Ebola Treatment

Ebola Treatment Centers

What does it mean when I say I am working at an Ebola Treatment Center?  Well, I wasn’t completely sure that I knew when I got here, but have a much better idea since being here in Lunsar for the past 4 days.  So this blog may be a bit more technical than some and I hope you can forgive me for that...The Ebola treatment centers set up all over Sierra Leone are new encampments, and there are many different ones run by different organizations.  The one here in Lunsar where I am staying has been up and running for the past 2 months, and is the busiest one in Sierra Leone run by International Medical Corps, a US and UK based organization that gets its support from many different areas.  Here is there web site if you are interested  https://internationalmedicalcorps.org/section/about/mission#.VKo8wVWJOuY   Some of the focus of IMC has been shifting from Liberia, where the epidemic is decreasing, to Sierra Leone, where it may still be increasing.  There is also a brand new treatment center in Makeni, less than an hour down the road, but due to the fact that it is new, and (I hope, maybe a lessening of the incidence,) it is not very busy so far.  I think they had all of 3 patients 3 days ago, which must be boredom city, as they have an even greater staff and capacity for 100 patients.

The team is staying at a resort motel, that has been hurriedly opened,  also in response to the crisis.  Resort may be a bit generous, but the accomodations are comfortable, and quite livable.  In fact they are still cutting down trees, to make way for the buildings, and the construction is a bit rough around the edges, since it has been built in haste, but it is still a work in progress. Here is one photo of my place of abode..

 All the workers are housed in separate compartments for obvious reasons, and there is a no touch rule in effect.  We have transportation to and from work, a distance of 4 miles or so.  The Ebola Treatment Center (ETC) is the medical option in this area for Ebola patients, and currently has about 20 patients or so.  When you get into the van to go into the ETC, they always take your temperature before you get in the van.  When you get to the work site, you are met by a very friendly but firm greeter, who once again takes a temperature..and if you are over 37.6 C I believe, is the cutoff, you get to remain outside the compound.  Yesterday, when I had been standing out in the hot sun for a half hour or so while we received an ambulance, my temperature on my forehead went up to 39, so I had to take a break in the shade until it came down to normal, which it did very rapidly.

So, in the ETC, there is a “clean side” and the ‘hot side”, and there is no mixture between the two, unless you are wearing protective equipment.  Before entering the clean side from the outside, you have to get the bottoms of your shoes sprayed off, which you do by balancing on one leg as they clean one side, then switch to the other one as you step across the red line into the ETC  Once inside, the first thing you do is take off your clothes, and put on their scrub suit, along with a big pair of rubber boots, which will be the outfit for the rest of the day.  You wear the protective equipment any time you go into the hot zone, and because of the restriction of the suit, can only be in it for 1-2 hours at max, and that is strictly enforced. The outfit allows no skin contact with any fluids, as the goggles cover the eyes, and the suit with the cap cover everything else, along with 2 sets of gloves. On the clean side, there are still many washing stations which you wash in a chlorine solution before any major change.  So there are many tents set up, a cafeteria, a kitchen, a medical tent where the doctors and nurses do their charting, a wash tent, a laundry room, and then the donning and doffing stations.  I guess the British influence gives those names, but the doffing, which is the most important in a sense, is where you take off the outfit.  That has to be done in a very precise manner to avoid having any contamination of the skin.  I am still learning that process, although I have done it every day since I have been here, but you do get better and with less travail as time goes along.

Patients are housed in 3 wards, Suspected, Probable, and Confirmed.  So all of the confirmed patients are in the same area.  Unsung heroes of the Ebola epidemic are Ebola survivors, many of whom volunteer to be caregivers in the Ebola wards.  Particularly with young children that are separated from their parents, or whose parents may have died, there is a need for someone who can stay back there and “look normal” and don’t have the restrictions that everyone else has.  One lady there has lost everyone else in her family, and so when asked why she volunteers, she said, “after all my family died, and I survived, I went home and cried for a month.  And then I realized that I could help others, so I volunteered.”  It gives new meaning to working through your grief, doesn’t it?  

Another unsung hero of this epidemic is Brussels Airlines, and Moroccan Airlines.  They are the only commercial carriers to continue flights to Freetown, and they have been the ferry for the hundreds of workers who have come to the area.  The fight would not be possible without them, I am afraid.  I don’t think the UN would have stepped up to get people down here.  My flight was almost all aid workers coming to help with the epidemic, and it seems like that is continuing.  So they have been invaluable in this process.  Also to be commended are the many who have given up time with family and friends to help fight this terrible epidemic.  

So, that is a technical explanation of what is a mulifaceted approach to fight the disease.  There are many aid organizations working here, and I believe at this point, Sierra Leone has enough ETCs to treat everyone with the disease. If it can be stopped, this is a good start...We continue to pray to that end.