Bailor Barrie is standing in the middle of the biggest slum in Freetown, home to the very poorest people of West Africa's Sierra Leone, one of the poorest countries on earth, in animated conversation with a woman who is refusing to take her medicine.
They call it Kingtom Bomeh, or the Dump, and the place is buzzing. Around him, people are buying and selling, washing clothes, scouring the mountains of rubbish in flip-flops for anything that can be sold, cooking, cleaning and even growing vegetables.
Having taken one dose of anti-cholera vaccine after the mudslide that devastated this city in August, the woman is adamant she will not be swallowing a second.
The mudslide followed several days of heavy rain and led Mount Sugar Loaf to buckle and break, killing more than 1000 people, including 60 children who were sleeping in an orphanage.
The woman complains to Barrie that the first vaccine caused vomiting and other side effects, like diarrhoea and headaches, and insists she is happy to take her chances with the cholera.
What she needs to understand, the doctor tells her, is that such side effects are unusual, and that that first dose offers just a measure of protection and only the second will give her the best chance of immunity. "How do you compare a few bouts of vomiting and diarrhoea with endless vomiting and a horrible death?" he asks.
Eventually, she relents, and submits to the team of modestly-paid volunteers who have methodically recorded who is living here and who has taken each dose of the vaccine.
At 38, Barrie is not only Sierra Leone's most eminent physician, with a masters degree in global health from Harvard University thanks to one scholarship, and the offer of another scholarship to complete a PhD at the University of California San Francisco. He is also the great persuader of the country patriots call "Sweet Salone", a doctor and campaigner who does his best work in shorts and a T-shirt.
He knows how to relate to these people because he is one of them. As a boy, living alone in extreme poverty just a few hundred metres from the squalor of the Bomeh, he raised his secondary school tuition fees and fed himself by selling roast meat, kerosene and cigarettes on the street, just as thousands do today.
When Ebola struck in 2014, claiming victims in every province of the West African country, he persuaded American doctor Paul Farmer and his ground-breaking organisation, Partners In Health (PIH), to help lead the response.
With Jon Lascher, now executive director of PIH Sierra Leone, Barrie was the first person from a non-government organisation to enter Port Loko, the epicentre of the epidemic in Sierra Leone, where there were 150 suspected Ebola cases.
"We drove from Freetown to Port Loko, through one military checkpoint after another," recalls Lascher.
"Bailor mentioned that it was the first time since the civil war ended 12 years earlier that he felt like it had returned. The difference this time was that the bullets were invisible."
When it came to educating his peers about AIDS, Barrie had opted for an unconventional tactic. After inviting health workers at his Wellbody Clinic in Kono to join patients for a feast, he informed his nephew, Ahmidu Barrie, that the patients had prepared the food.
"I went to a corner and started vomiting and he just smiled and said, 'You've already eaten the food and you have nothing to fear'," Ahmidu recalls. "It was his way of telling me to stop stigmatising patients, to realise that they are human and to bring me closer to them."
Only once did Barrie's power to persuade fail him, and it very nearly proved fatal.
In January 1999, in the midst of the country's 11-year and obscenely brutal civil war, Barrie was a young medical student who had come to Freetown to buy rice. Stopped by a militia at a government checkpoint, he was accused of being a rebel on the grounds that an unsightly burn on his hip had been self-inflicted, to cover a marking showing loyalty to the rebels.
Barrie insisted that he was a medical student and had accidentally scalded himself with coffee while studying late at night.
The accuser responded with the words "give me six feet", which meant he needed enough space to execute him with a shot to the head. It was then that someone arrived from the morgue to pick up the body of a woman who had just been executed. The undertaker recognised Barrie and identified him as one of the students who frequented the morgue as part of their training.
Barrie was traumatised by witnessing the woman's execution, but spared. Two years earlier, he had attended a peace rally in Freetown and was holding up a banner with a friend when the friend was shot through the heart by the rebels. "That affected me for several years," he says.
Now he is focused on another project of persuasion: convincing a critical mass of his countrymen and women to end the corruption that is one of the biggest barriers to tackling poverty.
"I have this dream that one day this country will change," he tells me. "It's happening right now. Most of the young doctors coming out of medical school are enthusiastic, they believe in social justice, and I'm thinking how can we protect that passion, that vision?
"Most people come out and, along the way, they get corrupted by the structural violence of the system, but if people built those structures, people can dismantle them."
The task for organisations like Wellbody and Partners In Health, he says, is to protect and nurture people until they can take up the work of change.
Barrie is a glass three-quarters-full person, no matter how brutal and bleak things may appear, and Sierra Leone, with a life expectancy for men of just 49 years, is a country that much too often has been on intimate terms with brutality and bleakness.
When the Ebola epidemic began, he was evacuated to the United States with his wife and two young children at the request of Harvard, but had no hesitation about returning.
"People wouldn't have blamed him if he opted for a far simpler life in America, but he chose to return and fight, not just to end Ebola, but to reinvigorate the public health system," says Lascher.
Barrie says his optimism comes from two places. The first is his own story, the mere fact that he survived. "With all the hurdles that came in my life, especially during the war, I just kept going because I just have this passion and vision that I want to be a doctor," he says.
For six years of the war, he was without his mother, who was taken by the rebels and presumed dead. At one point, he walked 10 kilometres to and from university each day, transcribed the text from the medical books he could not afford to buy, and survived on three or four hours' sleep.
"I remember vividly children walking to school, some without shoes, and thinking 'If I become a doctor, I'll come back help these communities and all those people who are suffering'. That was the vision. I never read books about poverty and health, but the connection was always in my head."
The other source of optimism is the change that he has witnessed and the connections he has made, first with Dan Kelly, the American doctor who helped him realise the dream of starting the Wellbody health clinic, initially focusing on the amputees from the 1991-2002 civil war.
"Dan Kelly came here after the war and saw all these amputated civilians in the streets begging and asked, 'How can we help these people?' I said two ways: you can help them one time, give them food or whatever, and they would still be in the street, begging. But if you want to help in a sustained way, let's build an organisation. You can be raising money in America, I can be implementing the programs here. He thought that was a good idea."
Then came the partnership with Paul Farmer, Ophelia Dahl (daughter of author Roald) and Dr Jim Yong Kim (president of the World Bank since 2012) who started Partners In Health in Haiti and led the struggle to bring medical care to the poorest people and most neglected regions of the world.
Amid the devastation from the recent mudslide, there was also a remarkable positive: a collaboration with the Global Alliance for Vaccines and Immunisation to vaccinate more than half a million people against cholera. So far there has not been a single case of the infection.
As Barrie points out, this success was the result of the campaign by Partners In Health to secure vaccinations in Haiti in 2012 and change the policy of the World Health Organisation which, until then, was to oppose recommending the use of the vaccine on a mass scale in poor countries, largely because of the cost.
Because of that campaign, the WHO changed its policy and created a global stockpile of cholera vaccine, which was how Sierra Leone was able to benefit following the mudslide. "The amazing thing about this cholera vaccine is that it took us two weeks to mobilise the resources, get the vaccines into the country and start the immunisation," says Barrie.
Barrie's Wellbody Clinic at Kono is now regarded as the best in the country, catering each day for up to 250 patients who only pay if they can afford it. A short walk away is the region's hospital, Koidu Government Hospital, run in a partnership with PIH, which is also considered the country's best.
"But it's not best [standard] if you compare it with other hospitals in America, Europe or Australia," says Barrie. "On those comparisons, we are way, way down. There is still so much to do."
The immediate priority is help to secure financial support from the Global Fund to scale up the response to the threat posed by multidrug-resistant tuberculosis and other diseases, to strengthen the national health system that is still dysfunctional in many regions and to expand a community health worker program that was so critical to making Sierra Leone Ebola-free.
Founded in 2002, the Global Fund is a partnership between governments, civil society, the private sector and people affected by HIV, tuberculosis and malaria that invests around $US4 billion ($5.2 billion) a year in programs by local experts and communities most in need.
Barrie had hoped the PhD at UCSF would better equip him to help lead the fight to secure the best health care for his people and to nurture the cultural change that is so desperately needed, but his study in California is now on hold.
He was not able to take up the scholarship because he was refused a visa to the US - on the grounds that he could not prove that he would return to Sierra Leone when he completed the course.
"She never explored my commitment to this country," Barrie says of the official who rejected his application. "This is my home. This is where I want to work."
He could be angry, even bitter, that he missed out on this opportunity, but that is not his way. "I'm not frustrated that I stayed," he says. "I'm not even sad, because of the work I'm doing right now."
Bailor Barrie, Sierra Leone's most eminent physician, with his footballing acquaintance. Photo: Michael Gordon
In the boy's wide, optimistic eyes, he sees his own reflection.
