The ETC in Lunsar |
Recently the stigma attached to a single Ebola
infected patient has now been transferred to an entire Ebola quarantined village
or area. Ebola survivors once shunned by
their own village now are welcome back because they are being supported by NGOs
with food, clothing, beddings, and a stipend of 500,000 Leones a month. It is the custom of Sierra Leoneans to share
what they receive so some relatives may potentially benefit from their
home-coming. They continue to have
problem with loss of livelihood as few people would buy produce from Ebola
survivors.
A quarantined village is guarded by soldiers or
police. Food is delivered by NGOs and
pushed into the cordoned area. Sometimes
the delivery did not come on a timely manner and so the psychosocial team will
have to advocate for them. However if
one person in the quarantined village comes down with Ebola, the rest will have
to restart their quarantine period from day one all over again.
Sierra Leoneans treat their sick ones with a lot of
care and love. The sick person becomes
like a child, he is washed and fed, made to lie down on someone’s lap while his
head and body are stroke and touched. A
dead person has to be washed and touched before the burial. Ebola has changed all that. There is to be no washing or touching. Here in the Lunsar ETC, there is no cemetery,
so patients’ bodies are taken away to be buried either in Lunsar or Port Loko
cemeteries. If a patient is from very
far away, the relatives will have to make do with a distant burial site. If they could not attend the burial, they
would be given the plot number so they could pay a visit to the grave site at a
future date. I am very appreciative and
thankful of the proximity of the grave site in Bong.
Attending burials of some of my patients and
visiting the cemetery to reflect seemed to give me some closure of the
emotional aspects of volunteering in the ETU.
Evidently fear and distrust of authority continue to
be pervasive. Accordingly to the psychosocial
person in charge here, as recently as 2 weeks ago in a village in Makeni in
Bombali District, a couple put their sick child secretly in a separate hut with
no care and little food and she died a few days later. When officials came to the village for a
headcount, they recruited another girl. Fearing that they could be found out by the
Village Chief and be fined, in the dead of night they tried to throw her body into
a latrine which was too small. In desperation
they contrived to dump her body in a well but were caught.
Despite counseling to abstain from sex for 90 days
after being Ebola-free, a young man had sex with his wife who contracted Ebola,
he is being held on a charge of intent on an act of grievous bodily harm.
In November of 2014, UNICEF helped to create the
District Ebola Response Centre (DERC) for the Western Rural District where the
Ebola transmission is still ongoing. In
order to bring Ebola cases to zero, many community social mobilizers have been
trained to look out for Ebola cases for prompt medical response.
Finally in the late morning I donned and went into
the ETC with two other doctors. Today there are only 7
patients, 4 in the Confirmed Ward and 3 in the Suspected Ward where Joseph was later
admitted. Mamusa, a young lady in the
Suspected Ward, is mainly weak with a fever and has to be encouraged to eat and
drink. We urged the caretaker to help
her in our absence. Here the Ebola tests
are sent to Port Loko, half an hour away, but may take up to a day to get the
results back.
The Probable Ward remains empty.
In the Confirmed Ward, Fatmata 1’s neck is like a bull
frog today with swollen lymph nodes, she is unable to open her mouth wide
enough for us to see her pharynx. We started
her on antibiotics: ceftriaxone and clindamycin yesterday afternoon. Her fever persists. Because of her pain I am leaning more towards
a bacterial than a tubercular lymphadenitis.
Augusta’s Ebola test turned negative on Valentine’s
Day on day 12, she would have to wait for 48 hours to get another test before
she is declared Ebola-free. Sullieu and Gabriel remain stable.
We finished rounds in less than an hour. Prior to going into the ETC while I was
attending the psychosocial lecture, the doctors had gone around outside of the
ETC in scrubs to round on the stable patients by talking over the fence
querying them about their symptoms. This
helps to curtail the length of time spent in the ETC in full PPE. The sick ones who remain in bed would be
attended to in more detail later inside the ETC. Here in Lunsar, one is not allowed to stay in
the ETC for more than an hour and a half.
The white tents of the ETC are sweat boxes and there
are no windows for cross ventilation or fans.
The very sick patients, who stay inside, sweat profusely. This makes hydration even more urgent.
After rounds I was shown the charting for the patients and transcribing of the signs and symptoms called over the orange fence in the morning. There was no such consistent charting in Bong, at least out of the ETU, all our charting was done inside and the charts remained inside the ETU and we could not review them at leisure. This also made our rounds in Bong much longer because of the documentation and ordering done inside.
Now that I have been through the ETC twice, I will
be put on the schedule with the rest of the doctors starting tomorrow. I am assigned the afternoon shift.
In the late afternoon back in Bai-Suba, I fed the baby
lamb some blades of tender grass, she followed me and gamboled joyfully. I saw her playing with a crow a few mornings
ago. She must be lonesome for a
playmate.
Feeding Shikira |
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