It seems as if an hour
doesn't go by without Ebola being a part of it. Whether it is during a
conversation, work at the hospital, a radio programme, an advertisement, a
bucket of chlorinated bleach outside a restaurant, an ambulance with driver in
a protective suit that drives by, the constant thought of not touching one's
face, no personal contact, a billboard etc. Ebola has become entwined with
daily life. Strangely though, when driving through Freetown things still feel
fairly normal. It's a bizarre situation.
Sadly, the situation in
Freetown is getting worse with today's report revealing 1001 confirmed cases in the Western
Area district (Freetown and outskirts). It is concerning that this might be the tip of the iceberg since it only includes cases reporting to a health facility. Since isolation beds are full, sick people are often turned away at the gate and forced to go back home meaning they aren't tested for the disease yet and they can further spread Ebola at home if that is what they have. As beds open up, sick people are transferred to a facility or someone waiting outside the gate may be lucky to get in. In an overcrowded urban setting, numbers are going to increase exponentially. I fear that Ebola will not only be a
continuous part of daily life as people take precautions, but it will become a
real life event for many people who will lose family members and colleagues to
this dreadful disease, not to mention to other diseases due to the lack of
healthcare in the country at the moment. In contrast to the USA, where the
chance of someone knowing a person infected with Ebola (much less die of Ebola)
is very small, for people in Freetown, the likelihood is far greater.
At the Children's
hospital on Friday we received results back from
the Ebola lab and had to transfer three confirmed Ebola patients to the
treatment centre in Hastings. Two were mothers whose children died in the
isolation unit in the hospital earlier in the week. And the third was a
little boy who was admitted to the isolation unit 9 days ago. The
ambulance arrived and while hospital staff put on full protective suits to
escort the mothers to the vehicle, a father walked with his son in his arms
from the isolation unit to the ambulance. It was heartbreaking to watch the
father lift his 6 year old son into the back of an ambulance not knowing
if/when he would see him again. I cannot imagine what he was feeling. I
felt sorry for one of the ladies who looked terrified as they were lifting her
in. She has already lost her toddler and now she was being taken to a place she
does not know or understand by people in full protective suits.
On Friday I
witnessed the impact of Ebola on three families, but many more families out
there will experience similar tragedies. Unfortunately the case numbers seem to
be increasing at a faster pace than we can contain it. Efforts are being made
to improve contact tracing, case identification, case management (isolation,
testing, treatment) and dead body management (safe burials) but it is complex.
Basically we need to achieve 70% safe burials and 70% isolation
nationwide to see transmission reduce. I hope that somehow the situation will
start to improve with more relief efforts on the ground and we will begin to
see a decline in numbers. I just feel like we don't have much time to wait!
Thankfully in the East of Sierra Leone cases have decreased from a high of 50
per week to 4 per week.
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