A Moral Dilemma: Do Some Lives Matter Less?

During my morning run I try to avoid the open meeting hut of the drivers but this morning there was no one there, then it dawned on me that today was a Sunday.  So I went to St. Peter’s.  This time I sat in the back bench against the wall.  From there I could observe that many of the women had their babies with them and they stuck to the back in case their babies made too much noise.  Outside like in past Sunday, a gathering of disabled and elderly folks waited for church dismissal.  How they could withstand the searing heat of the hot and unforgiving sun was beyond me.  A little boy dressed in a suit which was probably bought deliberately oversized so it would last longer walked with his proud mother elegantly dressed in a deep purple traditional dress with an equally fantastic headdress.

Back to the ETC in the afternoon, the 14-week pregnant woman who died had Ebola.  Yesterday a mother Mariatu and her sister-in-law Asiatu who lived in Rosemarie’s house were admitted.  Rosemarie died of Ebola a few days ago; Mariatu and Asiatu were tested positive.  These two looked well now but it might be the calm before the storm of Ebola havoc.  Asiatu was tall and attractive with prominent high cheek bones while Mariatu was topless with dangling breasts the whole time she talked to us, never once felt self-conscious about her revealing condition.  Instead she asked for a wrap to cover her head. It must be the natural thing here for even the two healthcare workers rounding with me seemed pretty much unperturbed.  We were there for a fairly long period having to wait for her 1000 liters to drip in while I dripped sweats inside my PPE.

Faday had one negative test and a second one would declare him Ebola-free.  The Lunsar ETC is really starving for a celebration, it has been about two weeks since we last had a victorious discharge.

The infected national healthcare worker was finally to be transferred to Kerry Town ETC for infected healthcare workers.  Why it took two days to get admission there was a mystery.  The patient refused to go at first having had a good experience in our ETC.  As the disease progressed, diarrhea had started with fairly significant abdominal pain which required morphine, we gave aggressive hydration.  I could just picture this strong patient becoming weaker in the next several days.  Just before the transfer, six of us in our PPE surrounded this patient to give us our support, rallying the cry that the patient needs to be strong in the next several days.  I will always remember this tableau of solidarity for one of our own who has fallen ill.  As everyone then got busy getting things ready, I spent a few private moments holding the patient’s hand as I would like to have done to me, giving some words of encouragement.  Just before departing we gave the patient a shot of morphine for the abdominal pain and the IV fluid was still hanging.

As the infected American healthcare worker was medevac’d to NIH in US, some volunteers asked the question why a national who had worked alongside this American with the same NGO, risking his/her life in the front line is not given the same aggressive care.  Is a national life less than an American's? I had asked myself the same questions as I watched the patient got off the ambulance and took the long lonely walk down the corridor to the Confirmed Ward. Did the patient feel abandoned by his/her colleagues? How does one reconcile with this moral dilemma?  As the American media reported that 10 more potentially exposed Americans from PIH were evacuated to be isolated in US and to be close to facilities that could take care of them immediately if the need arises, the national who is infected and symptomatic stayed in our humble ETC where we have no ability to do more aggressive treatment than vigorous IV hydration.  Oftentimes in any NGO, expats seem to enjoy better working and living conditions than the nationals and one wonders whether the nationals feel like a second class citizen in their own country. On the PIH website that is a caption that reads “The idea that some lives matter less is the root of all that's wrong with the world”.

We all hope this patient well and our prayers go with the patient every single day.