHMT--it's really a big problem. That's why we are praying to God not to have this type of crisis. Really. Because we are really demotivated, especially we health staff that worked for this Ebola outbreak.

Q: Were people always getting paid on time?

KARGBO: Well, some--for we, the DHMTs only, we are receiving our usual salary. But most people--I just received [money] for Ebola when I was made contact 00:20:00tracing coordinator funded by UNFPA, giving me four hundred thousand every month. But still, I managed it because at that time, I had my own family. It's really not easy.

Q: Can you tell me what it felt like sending your contact tracers into areas where there might have been resistance? You described one person being--I don't remember if you said beaten by a rock or had rocks thrown at him. What's it like as the supervisor sending probably your younger people into that kind of environment?

KARGBO: You know, by that time we don't have opportunity of jobs, again, especially when we have these crises, so you have these guys in their community. An example, at Kunikie Sanda, we have one or two supervisors supervising the contact tracers. Most of the contact tracers are community health workers, have 00:21:00been working in their communities. At any time when we go there with an ambulance, we just go straight to the house and remove the suspected [case]. [unclear] Doing the contact tracing in this community, [these contact tracers are giving us information about the sick person in their community and report directly to the supervisor. That's why we make sure that we give them phones and incentives every month. But these contact tracers have been on pressure in the community, a] lot of frustrating things happening in the community, abusing them, giving them all kinds of names [with insulting language]. In fact, they don't have trust in them during that time. Thank God, when you came in to build up confidence, community engagement during--if ever they have confidence, because they know that at any time, when there is an ambulance, go there, and have the person removed. No. The time of Ebola, people have seen the hospitals 00:22:00as an area of dying. When you want to die, during the time of [Ebola], you go to the hospital, you die. Or you go to your health center, you die. So that was why when we used these guys, they call us, we go there and remove them. That is why you see most people were not accessing the health facilities. We had a lot of quacks. People are doing some quacking in their community because they don't have trust on health stuff again because of this Ebola. These are the things happening, but thank God, the communities--the contact tracers that we have from their communities, they worked very hard to make sure that we put this thing to zero. It's good that we used their children in their community because if we should have used another body or sending another body, we should have not controlled this type of outbreak. Thank God we were able to fight, and later, 00:23:00when we had this NERC, support from NERC coming, continue.

Q: So the support from NERC was a big turning point, would you say?

KARGBO: Yeah. They supported us because when they came in, they came with a lot of logistics, vehicles, [building up capacity on Ebola with partners, to have a quick response.] Even the time when DHMTs were overseeing this Ebola outbreak, we used our CHOs, our staff, to do burial in their community because at that time, there is no supported form for burials. Unless when they started sending 00:24:00support, that we recruit chiefdom buriers that have been doing it in their chiefdoms. But at that time, they were just working. So these people buried in a location, just when the DERC [District Ebola Response Center] came in and came with a lot of logistics--bikes, vehicles--and the response started to at least achieve its own process.

Q: You described how you yourself donned PPE and went into a house.

KARGBO: Yeah. Yeah--

Q: What's that like for you?

KARGBO: At that time, I used one PPE for the likes of one week. Because--[laughs]--PPE were not sufficient. Do you understand? We have few PPEs.

Q: So few gloves, few--

KARGBO: Few PPE. In fact, the gloves, we have chlorine. When we use the gloves, we wash it with chlorine, we dry them out, and use it. Even the PPE, we have 00:25:00been using that. We don't burn them because when you burn, you don't have them again. Because we don't have a lot of logistics. That is why I said, Ebola came into the country, it really helped us to see our nakedness and make sure that we put systems in place during times of health. The health system had become so weak. But we managed our few resources, we managed, because we are Ministry of Health and Sanitation workers, and we [signed up] for that. Our motto is to save life, so we need to save lives. The time I contracted the virus, I should--[but due to the effort of the community and really the respect of my community, I make sure I continue to work with them.] I'm sorry, that is it.

Q: Weren't you afraid sometimes, though? I mean you were in such close contact with people.

KARGBO: Well, it is a matter of when you have a lot of soldiers, you are the 00:26:00commander of the soldiers and the commander of contact tracing. If I started to become afraid, what would the other workers do? They, too, will be afraid. So that is why, when they see me there in the [unclear] there, they feel encouraged, they too [will] continue to do their hard work and make sure they work as a team. If I return back, say all of them, okay, our boss is there, when you come blah, blah, blah, it goes back. Doing nothing. So they too will not give me information. So sometimes you need to sacrifice. If God needs your life, you will continue to have it. If you are gone, you are gone. Yeah. So it's really not easy for us.

[interruption]

Q: Do you remember when CDC first came to Magburaka and the people you first started to work with from CDC?

KARGBO: Yeah. The people that I first started to work with--there is a very tall 00:27:00lady. I still remember thereafter--I cannot remember a lot. The only thing, after about three or four things Dan [Daniel W. Martin] came, [unclear] also came. Even this one, last month I saw her. In fact, she has a dog, [unclear], my dog. Most times they have the [unclear]. But I cannot remember most of their names. I'll just try to name a few. But the first lady that came there was a very tall lady. If you can call it and identify her, I will know, but I cannot remember her name for now. A very tall lady [that I cannot remember her name, but she is a woman with good experiences in fighting Ebola]. [laughter] Because she's so tall, [most time fine it's easy to bring out issues.] I think most of 00:28:00the time, the times that CDC came, it relieved our work because they tried to put in a system by implementing a case investigator. During that time of Ebola, I do contact tracing, I do surveillance, be the surveillance officer. I do case investigators. We supply food. A lot of work because no resources. You earlier, people coming, when you know that at the end of the month, you expect something, [you will have the courage to work effectively.] But when you know that you don't expect something, [you will not be effective on other work pertaining to Ebola.] During the time when CDC came in, we were the first people that they trained on case investigator, because the second one that they trained, Bob--Bob 00:29:00died. Not of Ebola, he had a liver problem. So they trained us before Concern [Worldwide] started to come with their support.

Q: Concern came with the support?

KARGBO: Yeah, by supporting the case investigator. Thereafter, when we have trained the case investigator, I removed myself there and concentrate on my contact tracing.

Q: When people from different agencies like CDC or Concern came in, did you feel like you were listened to?

KARGBO: Pardon?

Q: Did you feel like you were listened to always by these international organizations that came in? That they respected your expertise, your local knowledge?

KARGBO: Yeah. Any time we have an NGO [nongovernmental organization] [unclear] We had a meeting, an entry meeting, we discuss their motive. It's a big relief 00:30:00because if you know that I'm doing this A, B, C, and D, because there is no phone, when they came in they set up a platform and got more people involved in the program so that more or less work would be done. But the intervention of CDC and NGO partners, it relieved our stress because we had no time to have rest. Sometimes we are out till one o'clock in the morning doing the work because there is no one who you expect to do the work when there is no phone, when there are no logistics, unless we do it. Because we have been assigned by the Ministry that we have to do this. So that is why.

Q: Was there anything that you noticed that they could have done better, those international organizations who came in? Any suggestions for them for when they 00:31:00work on a similar outbreak that happens in the future?

KARGBO: Well, in the future, the system--in fact, even in the area that they have been treating the patients, I was there at Bo. I was admitted there. Quick response is not available in the treatment center. You'll be there--in fact, people to respond to you on time is really difficult, the time I was in the treatment center. For me, since I know that I'm offering medical, even in the treatment center, I go in for the virus, go in there, a lot of free--in fact, if willing, when people have the disease, conveyed to the treatment centers, they 00:32:00open IV [intravenous] lines. We should have got a lot of survivors, more than the [number] that we have. I thank God for Dr. Osaio. He called the CHOs there [and told them to please try to manage me so that I can recover. They really treated me immediately and gave me IV fluids with other medication.] So I bless Dr. Osaio for that. That's why he is always my commander, because he helped to save my life. But really, if these people there at the treatment center, they try to open IV lines straight, trying to rehydrate them again, we shall have a lot of survivors. Because supplying ORS [oral rehydration solution] makes you to vomit again. But given a lot of IV fluids helps you to regain your strength. So 00:33:00if they would have [given IV fluids to Ebola patients like 34 Military Hospital in Freetown, they should have gotten a lots of survivals.] When you go there--in fact, when you go there they just send you the ORS. They say you have to mix it. Everybody is afraid of the virus, but believe me, you should have good, technical know-how, how to treat this virus. Ordinary fluids, giving a lot of fluids, will kill this virus. It's a fragile virus. Do you understand? But people have been sent there--in fact, two of our--one ambulance guy and one of the other guys died because of late response. The guy was seriously vomiting with frequent stool, till the other day without giving no attention of drugs. 00:34:00The only drug that they gave him--I mixed ORS for our ambulance driver, but he died. I don't have the materials to open IV lines, because if I should have had those materials, I should have done it there. Even it comes on the time, the third day that I started to recover, whenever--immediately when the [unclear] came in, they saw the drip. They said oh--I said, no, I can do it. I made sure that I release the drip IV down because I was still vomiting. But I thank God. God gave me the knowledge to do that, and by the help of Dr. Osaio and the CHOs in Bo, it makes me--but most of these people died because of late response. Given just ORS. Sometimes they have this ORS. Sometimes, the person is 00:35:00stressful. He cannot do nothing. It's stressful. Any stress, we cannot do nothing. How do you want the person to do? Just lie down, having frequent stool, having frequent vomiting. Later, he dies because no active immediate response given. That's why you see people have been afraid to go to Kailahun or to go to Bo because when you go there, you will die. For me, I was in the treatment center for three days when my result came out. Because I know that [unclear] because every day, I'm playing with this, I'm doing this. I think that I will get the virus. That I have been known. Because things were not too fine during the time when this Ebola outbreak came.

Q: For a while there was no Ebola treatment unit in the districts.

KARGBO: The district, we didn't have any Ebola treatment units. We had the holding center at the hospital. There, we have you there for some time. There, they tell you if your result proves positive, they send you to Kailahun. Initially, we have to wait for the ambulance after Bombali, Kambia, Port Loko, before the ambulance comes here and we have this patient conveyed to Kailahun.

Q: But eventually they did build--was it the British who built a unit between here and Makeni?

KARGBO: That is at the last stage now. That is the last stage. The treatment center in Makeni is the last stage now. Ebola had almost gotten to an end. In fact, here in Tonkolili, we had not been having it. I can remember our last day of this virus was I think April. We had two days free; the 17th of April [2015]. 00:37:00I think that's the nineteen days; on the 19th, we are free of Ebola. So at that time, in fact, the treatment center in Bombali I think, even this part of Lunsar, it was just when Ebola almost started to go. People knew how Ebola behaved and how to report it. But any time we have an Ebola outbreak, it's really a tedious time. It's really a very difficult time for us.

Q: Can I ask what it was like getting to meet and getting to work with Mr. Dan Martin, who is sitting right here?

KARGBO: He's my tutor. I gained a lot of things from him. Most time, visiting the Koni case because we had been having a lot of Ebola cases there. So most 00:38:00time, visited Kunikie Sanda, Tane, [and other areas]. Most of them. I think the advent of the CDC really--we appreciate them at the DHMT because they don't just come in and take people, but they empowered us. They gave us a lot of training for sustainability. But some NGOs, they came with different entitied people. For now, Ebola has gone, all of them are gone. We are still doing our active surveillance. But CDC made sure that they empower us, build up our capacity, and we're trained to do that. That is why the time when I think we are traveling from Masingbi, when Dan got a call that he's going, I said, wow. We know how we sometimes feel when CDC are leaving. We know. Because they don't come with 00:39:00people outside to help us for the work, but they make sure that they build up our capacity and make sure that--and train us how to do things. It's not because he's there, but I need to say the truth. When I saw him today, I embraced him. Tushar [Singh] is another man. In fact, when we had our last Ebola outbreak, Tushar came [again to support us to win the fight of Ebola]. And they trust me because for now, the knowledge that I have got for contact tracing is too much because the last time, we had one [suspect of Ebola] that escaped. I went all out to catch the contact because of the knowledge I had through these guys.

Q: What happened exactly?

KARGBO: What happened in that Masanga, that's the last contact we had, the hospital and [unclear]. The guy lived in the same ward because he heard about this disease. He ran away. And what happened, I could not locate the guy. So that was explained to me. I got my guys to go to the field. I tried to have the names of the community, their friends, the area they lived, the guy's telephone number. We tried, tried, but we could not get him. So what I did, I tried to use another method. Calling the guy, saying I am so-and-so, because I already know his friends around. So I used one of his friend's names, that "I have for you this money," this money is from so-and-so area. Because I know that he has been doing microcredit. The guy has been doing microcredit. So I told him that, 00:41:00"There is this money for you for the microcredit." He said, "Okay. Where are you?" I said, "Just come by Magburaka UT Bank, you will meet me there." So the guy came. When the guy came, we had the guy handled and had him quarantined. But fortunately for him, he did not catch the virus.

So, you see? Because we have a lot of training from these guys from the CDC. We even had one Indian woman [that most times supported us during the time of contact tracing]. I remember a time we went at Bendugu. All of us went together, [and she resembled--like she comes from India. CDC and DHMT most often team together,] using the same vehicle. Dr. Osaio sometimes [told the CDC team that he was working on] Operation Chase the Virus during the night. If we catch the 00:42:00virus, we will come and tell you." We had those forms during most times. But thank God, our commanding officer didn't catch the virus. But I, as a supporting commander, I caught the virus, and I survived. So this now, we are creating forms, sorting them, we made with Dr. Osaio.

Q: Can I--you can say no if you want to.

KARGBO: Yeah.

Q: You've told me some bits and pieces about your own experience with Ebola. Coming down with it, being treated in Bo. Would you mind starting from the beginning when you first started showing symptoms and telling me that story?

KARGBO: Yeah. That was on Friday that Dr. Osaio said, "Augustine, let's go travel to Mile 91." I said "No problem," because I'm working with him closely, doing everything closely with him. So no problem. He said, "Can you drive?" I 00:43:00said, "No." I said, "Doctor, I drove all night, I don't need to drive this morning. You drive." He said "No problem." We arrive in Mile 91 and buy some things. At that time, I have bread because most times when my food is prepared at home, they just put it in the plastic and send it to me. So I have bread. Dr. Osaio said, "Augustine, I'm hungry." I said, "I have bread, let's share." I said, "For me, I cannot eat now because I have no appetite." He said, "What's happened?" I said, "Nothing." So he got some soft drink and cool water for me, so I drank the water and soft drink. So we went and visited the holding center in Mile 91. The nurses prepared some food for us and we went there and have just two or three spoons for me. I told Dr. Osaio, "I'm okay." He said, "Augustine, what's wrong? You are normally eating a lot, but not today." I said, "No, I'm 00:44:00okay." So when we are coming, he is observing me. When we came back I said, "Doctor, I need to rest." I said, "I've been exhausted all this week." I said, "I need to rest." He said, "Okay." So I went back home.

The day after, he called me by seven and said, "Augustine, how are you feeling?" I said, "I'm not feeling right." I said, "In fact, I've started to vomit." He said, "Wow!" He visited me then. He gave me a lot of [TUTIC water]. I started drinking. One night, I was having frequent stool all night. [unclear minimal. So I took some tablets so it managed to cut it down. But yesterday, I was having vomiting. I have one of my--my fiance, I called her to open an IV line for me, 00:45:00so she opened the IV line and gave me [unclear]. But yet still, I was feeling somehow [unclear]. So what I did, I called the ambulance without notification of the DMO or even the operations people there. [unclear] So I called the ambulance, I rode in the ambulance unbeknownst to my family, in fact. I have been conveyed to the holding center. There, I told Dr. Osaio, I said, "Doctor, it's good for you to refer me." He said, "Augustine, you have not even been tested." I said, "Doctor, let me go." So they gave me the ambulance and I was conveyed. During the time, in fact, the CDC--the NERC did not want to release the ambulance because there were no confirmed results from the people from 00:46:00Kailahun that I am positive, so they don't want to release the ambulance for that. So, doctor said no. The doctor managed to send the ambulance, and I was there for three days before my results came out. I have been on treatment. So if they would have [made me wait] for the next two days, I should have died. But thank God for Dr. Osaio, at least, to speed up my [unclear] and made sure that I was referred immediately.

Q: Can you tell me what happens next?

KARGBO: There, it's really terrible. That is why I said Dr. Osaio played a great role for me. Because why do you see most people dying there? Because of late attention. When I reached there, just during the day because I was there by [unclear] through the night, I was struggling to give myself water, mixing ORS. 00:47:00No attention. During the night, I called Dr. Osaio, I said, "Doctor, since this afternoon when I arrived here, no IV drip, no drugs, nothing." I said, "I'm dying." So he called the CHOs there during the night and they opened IV lines for me. In fact, I even called for supportive drugs. I was having hiccups, a lot of hiccups, that people even cried for me, "Our boss is gone." So what I did, I called my [wife Memunatu that she needs to send Largactil tabs for me, so she did.They used the] bike I was using, I asked her to give the guy the bike and [send the drug for me]. So she sends me six tabs of Largactil.

Q: What is Largactil?

KARGBO: Largactil is a sedating drug. Chlorpromazine. It's a sedating drug.

Q: Sedative drug. Okay.

KARGBO: It's a drug that stops vomiting or hiccups. It's a drug that stops hiccups. It makes you to become dizzy, or sometimes fatigued. Everything. But it's good. So I sent the doc [doctor] for that. They sent the drug for me, Largactil six. I took three tablets instead of taking two because it's fifty milligrams. So I took about one hundred twenty-five milligrams. So I slept for two or three days without eating in fact. So people think I have died. But those that work in the holding center, when they go, they know that I'm talking with the [unclear] to rest. I was having my water, I was having some other things, 00:49:00Lucozade drink for energy, because people are sending some things for me. So when I wake up I drink and I rest. For three days, I'm sleeping without doing nothing. So by the time--after three days, the hiccups stopped, the vomiting stopped, diarrhea stopped. So I started to take in food. That is why I say I spent only nine days in the treatment center. Thereafter, I came back, just about two weeks, I started to work again. In fact, when I started to work again, we had a case in the [unclear] area. Immediately, Dr. Osaio said, "Augustine, are you okay?" I said, "Yes." I said, "Doctor, let's go there." I went and took the spare and the [unclear]. I said, "Doctor, let's go." Everybody saying, "Augustine, you have come again. You are just from dying and you have come again." I said, no, we need to work, we just need to work. But thank God we 00:50:00succeeded. That is my only--my thankfulness to God.

Q: How did people greet you when you came back?

[interruption]

KARGBO: During the time when I came back, I had a lot of people, in fact, they did not greet me really. But when they see me actively involved in the process again, people feel so happy about me continuing to work again. We just need to do that, we just need to do that.

Q: Sure. Would this also be a good time to reset? Oh, I guess you already did. Okay. I'm hoping to take advantage of the fact that we have Mr. Dan Martin here who worked here in Tonkolili with you, Augustine, and see if he has anything 00:51:00he'd like to say or any questions for you. I'm passing the mic [microphone].

KARGBO: If I'd like to ask any questions. [shuffling]

MARTIN: So my friend, I just have to say first that having this privilege to talk to you after all these years is really powerful to me too, so thank you.

KARGBO: Thank you, too.

MARTIN: But I wonder, you told us a little about Operation Chase the Virus earlier, and some of my funniest memories of you are actually from the times that we were chasing the virus. [laughter] I wonder if you might tell us a little more just about the process, starting with, we get a call. Sometimes you'd get the call directly. We didn't usually get 1-1-7, right?

KARGBO: No.

MARTIN: Usually the call came either to you or--

KARGBO: The DMO.

MARTIN: --to Dr. Osaiyo Osaio directly.

KARGBO: The surveillance. Or to [David].

MARTIN: Sometimes to Tejan.

KARGBO: Or Yopoi.

MARTIN: Or Yopoi gets the calls.

KARGBO: From the DHMT, that was it.

MARTIN: Yeah, yeah. Yopoi was our M&E, monitoring and evaluation officer. So somebody gets a call. Tell us a little bit--so what happens next? Call comes in.

KARGBO: When a call comes in from the community that there is a person who is sick, we talk with the contact tracer, identify the house. How many houses that are there, what area, the right side or the left side. Maybe he says the right side. When entering, just count three or four or five houses, it's that very house. We ask all those questions. Maybe you tell me it's the third house on the right, there is a stone there. So we will hang on till the night, nine o'clock. Nine, eight, ten o'clock, during the night. We launch our operation. When we go there, we have one ambulance, one DMO vehicle, and one operational vehicle that 00:53:00I'm using because I'm driving again. When we reach the ambulance, we're straight back at the middle of the town, one vehicle will pass at the edge of the town and one vehicle will stay at the beginning of the town. We come down, we call the chief, we say we are here for a purpose, and this is that. At that time, we have support from the Ministry--military people. I think we have them, two or three guys working there. So when we are there, we explain to them our motive. So we start hutting their houses. Any door that we meet and close down, [we try to talk to them and cajole them to have access to the rooms]. After, we will gain entrance to the room. Sometimes when we spray the door, we will meet the 00:54:00patient lying down there. We move the patient and have them conveyed out to the hospital. If they become tested and prove positive, at that time after three days--because after three days, people have started to get signs and symptoms, three to four days it started. At that time, we will launch another operation by checking everyone in the village now. Any one sign. Maybe runny nose, maybe fever, headache, any one sign of Ebola, we move you there. So this is the way we were chasing the virus. This is the way.

MARTIN: What you just described, I just want to highlight this and you can tell us more about it, but you're describing something that not every district did.

KARGBO: Yeah.

MARTIN: This was in some ways really unique to Tonkolili I think. Because--

KARGBO: I think it's only Tonkolili that did Operation Chase the Virus. [unclear] that operation. That's why, perhaps, when the president came in here 00:55:00during that time, I was given permission to talk and we explained it to them. Because, why does Tonkolili succeed on that, by having few people dying in Ebola and we have a lot of survivors? Because of this operation that we launched. You know, Ebola, when you remove the person earlier in the community, there is a chance for them to survive. But if you have the patient down, a lot of vomiting and everything, by the time you convey the patient to Magburaka hospital, the patient will die. So this is the reason why we conquered this virus with a lot of survivors.

MARTIN: Remember the day--it's actually the same day as the photograph I emailed you earlier.

KARGBO: I saw the photograph.

MARTIN: Remember the day that we went there? That was Masokory--

KARGBO: Masokory.

MARTIN: We went to both Mabakoh and Masokory same day, right?

KARGBO: Yeah, Masokory, yeah. The chief's house is there.

MARTIN: And remember that something happened before we picked up the patients that day, because that was the day that I think it was five women came in on an ambulance, survivors coming back from Kailahun. And I remember that as we walked back into town, you gave that speech to the people there about how--well, you tell me. It was about seeing people survive. Tell me more about that.

KARGBO: We went there because--the time we went with survivors, because I told them, to be survivor is a blessing to them. And they must encourage the survivors to stay in their houses, and they must observe them because maybe you can survive, discharged from the treatment center. Since this is the area where 00:57:00we had the treatment center, they went, you come back with the virus, so that is how we always make sure that we observe them for the next twenty-one days. So we actually [unclear], make sure that they do not tease them, provoke them, and continue to support them. Because at the end of the day, if we don't create a mechanism where the people will accept them again, it's a problem. So to make sure that we create those mechanisms, make sure that they respect them, they don't have a lot of humiliation, there are things. The day when we went to Mabakoh, people were so enthusiastic to receive their family because [they might] say their family, they have already died. Because when the ambulance picks you up, you die. So when you come back, they thought that their family, 00:58:00they rose from the dead. So they are happy, they dance a lot, they are so happy to receive them in a great, great, great manner in which they, too, as a survivor, they too are glad to be with their communities. Even for me, too, when I came back. In fact, I have become more than the president in the town I came. A lot of greetings, songs, a lot of things, yeah. Sometimes, at any time, you have your family going down there, they have caught the disease, contracted the disease. When you come back, they don't believe that really, you are the person. So that is why sometimes they jubilate.

MARTIN: And we jubilated far away too, believe me. Believe me, when we got that news. There was celebration in Atlanta, too.

KARGBO: There was a celebration here, a lot of celebrations.

MARTIN: Because by then, quite a bunch of us knew you. [laughter] But I remember that day because as we walked back into the village, you said to the people, "Look, you think everyone who goes away for Ebola is dead. Look at these survivors, these are your people, they're coming back. This is why we're telling you, please let us get you into treatment, please don't hide, please understand that if we get you early you have a chance." That was such an important message.

KARGBO: You report yourself earlier, you have a chance to survive. When you report earlier, you have a chance to survive. So that helped us greatly, because we had been preaching to them their chances to survive. Some accepted that. Some did not accept that.

MARTIN: So how are you since? I know sometimes the survivors have had trouble 01:00:00even afterwards. How is it for you?

KARGBO: I'm doing fine. The only thing, my eyesight, last--Tushar was here, I was having some eyesight [issues]. In fact, right now I'm in college, I'm in my second year doing public health at university.

MARTIN: Oh, good!

KARGBO: I'm doing a BS [bachelor of science degree] in public health.

MARTIN: At Njala [University]?

KARGBO: It's at the University of Makeni. I'm in my second year. Sometimes--for now, due to the brightness of the room, I'm reading this, but in the dark area, I cannot read this unless I use glasses. Sometimes it's too difficult for me. That is all my constraints. Because during the time I was having some rashes, but thank God it's better now, because I tried to make sure that I built up my immune system, tried to do one or two things. But the only problem that I have now is my eyesight sometimes, unless I use glasses to read.

MARTIN: So otherwise you're strong?

KARGBO: Yeah, I'm strong.

MARTIN: You look good, you look good.

KARGBO: I'm riding bikes, from here to Masingbi. I have bikes.

MARTIN: You're riding a bike to Masingbi?

KARGBO: Yeah, it's simple to ride a bike.

MARTIN: That's two hours by car. And they're not easy hours.

KARGBO: When you talk to my DMO, he will tell you that Augustine is one of the most active persons in the DHMT. [laughter] I still maintain my activeness within the DHMT, because I know that since I'm here, I need to prepare for my duty. I'm still working very hard.

MARTIN: I know you work hard. That's the Augustine I've always known. It gives me so much joy to see you back on your feet and healthy, my friend.

KARGBO: It's a pleasure. That is it. Thank God I survived.

MARTIN: Amen.

Q: Dan, unless you have more questions--

MARTIN: No, I can't think of anything now.

Q: Okay. Then the last thing I like to ask is, [shuffling] Augustine, is there 01:02:00anything that we haven't talked about that I haven't asked about, a reflection or a memory about the Ebola response, anything that you'd like to share and put on the record before we conclude the interview?

KARGBO: The Ebola memories--it has come, it has passed, we are still working. So we are grateful that we're working. You know, we are praying to God this thing won't happen again because we have these, our NGOs coming--last, they told us, some NGOs came in and said, we will support you, we will give you this, we will give you this. But just [for a few months] during that time. Especially with the elder people. No support. It's really not easy, but thank God we are still working to maintain our status and our family. It's just a matter of working 01:03:00at--if we say we rely on these people to settle our problems, we cannot achieve our aims and objectives at the end of the day.

Q: Thank you so much.

KARGBO: Most welcome.

Q: I know that it's been powerful for Dan and it's been excellent for me hearing you give your history. So thank you.

KARGBO: Most welcome.

END