Ebola: news no one wanted to hear...

The news that no one in Sierra Leone wanted to hear was announced on Tuesday the 29th of July 2014. Dr. Khan, leading expert in viral hemorrhagic fevers, passed away in the MSF treatment centre.

"It is with heavy heart that the Ministry of Health and Sanitations informs the general public that Sierra Leone’s only virologist Dr. Shiekh Umarr Khan passed away this afternoon at the treatment Center in Kailahun. His body has been conveyed at the Lassa Fever Mortuary in Kenema and plans are underway for his befitting burial on Thursday." 

Although Dr. Khan lost his own life to Ebola, he saved at least a hundred others from this dreadful disease. He took a risk to help his people, his country and lost his life to the very disease he was saving other people from. Dr. Khan is a hero in the eyes of Sierra Leoneans today. He literally put his life on the line for fellow Sierra Leoneans and many people are grateful to him.

Dr. Khan's death is a tragedy. As expert in viral haemorrhagic fevers and leader of the Kenema treatment centre, his death leaves a huge gap in the health care system, especially in this fight against Ebola. Who will step into his shoes?

As devastating as this news is to the entire country, I pray that it stirs people into action. I pray that doctors and nurses will (continue to) work in the front lines to combat this disease - I pray for courage, stamina and protection. I hope that the people of Sierra Leone, Liberia and Guinea will realize that Ebola is REAL. It is not the government injecting people and killing them, it is not a curse, it is not something the white man is making up to harvest organs, it is not a political game. Ebola is REAL. It is a disease that spreads through contact with bodily fluids from an infected person, which means it is also a disease that can be prevented if that contact is avoided. People need to realize that if their family member is suspected to have Ebola it is in the best interest of the patient, the family and the community for that person to be isolated. It is the only way to break the chain of transmission. People need to realize that treatment centers are not death chambers - they are places that optimize the chance of survival. There are survivors. Without going to a treatment centre, the chance of survival at home is close to zero, but by going to a treatment centre, especially going early, the chance of survival is higher (overall death rate in three countries is currently about 60%). There are so many things that the general public need to know. 

I pray that through the tragic death of Dr. Khan there will be a massive turnaround in behavior and attitudes and that necessary action will be taken on all fronts to end the Ebola epidemic. I realize that this will take some time but let's continue fighting, in honor of Dr. Kahn.

Ebola continues in Sierra Leone...

Since writing about Ebola two months ago, the number of confirmed cases continues to increase in Sierra Leone. According to today's report there are a total of 458 confirmed cases, most of which are in Kailahun and Kenema. However, seven other districts have had confirmed cases as well, three of these districts had their first cases in the past week. Unfortunately travel within the country and in some cases lack of containment of suspected or confirmed cases has led to the spread of Ebola. In many cases, people’s beliefs and behaviors have contributed to the ongoing transmission of the disease. I will write more about this next time.

This past week has been particularly challenging. The news of three of the nurses at Kenema government hospital, the site of one of the Ebola treatment centers, dying of Ebola early this week was a shock to many. It also led to health workers going on strike and the treatment centre being depleted of staff. Also, the news of Dr. Sheik Umar Kahn, head of the Lassa Fever Unit and current Ebola treatment centre, testing positive on Tuesday was also a big blow. Dr. Kahn, a 39 year old Sierra Leonean doctor, is one of the world's leading clinical experts in viral haemorrhagic diseases, so to hear that he had been infected with Ebola was a big concern. He has treated over 100 patients in the treatment centre, spending long hours trying to save their lives. Thankfully the news is that he is recovering in the treatment centre in Kailahun, run by MSF. Let’s hope he pulls through and that his story can be a testimony to the Sierra Leoneans that this disease is real and that treatment early on can save lives. Maybe this will urge people who are sick to seek care at nearby hospitals rather than hiding in their homes.

Another big concern for Freetown was when relatives forcefully removed a lady in her thirties, suspected of Ebola, from an isolation area in a government hospital on Wednesday afternoon. Very quickly health facilities were on the alert to look out for this patient and officers were trying to track her down. On Thursday morning her result came back positive for Ebola and at this stage it was even more of a concern that she was somewhere in the community. On Saturday morning she returned to her residence and agreed to go to the treatment centre with her parents. Meanwhile, her home was under quarantine with some of the contacts inside. Although she has been found, there is obvious concern that she was in the community for some time (60 hours?) and likely transmitted the disease to others. Transmission is through contact with bodily fluids, so hopefully very few people came in such close contact with her. With an incubation period of 2-21 days (average of 5-7), it’s probably a matter of days before we know what the impact is of her escape.

While I am writing this I am watching SLBC news and over the past hour I have seen multiple news stories about Ebola. One story featured an event held today: "Pharmacists, Pharmacy Technicians and Pharmacy Owners sensitized on Ebola". It was said that 80% of sick people seek pharmacies first for healthcare (rather than going to a clinic or hospital) and so pharmacy staff is advised to take precautions and refer any suspected cases to the nearest hospital so that the patient can be isolated to break the chain of transmission. Unfortunately in Sierra Leone, many pharmacies are like little clinics where patients can opt to be treated in a back room with drips and injections. This practice is strongly discouraged, especially with the presence of Ebola in the country. According to the report, two pharmacy workers have already contracted the disease. Another news item was about a sensitization day for youth in Kono, a district which to date has not had any cases. It is good to see that sensitization is taking place – this is essential!

So, the story continues. I am wondering if we have already reached the climax, or if it is still to come. More soon…