Perspectives

Lifeline

When Sierra Leone was in the throes of the deadly Ebola outbreak, Africell mobilized a comprehensive response. Brunswick’s Sam Williams talks to the CEO.

The story of the ebola crisis in Sierra Leone has many characters.

Viewers of western news bulletins in the dreadful years between 2014 and 2016 will remember doctors in “hazmat” suits ghosting through hospital wards, or they may recall a handful of international aid workers accidentally flying the virus home with them. Sierra Leone’s government and military, as well as foreign governments, NGOs and charities, all played fundamental roles in the campaign. To this group belonged some of the country’s best known brands.

In normal times, these companies would have been concerned with business as usual—the daily pressures of marketing and sales, operations and personnel. But as Sierra Leone faced disaster, some companies set new priorities and offered to help. 

 

Photograph: Associated Press

Africell was among them. 

Africa’s celebrated telecoms revolution is well known. In a scramble for coverage in the early years of this millennium, companies built grids that would give the majority of Africa its first connections. Africans embraced the new opportunities that created: faster payments, cheaper insurance, easier contact with family and friends. Studies show that the expansion of mobile networks in Africa uncorked a wave of economic progress. On average, every 10 percent increase in mobile-phone penetration in developing African countries has added 1 percent to GDP growth per-person-per-year.

Telecoms markets in much of Africa are dominated by multinationals operating in dozens of countries—leviathans whose economies of scale are often betrayed by inefficiency. In Sierra Leone, by contrast, the mobile market is led by a company called Africell, a comparatively small and specialized unit operating in only four countries. In a regional industry line-up, Africell’s profile is unique.

In 2014—the year Ebola bared its fangs—Africell had a market share in Sierra Leone of 70 percent. In the nine years since its first tower was installed on a hill above Freetown harbor, operations had spread across the country. Its orange and plum color scheme became a familiar presence, and its sponsorship of local initiatives projected a likeable personality. Sierra Leoneans had come to appreciate the affordable and dependable service.

Sierra Leone’s name means “Lion Mountains,” named, some say, by early Portuguese navigators skirting West Africa’s tropical shore who thought the muscular hills looming over its beaches resembled a lion’s back. The name stuck. The sands are white, the forests green, and the sea a lapis lazuli blue. Elephant, hippo and leopard still stalk the jungle.

That enduring beauty masks a turbulent history. Sierra Leone was established in the 18th century as a refuge for slaves freed during the American Revolution. Tension lurked between migrants, colonial officers and tribal chiefs. Conflict flashed and fizzled. Eventually, in 1961, a delegation of Sierra Leoneans to London secured the country’s independence. And although the new Republic of Sierra Leone was at first a democracy, institutions were too weak to withstand a military coup in 1967. This opened the door to a quarter century of further coups, corruption and authoritarianism.

The grim conclusion of this unstable era was Sierra Leone’s civil war. In 1991, Sierra Leone dissolved into darkness—over 50,000 people were killed. Civil society was left in shattered ruins and the economy shrunk to a husk. Observers commented on the chilling insanity of the fighting as if the country itself was possessed by demons—a Hobbesian “war of all against all.”

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Shadi Al-Gerjawi, CEO of Africell in Sierra Leone.

The war ended in 2002 and reconstruction began. Supported by the international community, elections produced a democratic government. Businesses began investing. Its mineral bounty, fertile land, deep harbors and blissful beaches give Sierra Leone an obvious appeal. Between 2002 and 2014 the nation’s GDP grew from $1.25 billion to over $5 billion. Africell’s growth was part of the resurgence.

Then, in March of 2014, a crop of Ebola cases appeared in and around Kenema, the country’s second biggest city. By June, the outbreak had exploded. The government hospital in Kenema struggled to cope with the flood of patients and the virus branched quickly into neighboring districts.

Panic flared. Still reeling from the ghastly trauma of war, many saw Ebola as less a pathogen than a curse—a macabre spirit condemning all in its path. It appeared to have neither cure nor defense and its hideous symptoms inspired an elemental horror. The world sat up, alarmed by Ebola’s virulence and the possibility of an undiagnosed carrier boarding a flight at Freetown’s Lungi Airport. Sierra Leone seemed to be looking once again into an abyss.

“We didn’t wait for an emergency to be declared. As soon as the first cases were reported in March, we knew we had to start preparing,” says Shadi Al-Gerjawi, CEO of Africell in Sierra Leone. A long-time Freetown resident, Al-Gerjawi has led the business since it began in Sierra Leone in 2005. “As news of the outbreak spread, everyone felt hopeless. As far as they could see, the price of infection was ultimate: If you caught the virus, you died.”

As the first cases were reported in and around Kenema, Al-Gerjawi gathered his leadership team for a meeting.

“We decided early on that information was key. The best catalyst for Ebola would be ignorance,” he recollects. “If people didn’t understand what the disease was and how to avoid it then it would spread like fire.”

His team ensured information on risks and safety was understood by staff. Experts from the Ministry of Health were brought in. Grave-faced physicians explained in blunt and graphic detail what staff must do to protect themselves: report symptoms immediately; never touch a victim; whatever you do, do not attend funerals.

Staff were quizzed to ensure the information sunk in. The company created a unique SMS system. For eight hours each day, every 15 minutes, employees would receive an anti-Ebola tip by text message. “UNSUBSCRIBE” was not an option. This digital liturgy, which might have felt Orwellian in ordinary times, meant that Africell staff were as conversant in the axioms of hygiene as any medic.

It was the doctors and nurses who were in the trenches, but because of radio broadcasting, people who might previously have ignored government advice started to listen.

Shadi Al-Gerjawi CEO of Africell in Sierra Leone

“Our people had a sound understanding of Ebola,” Al-Gerjawi says. “Unlike other Sierra Leoneans who hadn’t benefited from that training—and who often, unwittingly, did things that might facilitate its spread, such as handling victims or hiding symptoms—we were in a good position to continue working safely.”

As the humanitarian crisis worsened, President Ernest Bai Koroma announced the creation of a National Ebola Response Committee (NERC), bringing various departments and international agencies involved in the response under a single command chaired by the President and operated by the Defense Minister. Though no private companies were members, Africell had a de facto seat at the table.

“We were the biggest mobile company in the country, and one of the biggest employers and taxpayers, so we knew the government well,” Al-Gerjawi says. “The government and its international partners realized that our technology, network and on-the-ground knowledge could prove useful and they invited us into the decision-making group.”

Africell began by providing phone connections to incoming agencies. Lungi Airport was thronged by foreign doctors, soldiers and bureaucrats who needed access to Sierra Leone’s mobile network. They bore medicines, strategies and spreadsheets, but without the communication link, they would be hamstrung.

“The immediate priority was to get these people connected. We activated hundreds of SIM cards, with pre-connected handsets that operated at a fraction of the cost of the bulky satellite phones they brought with them.”

Where Sierra Leoneans had had a confusing menu of numbers to call in an emergency, Africell set up an emergency phone line that patched all Ebola-related calls to NERC operators. “The best thing about the emergency line was that, as well as creating a single point of contact, it generated data. We analyzed incoming reports and the findings allowed the government to construct a dynamic picture of how the disease was proliferating.”

Although the ranks of foreign specialists were swelling, the on-the-ground response was still dominated by Sierra Leoneans. They filled most of the riskiest front-line roles: ambulance drivers, nurses, gravediggers. With equipment scarce, villagers sometimes hostile to outside help, and lethal pestilence a daily hazard, these responders faced extraordinary pressure. Maintaining morale was vital.

“We had recently been working on our mobile payment services. When Ebola hit, the potential utility of these services was obvious. The people working at the front line of the crisis needed to be paid. Africell set up a platform for wages to be paid cheaply and on time.”

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Nyangei Island, the Turtle Islands, Sierra Leone. The picturesque land, now a tourist mecca, has had a turbulent history.

Economic spasm necessitated the delivery of food aid, and the agencies responsible faced the formidable and chaotic task of monitoring exactly who received what. To make sure rations got to the correct people, Africell distributed SIM cards used for identification, smoothing the entire process.

The combustion of a limited outbreak into a flaming epidemic had no single cause, but it was exacerbated by a shortage of at least two resources: hospital beds and quarantine spaces. Beds were important because only in hospitals could victims receive the highly specialized care they needed. Quarantines were important because, without them, doting family members would succumb to the virus themselves. Homes would become mortuaries.

NERC oversaw the construction of more hospitals and quarantine spaces, a task as urgent in the hinterlands as it was in the capital. Government workers, supported by foreign specialists—including a major deployment of British troops—set about erecting the new sites. Freetown’s density meant that Ebola erupted there with volcanic force. But the city also benefited from the best pre-existing hospitals. In some more remote areas, adequate care facilities were sometimes entirely absent.

Al-Gerjawi remembers how they tackled that: “Many of the new sites were built away from towns, where mobile coverage was weaker. We shuffled our network to address this. On several occasions, we actually took masts from areas of strong coverage and planted them directly by the new premises—which were sometimes hundreds of miles away. Isolated patients could then communicate with loved ones without risking face-to-face contact. This was wonderful.”

As Shadi Al-Gerjawi and his team had predicted in March 2014, information played a key role in the battle against Ebola. But achieving victory was complicated by two factors. The first was that the instructions of health authorities often clashed with traditional custom. Kinship is the organizing principle of Sierra Leone’s tribal communities, but behavior required to counter the spread of the disease seemed to defy this. For many Sierra Leoneans, not feeding a sick mother or keeping a dying child at arm’s length were unthinkable. Yet that was the advice of the government—plus the WHO, Red Cross, Médecins San Frontières, and other organizations working to stem the epidemic.

The second challenge was the emotionally charged, often irrational criticism faced by the government. Certainly there were areas where government could have been better prepared, but Ebola hit Sierra Leone like a lightning bolt. Tragedy was unavoidable.

Public discourse became a storm of accusation and recrimination. Sierra Leone’s airwaves boiled. Callers to radio shows skewered the government, the UN, the Red Cross, foreign soldiers, and anyone else visibly associated with the disease. Conspiracy theorists frightened listeners with outlandish claims.

Strategists in Freetown could see that the angry chorus was inhibiting efforts to convey consistent information about good Ebola avoidance practices. But at the same time, the fevered debate was also to a certain extent caused by a vacuum of information. What was needed was an authoritative source capable of winning the trust of ordinary Sierra Leoneans. Radio was the answer.

For eight hours each day, every 15 minutes, employees would receive an anti-Ebola tip by text message.

“Even though NERC and its subsidiary agencies were working incredibly hard, the war of words was a struggle,” Shadi Al-Gerjawi explains. “We brainstormed how we could potentially help public interest announcements cut through. We decided to launch a new, nationwide radio-station effort dedicated specifically to Ebola issues, and to make it available to the government and its partner agencies who were trying to make themselves heard.”

It worked. The national network of community radio stations was mobilized and coordinated, beginning in 2014. Previously, a multitude of local outfits displaying little interest in correcting falsehoods had jousted for the public’s attention. But now, Sierra Leoneans had a single verifiable source broadcasting Ebola news impartially.

The Africell brand lent familiarity. Popular DJs helped messages resonate in plain language. Spit-flecked homilies were replaced by evidence-backed updates. The government and the international agencies all had designated broadcast slots, including the popular “Join Hands to Drive Ebola Out” program with Joe Bangura, an Africell executive. At reliable intervals, listeners could tune in and learn what they needed to about the situation. As the months passed and listener numbers grew, the cacophony elsewhere subsided.

“Of course, it was the doctors and nurses who were in the trenches,” Al-Gerjawi says. “But because of radio broadcasting, people who might previously have ignored government advice started to listen, comforted by the fact it came from a trustworthy source. The radio contributed to a sense of national unity—that we really were all in this together, working toward a common goal.”

By the time it was declared clear in March 2016, the Ebola virus had killed almost 4,000 Sierra Leoneans and infected another 11,000. Those lucky enough to survive had experienced hell. Scarcely any families or communities were unaffected. In addition to Sierra Leone, many lives were lost in neighboring Guinea and Liberia, as well as in Nigeria and Mali. At its peak, the WHO warned of a possible pandemic, enveloping the whole world.

It’s three years on and today, Sierra Leone presents a startlingly different picture. The economy is growing. International investment is brisk. Tourists are arriving daily with surfboards and hiking boots. A new democratic government, elected in 2018, focuses on relatively benign matters such as interest rates and infrastructure. Freetown’s strobe-lit bars and beachfront crab shacks are busy all day and all night.

Shadi Al-Gerjawi dismisses the notion that the Ebola crisis was vanquished by heroes.

“No,” he says. “The notion of heroism in that situation is unhelpful. When people took risks, they caught the virus. And if they did that, they often either died or passed it on. What was needed was discipline. We told colleagues to ‘help yourself before you help others.’ People were deliberately encouraged to not be heroes.

“We just got on with it. We believe our efforts helped the overall response, and that is great. But we haven’t tried to show off. Sierra Leoneans remember the Ebola outbreak, but they don’t like to think about it too much. People are focused on the future. When they judge Africell, they judge what we do for them now, in 2019—not what we might have done in the past.

“More than anything else, people care about cheap rates and fast internet. That suits us just fine.”

Sam Williams is an Associate with Brunswick, based in Abu Dhabi.

Nyangei Island Photograph: Tommy E Trenchard / Alamy Stock Photo
Photograph of Mr. Al-Gerjawi: Courtesy of Africell

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