In the midst of a ‘perfect storm’: Unpacking the causes and consequences of Ebola-related stigma for children orphaned by Ebola in Sierra Leone

The West African Ebola virus epidemic resulted in the deaths of more than 11,000 people and caused significant social disruption. Little is known about how the world's worst Ebola outbreak has affected the thousands of children left orphaned as their parents or caregivers succumbed to the virus. Given the infectious nature of Ebola, and numerous anecdotal accounts of stigmatisation, we set out to examine children's social representations of peers orphaned by Ebola, unpacking the causes and consequences of Ebola-related stigma. The study was conducted in 2015 in Freetown, Sierra Leone. Data was generated through drawings and captions from 24 children living in four different communities in Freetown and interviews with four key informants. The children were first invited to draw a child whose family has been affected by Ebola and subsequently asked to write 3–10 phrases explaining the drawing. The drawings and captions were thematically condensed and key thematic areas were identified. The thematic areas emerging from the drawings were subsequently used to frame the interviews with practitioners. Unsurprisingly, Ebola was represented as a highly stigmatized and feared disease. Children drew and wrote vividly about health campaigns initiated to contain the epidemic, such as the ‘no touch’ policy and quarantine of suspected Ebola cases. Although important, the health campaigns appeared to cement an ‘othering’ of anyone associated with Ebola. Children orphaned by Ebola were depicted as excluded from social interaction due to the association with Ebola. This prevailing fear and stigma of Ebola were described to undermine the willingness of community members to help orphaned children and described to have severe psychological repercussions for children orphaned by Ebola. Many of our findings resonate strongly with the experiences of children orphaned by AIDS, calling for a greater focus on the risk of Ebola-related stigma and further discussion on the transferability and applicability of lessons learned from research on HIV-related stigma.