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Thursday 1 January 2015

The Ebola Crisis

From: Rachel Duncombe-Anderson
Sent: Monday, December 22, 2014 9:13 AM
Subject: The ETC opens
 

Hi there gang,
 
Well after a week of a lot of action actually setting up an Ebola Training Centre (ETC) but with no actual patients we finally opened on Friday.  The hold up came about due to a variety of reasons but the main one was getting the wider team ready. 
 
National nurses  - nursing in Sierra Leone rarely involves washing or feeding as that remains the duty of the patient’s family.  There is of lot of passivity in terms of decision-making as I suspect that they are endlessly given tasks to perform rather than plan patient care.  This means that the nurses are definitely a mixed bag.  That said my team is enthusiastic and learning a lot – they are loving our mantra of DGE (Don’t Get Ebola) and feel passionately about wanting to help their country and their people. We have one Ebola survivor amongst us too which gives everyone some hope.
 
The WASH team (Water and Sanitation Hygiene) – if I’m honest these guys are the heroes – they do 80% of the work and are the people at the greatest risk during most shifts.  They meet the ambulance, spraying everything down as we receive the new patients, they are vital in our doffing process and I can promise you that when you have been in that PPE for over an hour and half you completely rely on them to talk you through getting that contaminated kit off you.  Finally, they do all the clearing up – the laundry, clearing up any fluids on the floor in the High Risk zone and also if any patient has passed away they are the ones who deal with it. They are in contact with the high viral loads at these times.
 
As you can imagine although we wanted to open on Wednesday there was no way we going to rush this if the Wash team weren’t ready and they weren’t but now up and running they are completely coming into their own.
 
I promised that I wouldn’t overdo it when I wrote but I want to tell you about a few patients we have. We now have 10 patients which in 3 days is a pretty good scale up in terms of our getting used the admission and the care process.
 
I am going to make up the names for confidentiality sake but we have Magda who is a 13 year old girl who has won all our hearts. She is tiny and physically doesn’t look older than about 9/10 years and we do have to resort to bribery when it comes to getting medications into her. I promised her a dance if she swallowed some tablets – it raised a faint smile but not the beam the team got for giving her some coke. Just getting some sugar into her is our goal as she refuses the Oral Rehydration Solution(ORS) but she is very weak and we aren’t hopeful. Her father denies that she has ebola despite his wife/her mother dying last week.
 
The second patient who has also won our hearts is Isaiah who is also young and has lost 6 members of his family in the last months. He sobbed on us today because he so wants to talk to someone in his family and he is alone in a 30 bed Probable ward.  The good news for him is that 1) his first test was negative today 2) we have managed to get some toys for him 3) and the psychosocial team are hunting for someone from his family so that he can be in touch with them. Once found they will give him a phone for him to talk to them and or arrange a visit from the family.  Psychosocial are amazing and work so hard to link the community with the patients.
 
Just as we were finishing our shift today a grandmother (38) arrived with her 23 day old twin grandchildren. Mum died 3 days ago and had been breastfeeding so although they currently have no symptoms we need to monitor them closely. They are absolutely gorgeous and of course in full PPE we can give them a lot of cuddling. There isn’t anyone who doesn’t want to have a bit of hug love.
 
Anyway all good here – this is a very cruel disease and I would ask you would think of Sierra Leone at this time. The cases in Freetown have quadrupled in the last week and there are still signs that we aren’t beating this thing.
 
Thanks again for your support. We still don’t have great internet so I’m sorry to those who have written little notes and who I would love to respond to but haven’t yet.
 
Big love and have a good few days in the run up to Christmas.
 
Rachel
 
Ps the opening ceremony of the ETC was incredible. There was a Christian and then a Muslim prayer and then there was a song asking the Spirit of God to come down and beat Ebola. A few tears were shed.
PPS I just heard this morning that the twins died overnight - we had heard that they had tested positive but we didn't think it would be so quick. I guess they have gone Home. We're all pretty low
PPs - A radio 4 interview if you're interested -
http://www.bbc.co.uk/programmes/b04tlys3
 
  Prayer points
-       The six hour shifts are exhausting and we work six days in a row. Please continue to pray for energy and protection in our health
-       I found my first patient who had passed away today. The team ahead of me had just been with him alive but 20 minutes later he was gone. It completely shocked me and just need some prayers for strength as this is really one of the most cruel diseases I have ever seen.
-       That we might be able to engage in some way with the festive season – Jesus is here and many of my staff believe that or have a sense of the significance of the date but it is hard to feel that jolly and yet joy is possible.

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