Monday, March 23, 2015

EVD: conversations during my travels...

It's inevitable that some slightly awkward conversations will come up related to Ebola during one's travels having come from the Ebola region. I have to say that as terrible as EVD is, knowing the mode of transmission and the extremely small risk of it reaching the Europe, I find the conversations and people's reactions somewhat amusing.

Conversation with the immigration officer at Heathrow:
Officer: Good morning
Me: Good morning, how are you? [handing over my passport]
Officer: [scans passport and looks puzzled] Where did you just travel from?
Me: Brussels and prior to that Sierra Leone
Officer: Um, that's what I thought
[pause in the conversation]
Officer: I am sorry but I will have to call someone
Me: That's fine, that is what I expected.
Officer: I am going to have to have someone from public health England meet with you
Me: No problem
Officer: You haven't been around any dead bodies recently have you?
Me: No, don't worry, I haven't and I am well 
Officer: Okay, sorry, this is the first time I have encountered this
Me: You don't have to worry, there's no risk to you
Officer: Okay, please have a seat and wait

Conversation with the man sealing suitcases at  Luton (yes, my suitcase if falling apart):
Me: Good afternoon, I would like to seal my suitcase
Man: Okay, I can help you [takes the suitcase and puts it on the machine]
Man: Where are you traveling to?
Me: Amsterdam and then Geneva
Man: Oh, that sounds interesting, what are you doing in Geneva?
Me: I am going to a WHO meeting
Man: Oh, wow, what is that about?
Me: Ebola
Man: Are you sure it's safe for me to touch your suitcase?
Me: Yes, it's not a problem at all, you are safe, I am well, there's no risk 
Man: If my 11 year old daughter finds out about this she is going to be terrified
Me: Really, there's no risk
Man: My daughter is worried that I will get Ebola since I work at an airport. I better not tell her about this.
Me: I think you are pretty safe here in Luton, I wouldn't worry about it. Thanks for sealing my suitcase.
[and off I went with my sealed suitcase]

And there you have it. Some people just don't know what to do when they hear the word Ebola. I guess that is understandable. I have to say, I have wondered how people in the plane would react if they knew I had just come from Sierra Leone. I bet some people would feel pretty uncomfortable for no reason. Thankfully, so far, friends I have met up with in London have not treated me any differently and it's been great (although a bit weird) to shake hands and hug people again. And today for the first time in a long time I held a healthy baby on my lap - that's been a while. It made me realize how little physical contact I have with people now in Freetown. 

EVD: One year since Ebola was confirmed in Guinea...

A year ago today the Ministry of Health of Guinea notified WHO of a rapidly evolving outbreak of Ebola virus disease (EVD) in forested areas of south-eastern Guinea. As of 22 March 2014, a total of 49 cases including 29 deaths had been reported. Now, a year later, the numbers are  higher than anyone could have ever dreamed of.

In Sierra Leone alone we have had over 8,000 confirmed cases of which more than 3000 people have died. In the region, over 10,000 people have died due to Ebola and that is only counting the Ebola deaths. So many more people have died of other illnesses, in part due to the unavailability of health care services and fear of patients to go to health facilities for medical care. There is a real need for all facilities to resume regular services safely.

On Friday we had 0 new cases in Sierra Leone. Today we had 2. The numbers are definitely much lower than they were in November and December when we were averaging anything from 50-70 cases per day. However, although we have now reached the tail end, this phase of the outbreak may yet drag on for some time. The fewer cases recorded, the more chance that people become complacent and revert back to their traditional practices, such as following the traditional burial rites. 

Last week Liberia recorded its first case in more than two weeks of not recording any. In Guinea and Sierra Leone there are still pockets of high transmission. Even worse, in some incidences, is cases that arise without any known contacts. This is a cause of concern, as it means there are more cases out there that no one is aware of. 

Of the 13 districts in Sierra Leone, 4 of them are well past the 42 days without any new cases and 3 districts have gone 21 days without any new cases. However, the remaining 6 districts have all had cases within the last 0-8 days. There is still a lot of work to be done in the area of contact tracing and early case identification. For as long as there is one case in the sub-region, there is a chance that the the epidemic can ignite.

In the Children's Hospital our last positive case of Ebola was 12 days ago. However, staff must remain vigilant. They need to keep screening patients and isolating any children who meet the case definition. One Ebola case that ends up on the general wards in the hospital by mistake could have disastrous effects. We need to keep the safety of staff in mind and be on the alert for any suspect cases. Our plan is to do more training soon on effective screening and safe provision of care during an outbreak. 

Hoping to see zero cases for more than 42 days consecutively throughout the region someday this year...

~ Act Justly. Love Mercy. Walk Humbly. micah 6:8 ~