While the panic over American Ebola patients being treated in Atlanta is unfounded, there is a very real and devastating crisis going on in West Africa, as the largest Ebola outbreak in history tears through rural villages, towns, and — for the first time ever — major cities, which are overcrowded and ill-prepared.
Liberia, Sierra Leone, and Guinea — the trio of countries at the center of the outbreak — are poor and decentralized, with scant health care resources to help contain the much-feared disease, which kills the majority of people infected. At last count, there were 1,603 suspected and confirmed cases and 887 deaths.
In a must-read piece for The New Yorker, Richard Preston, author of The Hot Zone, describes the harrowing situation on the ground in Sierra Leone, which currently has the highest number of suspected cases, 646.
Daniel Bausch, a Tulane University doctor and Ebola expert, tells Preston about the scene inside an Ebola ward he helped set up, “a cluster of small cinder-block buildings” where the facility’s director, Dr. Sheik Humarr Khan, and a single nurse were caring for 30 Ebola patients when he arrived.
“The floor was splashed with blood, vomitus, feces, and urine,” Bausch told Preston, explaining that sickened patients have trouble staying in bed. “You need a whole team to decontaminate the bed and lift the patient up off the floor and put him safely back in bed.”
Anyone who comes close to the patients must wear stuffy and cumbersome biohazard suits; the temperature inside them can reportedly rise to dangerous levels. The nurses were overwhelmed and underpaid. They were “working twelve hour days… [and] were supposed to be earning an extra thirty dollars a week in hazard pay,” Preston writes. “But the government of Sierra Leone had not provided it. Not unreasonably, many nurses had stopped showing up.”
Joseph Fair, another American Ebola expert, traveled to Kenema to help with the mounting crisis, Preston reports. He was very close with Khan, the Ebola facility’s director; Mbalu Sankoh, its chief nurse; and Alex Moigboi, another senior nurse.
Ten days after Fair’s arrival, Sankoh was dead. A fever she suspected was malaria may have actually been Ebola. Moigboi, too, died soon after, and later Khan, who died in a bed inside the facility he had run for a decade.
“For weeks,” Preston writes, “Dr. Fair has been going to funerals in Kenema,” as a growing number of the region’s most devoted healthcare workers have died. Now, Fair says, there is “a huge void.”
Elsewhere in the region, hundreds of healthcare professionals from all over the world are working around the clock, as Nicky Woolf details in The Guardian.
Doctors and nurses routinely work 15 — 16 hour days, seven days a week. William Fischer, a North Carolina doctor, sent “a brief email to friends and family that said ‘I love you all'” before heading into the center of the outbreak, on “marching orders from the World Health Organisation.”
“It gets emotionally taxing,” he tells Woolf.
Monia Sayah, a Brooklyn-based nurse with Doctors Without Borders, was deployed to Guinea treat the Ebola patients and describes to Woolf some rare moments of celebration, when a patient recovers and “the people cleaning the floors, people who do the laundry for us… the nurse, the doctor — everyone is so happy.”
But in an outbreak where survivors are in the minority, those moments are not the norm. Patients know how bad their odds are once they are sick.
“You can see the fear, the desperation when they look at us,” Sayah tells Woolf. “They hold your hand and don’t want to let go.”
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