Ebola in Sierra Leone: one year on...

Today marks the one year anniversary since Ebola was confirmed in Sierra Leone. It is not a happy one year anniversary, but there is hope. Thankfully the numbers have significantly reduced from a top high of about 500 new cases per week to about eight cases per week. That is due, amongst other things, to an increase in the number of treatment beds in December (therefore not keeping sick people in the community as long), safe burials, revised messaging to communities (early treatment means a better chance of survival), involvement of community leaders, setting up labs to quickly diagnose Ebola, better treatment options such as intravenous fluids encouraging the public that Ebola is not always fatal, improved contact tracing, and hours and hours of work delivered by individuals in Sierra Leone.

Here we are, a year later. Who would have thought a year ago that we would have 8,608 confirmed cases of which 3,542 people died in Sierra Leone alone? I would never have dreamed that a number of my doctor colleagues would succumb to this dreadful disease. I would never have thought that it would have disrupted the access to and quality of care in so many of the health facilities in the country. However, the facts remain unchanged. We are faced with many losses and left with a crippled healthcare system slowly trying to find its feet.

We cannot change the past, but what we can and should change is the way forward—behaviour change, positive attitudes, remaining vigilant, ending corruption, more collaboration and coordination, implementation of training, recognizing weaknesses and strengthening systems—collectively we can work towards these goals but it will undoubtedly be quite challenging.

Numbers have been reducing since January. We reached eight continuous days of zero cases about two weeks ago and then had new cases again. Today we have reached three continuous days of zero cases. However, it’s not over yet. Cases are still popping up around Western Area and a few other districts. We haven’t seen the end but we remain hopeful that we will soon.

It’s true that the road to zero has been long and bumpy but hopefully we will get there. The road to recovery and improved health systems will be even longer, but we can start making efforts to reach targets. Together we can do this. I pray for continued energy and resilience for all those working to bring Ebola to an end. We must continue to fight this fight. WE DE FET EBOLA! (Krio—translation: We will defeat Ebola!)

Also posted at: BMJ Blog

10 years since opening the outpatient clinic in Aberdeen...

On May 10, 2005 a pediatric clinic opened in Aberdeen, Freetown, Sierra Leone. A doctor from the Netherlands came to set up the clinic and after two months of preparations the doors were opened to patients. Soon this became known as one of the best pediatric clinics in Freetown and parents and children lined up to receive good quality care.

It is hard to believe that it has been 10 years since I opened the outpatient pediatric clinic in Aberdeen. At the time it was called the ACFC - Aberdeen Clinic and Fistula Centre - operated by Mercy Ships. It is now known as the Aberdeen Women's Centre and no longer run by MS. Although the pediatric clinic is currently closed due to Ebola, I am confident they will reopen in the next few months.

I remember the two months leading up to the opening of the clinic - it was a bit of a bumpy ride trying to get the community to agree to the scope of services that would be provided. I was keen to open a pediatric clinic since the child mortality rate in Sierra Leone was the highest in the world and there was no pediatric care nearby. Fortunately the stakeholders agreed that this was a good idea. 

Day 1 of the clinic went well and I soon went from seeing 3 patients, to 18 patients, to 27 patients, to 50 patients, to anywhere between 60 and 80 patients per day. There were many mornings that I had to turn patients away at the gate which was very difficult. There were some occasions in which children died in the clinic because they came in such a bad state and there was so little we could do for them. Those were difficult moments in which we were faced with the reality of the high child mortality rate in the country. Fortunately there were many children, thousands, that my team and I could help and for that I am grateful. It's fun reading through some of my blog posts from 2005-2009 to see some of the adventures I had working in Aberdeen. There were good times and bad times but overall it was such a great experience. It was a really busy time, running the clinic, seeing patients everyday, overseeing the lab and dispensary, ensuring supplies were available, etc. It was worth it though. It was a very rewarding time. A few of my nurses still work there and it is great to be in touch with them. Sometimes I run into some of 'my former patients' or their parents in town or at the Children's Hospital and it is always a blessing to know that I was able to make a difference in their lives. 

Supporting World Hand Hygiene Day with my colleagues - #safeHANDS...

Katie, myself, Bob, Yembeh, Dolphine, Aminata,
Alimamy, Alusine & Aqueelah - #safeHANDS

Today, May 5th 2015, marks ten years of the WHO Clean Care is Safer Care Program and National Celebration of World Hand Hygiene Day. Approximately 800 hospitals in the African region have signed up to promoting hand hygiene and this includes the three hospitals that Welbodi Partnership is supporting: the Ola During Children’s Hospital, Princess Christian Maternity Hospital and Rokupa Government Hospital. As an organisation we want to promote hand hygiene and reinforce handwashing in the hospitals we support. Our Infection Control teams will go to the various wards in each of the hospitals to demonstrate appropriate hand hygiene using special GloGerm to show how important thorough handwashing with soap and water is in keeping themselves and their patients safe.

The Ministry of Health and Sanitation is also ready to celebrate World Hand Hygiene day in collaboration with its partner organisations and a special event will be held at Connaught Hospital, where the Minister of Health and Sanitation will sign a statement pledging support to address health care associated infections in Sierra Leone. This is a milestone in Infection Prevention & Control in Sierra Leone and a necessary step in the fight against Ebola, as we strive to prevent any further health care worker infections of Ebola. We aim for safer health care facilities for staff and patients alike as we move forward in this new era of infection prevention and control in Sierra Leone.

Save Lives, Clean Your Hands!

#safeHANDS