Kanké, age 10. Donka Cholera Treatment Center in Conakry, Guinea.
The biggest change in my work since I moved to West Africa is the decreased number of assignments from news outlets. Part of it probably has to do with the fact that I am new to this region, but it's also undeniably a region with less mainstream-media interest, compared to the Middle East/Afghanistan. It's also not news that freelance photojournalists often supplement their journalism assignments with whatever will the pay the bills--weddings, corporate, advertising. This is the current reality. However, I've been lucky to be able to make a living strictly doing journalism. That is, up until now.
So, I've started doing a bit of photography for humanitarian organizations. I count myself lucky again, because the agencies I have worked with so far have allowed me to approach the work like a photojournalist. In particular, I found an assignment I recently did for Médecins Sans Frontières (Doctors without Borders) particularly fulfilling. I traveled to Sierra Leone and Guinea in August to photograph a growing cholera epidemic. It was a quick trip, only 3 days in the capital of each country, but I learned a lot and I was able to shoot it like any reportage assignment, which felt really good.
Cholera is a miserable illness. It causes days of diarrhea, vomiting and painful cramps.
In Freetown, the capital of Sierra Leone, at a Médecins Sans Frontières (MSF) emergency cholera treatment center located in the impoverished quarter of Mabella, nurses treated patients like 12-year-old Mohamed, above, with oral and intravenous fluids. More than 13,000 people suffering from cholera had been admitted to hospitals in Sierra Leone and Guinea by the end of August.
To understand why people get cholera, it is necessary to understand the conditions in which they live.
In Mabella, sewage and trash flow untreated into the ocean. There is no trash collection. There is no system to carry sewage safely away from this overcrowded neighborhood where some of Sierra Leone's poorest residents live. People don't have running water in their homes, and there are few toilets. Because of this lack of toilets, it is not uncommon for people to go to the bathroom out in the open.
People in Sierra Leone speak a language called Krio, a mixture of English, French, Portuguese, and Yoruba, brought to Sierra Leone by freed African slaves. The majority of people I encountered in Sierra Leone were incredibly warm and welcoming, despite living under difficult circumstances, and the language had this musical, slangy quality. I felt like I could almost understand, but I still needed an interpreter. When explaining to people who I was and why I was "snappin' " (taking photographs), the interpreter told them it was about "dis cholera business" (this cholera business). Boy is "bobo" and girl is "titi". Occasionally I could hear someone say "orpotoe," white person, as I passed by. Meeting people and listening to the language were by far my favorite parts of this assignment--besides the actual photography of course.
Residents crossed a bridge in Mabella.
A girl sat on a walking path between homes.
The war aside, Sierra Leone ranks near the very bottom at 180th of the 2011 United Nations Human Development Index, the UN's attempt to measure of "quality of life" around the world. (Click here to see the full list of rankings by country. The United States came in 4th.) Cholera is just one of many challenges the people of Sierra Leone face.
Aminata and her little brother sat outside their home.
Neneh, 15, prepared roasted peanuts to sell at the market.
The peanuts were washed before roasting.
Women prepared a big batch of stew to sell at the market.
Children filled buckets with water at one of Mabella's few water points right next to a waste water canal.
What can be done? The cholera treatment centers were built to offset the emergency, and health agencies worked to educated the public on how to protect themselves, even distributing bleach for people to add to their drinking water. But as long as people live without reliable access to sanitation and clean drinking water, I doubt cholera will ever completely go away.
Kadija, 4, rested in the arms of her mother in the observation area of Mabella Cholera Treatment Center.
Wellington Community Center in west Freetown was turned into another MSF cholera treatment center. Above, a nurse tried to ease 14-year-old Aminata's cramped limbs with massage.
Sia sat with her 5-year-old son Aliou at Wellington Cholera Treatment Center.
Due to a few logistical difficulties, I wasn't able to spend as much time outside the cholera treatment centers in Conakry as I would have liked. I really only got to visit this one neighborhood briefly and the port.
Guinea came in just a couple steps higher than Sierra Leone on the UN Human Development Index, at 178th.
Donka Cholera Treatment Center.