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The Ebola epidemic that started in March continues, with the three West African countries of Sierra Leone, Guinea and Liberia being hardest hit. To date there have been a total of 13,000 cases, with 4,800 deaths from the disease. New cases continue, and in Sierra Leone the incidence continues to rise.
The ETC has been open for about six weeks and is slowly increasing its patient intake as procedures are refined, and further human resources arrive. It is a 60-bed field hospital in a cleared section of jungle, 15km outside of Kenema town. It’s a unique set up due to the need for strict isolation requirements and infection control procedures.The work at the ETC is challenging, busy, frustrating, physically difficult, and mostly very sad. There’s a 50-70% mortality rate of admissions to the centre, so there is dying and death on a daily basis. Our patients include children and babies. There is a low chance of survival for babies born to mothers with Ebola, and after only two weeks working we’ve already had two deaths of babies under one month old. Many children have been orphaned, and some parents watch as one after another of their children dies to the disease. It’s a particularly sad disease as patients are often stigmatized by their communities, and sometimes their families. They must also be isolated from any contact with family, so as not to transfer the disease. This adds a further cruel blow as it means that many will die away from loved ones and alone.
However, there are some good outcomes, with some patients recovering and being discharged. The discharge process includes a chlorine shower affectionately termed the ‘happy shower’, and patients are given support to return to their homes and communities.
There is certainly much to be done at the ETC, and my nursing role is varied. The centre is run by local Sierra Leone nurses, and mostly our nursing role as delegates is to support the local staff by educating, mentoring and supervising. Many jobs remind you that ‘you’re not in NZ now’, as I find myself prescribing, being in charge of the pharmacy and keeping it stocked, and yesterday interviewing for a pharmacist for the centre.
The nursing here is very different. Local nurses are used to families giving patients the basic care needed when ill – washing, feeding, helping to take medications etc. However, as patients are isolated from family in the centre this is not possible. So we are attempting to support the local staff to provide this much needed basic care so that patients can have the best chance to fight the disease, or can die in the most comfortable and peaceful way. There is certainly plenty to work on, but we think we’re starting to make some progress. However, its ‘little, little’ as they say here in Sierra Leone, and progress seems slow at times.
The weather is hot and humid, making it particularly challenging to ever be comfortable in the personal protective equipment that needs to be worn when caring for patients. Our hostel is an oasis to return to at the end of a busy day at work. There’s no hot water, but cold showers are all you want in this heat. There’s only intermittent electricity from a generator, so timing is crucial for some things. If you want to be fanned off to sleep, you need to dive into bed early enough before the power goes off.
My fellow international delegates work tirelessly here in their roles and are an inspiration. As are many of the local staff, whose delightful smiles seem to dissolve some of the frustrations felt at times. The community here is welcoming and expresses gratitude for the support the Red Cross is giving it. This really makes the times of heat and hardship feel all worthwhile.
Our aid worker programme is partly supported by funding from New Zealand Aid Programme through the Ministry of Foreign Affairs and Trade.