I have taken pride over my 40-plus years as a photojournalist in offering dignity to subjects I photograph, especially those who are sick or in distress while in front of my camera. My recent photographic assignment to cover the Ebola outbreak in Liberia has proved exceedingly challenging for me.
Respect is often the last and only thing that the world can offer a deceased or dying person. Yet the camera itself seems to be a betrayal of the dignity I so hope to offer. Sometimes, the harshness of a gruesome scene simply cannot be sanitised. How does one give dignity to the image of a woman who has died and is lying on the ground, unattended, uncovered and alone as people walk by or gaze from a distance?
But I believe that the world must see the horrible and dehumanising effects of Ebola. The story must be told; so one moves around with tender care, gingerly, without extreme intrusion.
Telling the Ebola story in Liberia means being near, within shooting range, of the ravages of the virus. That work brought me face to face with another dehumanising element of this virus: fear. Since a silent danger hides inside the Ebola-infected person, a simple touch could prove harmful. Extreme caution is required.
In Monrovia, where I spent two weeks last month, fear is always present: among the people, and among photojournalists in the act of capturing scenes of desperately ill Ebola-infected persons. Fear produces an internal struggle: How close to the subject do I get to make a compelling photograph?
If I get too close, is the risk of infection too great? Fear drives the process of capturing images. It becomes a tool that guides and reminds one to be excessively careful not to become infected. The rules are simple: Touch no one, and let no one touch you. Spray the bottom of your shoes with chlorine solution. Wash your hands frequently with that chlorine solution, even if you haven’t touched anything. The act becomes habitual.
Back in the United States, fear took on a different significance - hysteria. Syracuse University rescinded an invitation to me to be a mentor and coach to photojournalism students there this past weekend. A student learned that I had recently been in Liberia and expressed concerns. On the day of the scheduled workshop, I received a phone call asking me to stay away.
When I returned from Liberia, I followed all the guidelines for people returning from the Ebola zones. I followed recommendations from the Centers for Disease Control and Prevention and Doctors Without Borders (Medecins Sans Frontieres, or MSF) on how to watch for signs of symptoms. I took my temperature twice daily; in my case, out of anxiety, almost on the hour. My recommended 21 days of monitoring ended, and I am well. I am cleared to go back to work and was ready and anxious to mentor aspiring photojournalists.
I’m angered by the decision and sorry not to get to teach. It was a disservice to journalism students at Syracuse, a missed opportunity to share real-world experiences with future media professionals.
Especially now, I am cognizant of what I could have told them - about the power and necessity of capturing images that interpret the human experience while daily life unfolds under the cloud of Ebola.
In one of the most emotional encounters I faced in Liberia, I photographed a family that accompanied a sick woman who seemed near death as they sought treatment. She was bleeding from the mouth and her breathing was shallow; she could not walk. As the husband, a sister, a brother and a friend descended from the van, each wore large plastic bags around their hands, feet and bodies, trying to protect themselves from infection with makeshift coverings. They knew it was the only way to get their very ill relative to the Doctors Without Borders Ebola treatment unit. Waiting outside the gates was a given, but to the anxious family, I am sure one hour seemed far too long as the patient worsened.
At one point, I approached the woman’s sister, who had secluded herself against a wall away from the others and her sister fading away in the van. Standing at a safe distance, I asked her how long her sibling had been sick; she said about a week. She asked me questions that I could not completely understand and could not answer. As we tried to converse, neither fully understanding the other’s dialect, our eyes did the talking. To me, her eyes said, "This is the end." I looked at her and said, "You know she is very, very sick." She said, "Yes, I know." As I tried to continue our fruitless conversation, my voice broke and suddenly tears came involuntarily. By then, more patients arrived by ambulance and I resumed taking photographs.
It is profoundly difficult not to be a feeling human being while covering the Ebola crisis. Indeed, one has to feel compassion and, above all, try to show respect.
On three previous trips to Monrovia, near the end of the civil war there, I’d seen a country in ruins. People’s struggle for basic subsistence was palpable. Today, as Liberia’s economy began to improve after years of civil war, life moves at the hectic African pulse, and the Ebola virus continues to kill, seemingly, at a faster pace. As of Friday, according to the World Health Organisation, 2,484 people have reportedly died from Ebola in Liberia alone, and there have been 4,262 confirmed infected cases there. Government offices, including the Executive Mansion, are closed. The Liberian Ministry of Health and Social Welfare is the only government office currently functioning. It is the local authority responsible for getting rid of the Ebola virus.
Life is far from normal during the crisis, yet the streets remain choked with heavy traffic. Old vehicles with smoke blowing from their exhausts move around giant potholes and deep puddles, a result of the West African rainy season. Barefoot children in shorts race up to cars at intersections, hawking assorted items such as candy, chewing gum, cream biscuits, plastic bags of water and windshield wiper blades, while everybody seems to ignore traffic laws.
The Ebola virus has hit hard in the New Kru Town section of Monrovia. Burial crews in protective suits are so overwhelmed that bodies of people who have succumbed to Ebola often lie on the ground for long periods of time, even at the doorsteps of Redemption Hospital. The hospital, which is now closed to daily health concerns, is used as a holding and transfer facility for suspected and confirmed Ebola patients. When it is full, those who show up frequently wait outside, lying on the ground or sitting for hours in an ambulance, where they often eventually die. No one can approach or touch the bodies without protective gear. Health professionals say that the Ebola virus is most contagious when the host has died. Subsequently, bodies lie for hours before teams wearing protective suits can retrieve them.
In the capital, Monrovia, those who die from Ebola are cremated. But in the far outer counties, burial is still the only way. Health workers bury the dead inside plastic body bags. They lower the body, using simple strips of white cloth; then, leaning over the grave, a couple feet down; they have no choice but to simply drop the body down the rest of the way into the 6-by-4-by-6 hole -no coffin, no ceremony, no family or friends. The authorities have decreed this method to prevent the virus’s spread through burials.
In West Point, a bustling Monrovia slum with a population of 70,000, an ordinary afternoon can seem like a chaotic dance, with shacks, stalls, shops and houses that all look like one another. Startlingly, one day I watched from the front seat of our vehicle as people lined up for food handouts from the United Nations World Food Program, body-to-body, blatantly ignoring the call from authorities not to touch for fear of spreading the Ebola virus from close contact.
Irony is no stranger to West Point. When a Liberian magisterial judge tried to arraign a man and woman accused of grand theft, the man vomited while handcuffed to the woman in the small courtroom. Suddenly, the place was cleared and the couple isolated as an ambulance was called. After spraying down the area and the two accused thieves with chlorine solution, health workers dashed off with them in an ambulance to Redemption Hospital. As the vehicle arrived with its siren blaring outside the treatment facility, the doors opened for the two, who immediately took flight, running down the street, escaping their earlier fate of a Liberian jailhouse.
Monrovia is on the Atlantic Ocean, on Africa’s west coast. During the rainy season, which locals joke lasts six months of the year, the sky is gray, day and night. The nights are pitch-black, leaving visitors to ask, "Where is the moon?"
From high points in the city, I captured magnificent images of the ocean, the postcard-worthy sunset. It’s an image of a city in crisis and moving forward as if things were normal, hoping for dignity.