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As wi cam, na so wi dae goh

As wi cam, na so wi dae goh. Translation:  How we come into this world, in that way, we will also leave this world.

The middle-aged woman of two teenage daughters (I shall refer to her as Sia, not her real name) was brought to the Community Care Center (CCC) in rural Sierra Leone where I’m working as a healthcare volunteer. Sia came to the center after experiencing one of many "attacks" that were increasing in frequency over the last months. 

The story goes that her husband had brought her to the area from almost eight hours away to be attended by a Traditional Healer in a remote village.  Overcome by her undiagnosed illness, she fell into a semi conscious state then, shortly after arriving to the CCC, she became unresponsive. 

My team and I arrived late morning and found the nursing team working hard to get such a critical patient admitted and into the suspected case ward. Sia's husband anxiously awaited news of his wife under the nearby palm frond baffa hut. 

The nurse team provided initial care and needed to exit the ward having been in full protective equipment (PPE) for over an hour. We prepared to enter the red zone and formulated a carefully laid plan giving each team member a specific job to complete in a specific order. 

When in full PPE at midday in Sierra Leone, there is little room for fumbling around or delay if we forgot an item. Lab draw items - check.  IV fluid and catheters - check. Medications - check. Cleaning supplies - check. We dressed in full PPE, wrote our names and the time on our suits and brought our bucket of supplies into the suspect ward tent. Sia was lying half off a mattress that had been placed on the floor. She was minimally responsive and breathing fast with a rapid, weak pulse. I placed the IV knowing that unless the fluid bolus and medications change the immediate equation, Sia was not long for this world.

And, indeed, she slipped gently away over the next hour.

Sia was prepared for burial by the CCC nurses and safety workers. A nurse told me later how she set Sia's mouth, closed her eyes, prepared her clothes and crossed her hands in her lap then the team wrapped her respectfully and carefully in a blanket and into the body bag. She whispered into Sia's ear "It's not for me to do this work, but, today, I must do it for you.  I'm sorry." According to custom, Sia's family would have carefully prepared her body for burial.

The burial team arrived, dressed themselves in full PPE and carried Sia's white body bag coffin to the graveside where the women wailed and the men gathered with a pastor for a brief service where it was underlined that "Aw wi cam, na so wi dae goh". 

Perhaps not a fully traditional funeral in Sierra Leone but a Dignified and Safe burial for Sierra Leoneans by Sierra Leoneans.

So te go (Amen).

- - - - - - - - - - - - - - - - - -

I never thought I could feel lonely while drinking palm wine or, in the local language, "poyo." It has been made abundantly clear to me that enjoying a cuppa poyo is dependent on much more than the quality of the palm branch from which it is extracted by the poyo man and placed in the gourd or plastic jug. Poyo is sweetest when consumed while sitting comfortably and casually on a wooden bench, among friends, on a warm Sierra Leone evening as the sun is fading and a gentle breeze rustles the overhead palm branches. In that context, it is indeed a drink befitting its other Salone name ‘From God to Man.’

Desiring a taste of the native home brew, I arranged for the whitish gray and slightly fizzy with natural carbonation beverage to be brought to our lodging. It was this poyo experience that caused the sense of isolation noted in my opening line. It was consumed in Sierra Leone but in an expansive room filled with electrified light, long tables, red cloth covered chairs occupied by various and sundry ex-pats from non government organizations rallying around the Ebola Response flag. The experience, from my point of view, was incomplete; no palm tree, warm breeze, wooden bench or talk about nothing in particular among friends. And so I sat in a room full of people alone in my knowingness. 

Aw foh du (I must make do).

Varnes-Epstein is a physician assistant and mid-wife living in rural Gays Mills. She is currently in Sierra Leone working with Partners In Health in the fight against Ebola. Varnes-Epstein was stationed in Sierra Leone in the 1980s as a Peace Corps volunteer.

Previous, related articles:

Local woman volunteers in fight against Ebola, Jan. 16, 2015

Local medical practitioner sends update from Sierra Leone Ebola clinics,  Feb. 10, 2015

To learn more about the organization Varnes-Epstein works with, visit Partners in Health online at