Caitlin Ryan / MSF
Pierre Trbovic, a Belgian volunteer who arrived in Liberia with Doctors Without Borders in August.
TIME recently made the Ebola caregivers their collective ‘Person Of The Year‘ for 2014.
Here’s a harrowing story from one Ebola fighter who, despite not gracing the cover of TIME, struggled to make a difference in that battle.
We talked to him earlier this year, at the height of the outbreak in Liberia.
Within hours of his plane landing in Liberia, Pierre Trbovic was directing lines of the sick to cots, delivering water to a chronically dehydrated child and trying to console an older woman who cried out in pain.
These were Ebola sufferers — men, women, and children rendered powerless by the crippling virus. And Trbovic, a Belgian volunteer with Doctors Without Borders, was there to help.
But things quickly grew worse.
Within days, doctors found themselves bumping against each other while trying to move among the crowded, seemingly endless rows of patients. There were too many sick, his team of volunteer doctors realised, and far too few beds.
The line for the clinic extended into the street. Heavy rains came, but the line continued to grow.
That’s when Trbovic volunteered for a terrible task: turning sick people away at the door.
“This wasn’t a job that we planned for anyone to do, but somebody had to do it,” he wrote in a post on the Doctors Without Borders website.
Trbovic will never forget the first person he turned away, he writes. It was a father who’d brought his sick daughter to the clinic. “He was an educated man, and he pleaded with me to take his teenage daughter, saying that while he knew we couldn’t save her life, at least we could save the rest of his family from her.”
A Tough But Necessary Call
If Trbovic hadn’t begun turning people away, the situation at the clinic would only have gotten worse, threatening the safety of everyone involved and making it impossible for them to treat anyone.
Ebola is a terrible, messy virus — that’s likely why, despite doing their best to follow all the safety protocols, two American nurses who treated the first US Ebola patient became infected. In order to keep everyone safe, workers must adhere to strict, exhaustive procedures that apply to everything from getting dressed to feeding or cleaning up after patients.
Why Ebola Is So Hard To Treat
It takes doctors in Liberia 15 minutes just to put on their protective gear — which includes gloves, protective goggles, headgear, rubber boots and surgical trousers.
Because Ebola is spread through blood, saliva, feces, and vomit, and patients are often leaking these fluids, doctors have to be especially careful about getting accidentally sprayed or splashed. When someone is at the height of the illness (typically after five or more days), one-fifth of a teaspoon of that person’s blood can carry 10 billion viral Ebola particles.
An untreated HIV patient, by comparison, has just 50,000 to 100,000 particles in the same amount of blood; someone with untreated hepatitis C has between 5 million and 20 million.
The gear is its own hazard, too.
In the 90-degree Liberian heat, people unaccustomed to the climate can overheat quickly. A hazmat suit, which can weigh up to 18 pounds, makes everything worse. “It can take 15 minutes to dress fully in the personal protective equipment and, once inside, you can only stay for an hour before you are exhausted and covered in sweat,” wrote Trbovic. “You can’t overstay or it starts getting dangerous.”
Without the ability to care for them inside, Trbovic and his co-workers handed out home protection kits, boxes of supplies that include gloves, gowns, and masks, so that loved ones can take care of one another with a lower chance of getting infected themselves.
For now, that’s all he can do for the people who don’t make it inside the clinic.
“We regularly had ambulances turning up with suspected Ebola patients from other health facilities, but there was nothing we could do,” wrote Trbovic. “We couldn’t send them anywhere else. Everywhere was, and still is, full.”
A Continuing Battle
The Ebola fight remains far from over. Nearly 18,000 people have been reported sick with the virus; more than 6,000 have died.
While the number of sick in Liberia, where the virus has raged the worst, appears to be on the decline, cases continue to remain steady in Guinea and are continuing to climb in Sierra Leone.
To date, no federally approved medicine or vaccine for Ebola exists, but research is ongoing. One vaccine candidate showed promise in early trials in November, and scientists are continuing to test it.
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