Ebola death leads widow to continue dream
Martin Salia was a saviour in Sierra Leone, but his medical legacy is in his wife’s hands
Isatu Salia did not let go of the black box holding her husband’s ashes once she left the Nebraska hospital. It sat on her lap during the 2 ½-hour flight back to Maryland, and for the 30 minutes it took her brother to drive them to their sister’s home in Lanham.
It was too soon for her to be alone with Martin’s belongings, his clothes, their pictures. Their two sons, Maada, 20, and Hinwaii, 12, were already at the Lanham house. The boys rushed to hug her as she came through the doorway, and she held them tightly with one arm. With her free hand, she gripped the box.
About 30 other people had come to mourn with them that night: her mom, whom she had followed to Maryland from Sierra Leone 11 years earlier, eight siblings and their families, people from church.
Maada reassured her that everything would be OK. He had stayed with his younger brother while she flew to Omaha, to the hospital where Martin was evacuated to that was specially equipped to treat Ebola. With Isatu’s reluctant blessing, Martin had returned to work a few months earlier as chief surgeon of a hospital in Freetown, Sierra Leone, despite the outbreak. Martin was the only U.S.-based health-care worker who died of the virus. Five others, who were infected and treated in the U.S. survived.
President Barack Obama hailed Martin as a hero and sent a top aide to deliver condolences to the family in person.
As weeks passed, fewer visitors came. The meals from the church dwindled. Neighbours and some colleagues at her nursing job would not hug her, for fear of becoming infected.
There was never any risk, though. Isatu had not even been allowed in the same room as Martin when he was sick. His body was cremated as a precaution, and his ashes were put into a small white rubber box that was then encased in a black box.
When he died in November 2014, Sierra Leone had been in a state of emergency for months. In a year, the country was home to nearly a third of the more than 11,300 people fatally infected across West Africa. There were a handful of high-profile cases among travellers and health-care workers in the United States, and few Americans had been directly affected.
Fewer still paid attention to the outbreak once it began to recede after the new year. Ebola faded from headlines, but Martin’s loss still reverberates in Maryland and in Sierra Leone, where, before the outbreak, he had been among the 120 or so doctors serving a population of nearly six million. One colleague in Sierra Leone told the press that friends and hospital staff rolled on the ground, wailing at news of Martin’s death.
To be a doctor in Sierra Leone is to be exceptional. Martin was the son of a driver who rose to become a renowned surgeon. He could have moved abroad to earn more money, but instead spent the two years before his death shuttling between the comfortable suburban refuge Isatu had created for their family in Hyattsville and a Methodist Hospital in a poor section of Freetown, the capital.
Isatu, in turn, had dedicated her life to Martin, forgoing college to work while he finished medical school, helping support his family, paying the school fees of children they barely knew. His sacrifices were hers. But selflessness comes with a cost that is easily overlooked after the heroics are over. It took the form of grief and paralysis for Isatu, and guilt as well. In the year after his death, as she lay in bed each night with his ashes, she could not help but wonder if she had failed him and the country they had hoped to do so much for. And what could she do now?
Martin was the sixth of 11 Sierra Leone doctors who died of Ebola in 2014. Isatu knew them all. She had cooked for them when they came to hang out and study in the home she and Martin shared in Freetown 20 years ago.
“Everyone would call me Mommy and him Daddy,” she says. Martin was slender and a few inches shorter than Isatu’s six-foot frame. His high school friends nicknamed him “Simple,” because he refused most frivolities and felt most comfortable mingling with the country’s lower classes. Wherever they went, strangers and friends knew she and Martin would give them food and aid. “Anything we needed, he and his wife did it for us,” says Lucy Salia, Martin’s mother. “He was the strongest. He can do something for everyone.”
Their families didn’t approve of the match at first. They were from different ethnic groups — she was a Mende and he, a Temne. She was the daughter of an imam; he was a devout Catholic. “This is a disgrace,” her family would say when she first told them about Martin. “You’re a Muslim. How could you mingle with a Christian?”
But the couple ignored their families and married. At the time, a bloody civil war was ravaging the country. Isatu’s family fled to the United States, and, in 2003, her mother arranged for her to move with them to Maryland, while Martin looked after the boys and completed his medical training. Isatu enrolled in nursing school and two years later brought her sons to live with her. Once Martin met his training requirements, he was free to settle wherever he wished. But Martin wanted to be in Sierra Leone, Isatu says. He told her he could save more lives there than he ever could in the United States. Isatu recalls feeling “so inspired” by her husband she wanted to understand what drove him.
“The way he lived his life, I thought, ‘What kind of person is this, what kind of God does he follow?’” she says.
She started going to church with him. In 2006, she converted to Catholicism. Isatu and the children later became U.S. citizens. Martin became a permanent resident. The family settled into the house in Hyattsville.
He needed only a few more classes to be a fully licensed doctor in the States, and he planned to eventually complete them. But until then, while he lived in Maryland he helped Sierra Leonean medical students in the District of Columbia with their studies.
But Sierra Leone was never far from his mind. Isatu returned home one morning from an overnight nursing shift in late July 2014 to find him sitting frozen upright in the centre of their bed. He had just received a call. The first doctor in Sierra Leone had died of Ebola. Few surgeons were as skilled as Martin, or trained in what would be relatively simple procedures in the U.S., such as removing excess fluid from a patient’s brain. Only instead of being there, he was doing grocery store and carpool runs in suburban Maryland.
Isatu knew he wouldn’t leave without her blessing, and she told him she didn’t want him to return to Freetown. A few days later, she overheard him on another call, this time with a surgeon who told him that doctors and nurses were fleeing Sierra Leone. Patients were delaying their operations until Martin returned. Isatu could hear her husband’s guilt-tinged voice and agonized words.
“I was looking at him suffering through this, trying to make that decision,” she says. “He was sick to his stomach. He would say, ‘They need me, and people are dying, and I’m here.’”
She told him later he could go back to work. Martin left in late August for United Methodist Kissy Hospital in Freetown. Isatu spoke with him at least once a day. He kept assuring her he was not working with Ebola patients.
In early November, Isatu received a call from Martin, saying he had an inexplicable fever. He told her again that he hadn’t knowingly made contact with an Ebola patient, but was going to get tested. It was possible Martin had a patient who didn’t know she was infected. He and Isatu made a plan in case his test result was positive: Isatu would call the State Department to arrange to airlift Martin to a special facility in Nebraska set up to treat Ebola patients. But she was not to do anything until Martin called her first.
His first two Ebola tests were negative, and Isatu expected she would soon be driving to the airport to pick him up, once his fever subsided and he could travel with no risk of infecting others. She later learned someone had taken his cellphone. She doesn’t know why no one called her when his third Ebola test came back positive.
By Nov. 14, she felt she couldn’t delay any longer and alerted the State Department. Within 24 hours a plane arrived to pick up Martin. Doctors at the Nebraska Medical Center, which had just successfully treated two Ebola cases, said Martin arrived sicker than the others.
The next time Isatu saw Martin was through a video conference. He appeared unconscious and his mouth moved as if straining to speak. He died Nov. 17. Soon after, she received a bill from the State Department for over $200,000 for his evacuation and care.
For a few weeks after Martin’s death, Isatu had also scrambled to find a way to pay the $200,000 State Department bill until St. Mary’s connected her with the Paul G. Allen Family Foundation’s Ebola Program, which eventually picked up the tab.
Isatu hoped to build a modern hospital, the best in the country.
Money was tight, but she didn’t hesitate to keep paying tuition for five children back home to go to school; then she found five more who lost their parents to Ebola and started to pay the fees, too. She’s never met any of them but keeps their pictures on her phone.
The months of paralysis started to lift. Isatu went back to work and took on a second job. She also started to raise money for the hospital she hoped to open in Freetown. She decided she would dedicate herself to making that happen. But first, she needed to bury Martin. She set a date for the memorial service in November 2015 at St. Mary’s. On Nov. 7, 2015, the World Health Organization declared Sierra Leone Ebola-free.
Isatu made T-shirts with Martin’s face on them and sold them at the service for $10. The proceeds went to the newly created Dr. Martin Salia Family Foundation to fund the building of the hospital.
She no longer has Martin but she has their shared dream of the modern hospital in Freetown. She has also set up a website where people can donate money.
She has raised only $7,000 so far and realizes she may have to scale back her ambitions to something smaller like a clinic.
“Even if it’s not a hospital,” she says, “just do something, something where his name will be written.”