Monday, February 23, 2015

The Bumpy Road to Zero Cases of Ebola

At the Medical Tent, the temperature begins to get unbearably hot at noon and the blazing heat builds up steadily and by 2 pm at sign-out, invariably everyone starts to sweat and thirst sets in.

Eleven patients were signed out to us; the twelfth patient was Martha who reportedly just passed away before sign-out.  She had to be pronounced by a physician before the burial team could be called in.  Martha was the grandmother to Fatmata K, the four-year-old girl who passed away the day before; she became delirious and confused yesterday.   Now Kadiatu, Fatmata K’s mother and Doris’s aunt is critically ill.  She is still conscious, complains of painful swallowing and continues to have profuse diarrhea, with her eye balls rolling upwards reviewing the white of her eyes.  My Temne-speaking nurse says Kadiatu is trying to die.  Doris, however seems to fight hard with every ounce of her energy while her aunt is becoming weaker by the hour despite her bulky built.  Even with frequent diarrhea and abdominal pain, whenever I ask the slender and delicate Deborah how she is doing, she flutters her thick black eyelashes and always says she is doing well.  I do hope it will be so for her.

It was the busiest day since I came to Lunsar ETC. 

There were three admissions.  Ramata, a 13-year-old girl was brought in by an ambulance, comatose and with no information.  Clad in a sarong-like wrapper, Ramata's chest was uncovered revealing her breast buds; her hair all braided in corn rows tapering at the nape of her neck.  She groaned feebly when an IV line was put in but I could not elicit much response with sternal pressure or painful stimuli.  Her neck was stiff.  She was jaundiced, and had an enormous spleen.  She was started on IV Artesunate for cerebral malaria and ceftriaxone for bacterial meningitis.  However she is in extremis and may not make it through the night.

25-year-old Marie came in with her 1-year-old baby girl Suzah.  They were placed in the Suspected Ward even though only the mother fulfilled the criteria for admission.  The baby, without a caretaker, was admitted with her.  The happiest outcome is to have both Marie and her baby to be tested negative for Ebola.

Our third patient was 7-year-old Gibriel who has Ebola exposure and a history of fever but clinically stable.

Adamssay in the Probable Ward lost his pregnant wife to Ebola three weeks ago.  He looks strong now but has been throwing up everything he eats or drinks.  I made a mental note to let psycho social know about his recent loss.

Gabriel in the Confirmed Ward finally has his first negative Ebola test; a second negative test will buy him an exit from the ETC.

By the end of my shift, we had 14 patients, 5 confirmed and the rest in the Probable and Suspected Wards, most of whom I hope would turn out to be negative for Ebola.

The volunteers who have been here longest have observed that the town of Lunsar appears more bustling of late compared to when they first arrived.  They wonder if the town people are less vigilant about Ebola and ignore the warning regarding close contacts and gatherings.  In the ETC in Makeni, further north from us, there has been a recent surge in their admission rate as well.  All these certainly do not bode well towards the goal of zero cases of Ebola in Sierra Leone.

At the end of my day, I received an e-mail from Wellesley College sending me a link to the College Homepage Story

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