“My mama is dead in my house and we don’t know what to do.” In Sierra Leone, an 8-year-old boy called the national hotline by dialing 1-1-7 earlier this month. The father had already died, presumably from Ebola, and this boy was now head of the household with five younger siblings. He had decided to call for a burial team to pick up his mother’s remains.

In West Africa, the death of parents from the Ebola epidemic has caused a surge in orphans. They are mostly young children age 5 and under. Government officials estimate 25,900 or more of them are in urgent need of comprehensive care in Sierra Leone, Liberia, and Guinea. A very high percentage of these children have lost both parents to the virus. Many of the children are under quarantine. Fearful relatives are shunning or abandoning them as possible carriers of the virus.

But there is something worse for these orphans than abandonment: becoming infected with Ebola. “What I'm seeing on the ground is quite disturbing,” said Susan Hillis, a senior staff adviser in global health with the US Centers for Disease Control and Prevention (CDC), during an interview from Freetown, Sierra Leone. “Children under 5 in both Liberia and Sierra Leone, where I've been working, very commonly get into the ambulance with mom.”

She said typically an ambulance takes mothers to Ebola centers for admission. But there's no one to take the children. “By that point, everybody knows the mother probably has Ebola, and they are afraid of the children, who could transmit the infection to whoever is going to take care of them."

Until the Ebola outbreak, families often were willing to provide informal foster care. Hillis said, ...

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