It is a red (zone) Christmas for me. The Ebola hospital is quiet but our patients fluctuate wildly in their fight against Ebola, sometimes well enough to get up and walk, but then dipping into semi-consciousness and near moribund states. Ebola is a rolla coasta.

Seven patients and just one death so far since we opened. For Ibrahim there is a suggestion that there might have been other factors beyond Ebola contributing to his death. It was strange how he deteriorated so quickly, and he was complaining of back pain and pain at the back of his head before he lost consciousness.

I hear from one of the drivers that he resisted admission when he was first diagnosed, and was beaten badly before he came into hospital. Some elements of the police and the army have a reputation for excessive force. They won’t have risked touching him, so I wonder if rifle butts or sticks were involved and with his impaired clotting from the haemorrhagic fever if he might have had a cerebral bleed. We will never know, as a post mortem is impossible these days. However, I ask the head of the district Ebola response team to make some discreet enquiries.

The night shift of nurses and watsans have taken to sitting outside the floodlit dressing tent in rows of chairs, watching the entrancing spectacle of relays of teams donning their PPE. The strangeness of our dressing routines, as if dressing for a masked ball, provides an engaging nightly theatre.

I am on call with Chris, a Norwegian paramedic. We join the spectators and sit talking through our Christmas Eve on call. So they are bright and entertaining with their insight into local life and recent history. Many of the watsan are teachers, now unemployed with the closure of all the schools. They have taken jobs as hygienists, high risk but low paid jobs cleaning up the toxic diarrhoea and vomit on the wards.

They talk about how Ebola has changed their lives. Christmas used to be a time of great celebration and joyful parties; dancing on the beach until dawn. Now all such gatherings are banned. Christmas has been cancelled. Tomorrow will be another dull day with families and friends isolated from each other by self-imposed quarantine.

They tell us about the devastation caused from the recent civil war. Moyamba was a thriving district capital with running water and electricity. The Westside boys set up camp nearby and would come into town with murderous intent. The rebels smashed everything they found.

As we sit enveloped by the warm African night air, the staff recall their personal experiences of the torture the rebels inflicted. The drugged-up boy soldiers would tease their victims with choices of mutilations: long sleeve, short sleeve or sleeveless depending on where the arm would be cut off with a machete. They describe how they witnessed decapitations of their neighbours; how pregnant women would be cut open on a casual wager over the sex of the baby. How mothers would be forced to laugh while their children were brutally killed.

Mohammed, one of the dressers, tells me with pride how he was a soldier in the Sierra Leonean army, trained by the Scottish light infantry. He was caught in an ambush during the war and tortured and bayoneted. He shows me the scars on his arms and his back, and talks of the scars in his mind that are much slower to heal.

So much destruction and cruelty in such recent history. The seeds of the Ebola and cholera epidemics in the country are a legacy of this war. The wanton destruction of infrastructure - water supplies, electricity, sewage systems - and the failure to repair this in the subsequent peace.

Chris takes pity on them and for some reason decides that an introduction to Norwegian music might be exactly what they need. I am overcome with a sudden urge to stick a blanket over my head and try to sleep.

MORE BLOG POSTS FROM PROFESSOR JOHN WRIGHT