By Jo Dunlop
As an outbreak of Ebola virus in West Africa continues to spread, health workers in Sierra Leone are risking their lives in the effort to contain the deadly disease.
KENEMA, Sierra Leone, 6 August 2014 – The Ebola Unit at Kenema District Hospital has become what could be described as the ‘Ground Zero’ of Sierra Leone’s Ebola outbreak.
There are 45 Ebola patients in the hospital, which is packed to capacity, and more beds are likely to be filled before they start emptying. As one health official commented, “We can’t send anybody away – this is where you come if you have Ebola symptoms. If we have to, we will add more beds.”
In the past week, there have been more than 10 deaths in the hospital, and about five new cases admitted daily.
Ebola spreads through direct contact with bodily fluids of infected people or indirect contact with contaminated environments. There is no known cure or preventive vaccine, but early diagnosis and medical attention can increase the chances of survival.
Fallen colleagues
Behind the ominous chicken-wire fence and white plastic sheeting that surround the centre are the unsung heroes of the response effort: the health workers who are risking their lives to do their jobs.
Since the first cases emerged in Kenema District in March, the hospital has lost six health workers to the disease. A week ago, Sister Mbalu Fonnie, who was in charge of the nursing team at the treatment centre, passed away after contracting the virus two weeks earlier. Sister Fonnie was a mentor, a leader and a friend to many.
Sister Nancy Yoko wells up when she speaks of her colleague Sister Fonnie. “She is the reason I keep coming here every day. She motivated us. We all miss her so much,” she says. “But I will keep coming for her and all the other colleagues who have fallen ill to Ebola.”
“She taught me a lot, even when she was on her sick bed she told me how to do things, she never stopped helping us,” says Nancy.
A few days ago, Dr. Sheik Umar Khan, the only Sierra Leonean virologist at the forefront of the fight against Ebola in Kenema, also passed away after testing positive for the virus.
Increased risk
Given the number of staff cases and the high dropout rate of nurses unwilling to risk exposure to the disease, there is an overwhelming shortage of health workers at the centre. “I have not had a day off since this problem started three months ago,” says Sister Nancy, who, like most of her colleagues, has been on 12-hour shifts every day.
Under such conditions, those on the front line are in even greater danger of becoming infected. When used properly, protection suits worn by staff who come in contact with patients provide an effective shield against the virus. But the suits are uncomfortable, with two pairs of protective gloves, a mask and boots creating a furnace in Sierra Leone’s tropical temperatures. When health care workers have been on the ward for long hours, they become tired and less vigilant. They make mistakes and increase the risk of contracting the virus.
Trained to sacrifice
Despite their brave efforts and unwavering commitment, these nurses are also subjected to the stigma and fear that has characterised the epidemic since it first arrived in the country. “We are known as the ‘Ebola nurses’. No one wants to come close to us,” Sister Nancy says. “The nurses in the general ward won’t talk to us. Even our families are scared they will catch the virus from us.”
Nonetheless, Sister Nancy continues to show up for work every day. “I don’t feel afraid. I’m a nurse. I’m doing my job,” she says. “We are trained to sacrifice.”
Along with assisting in coordination efforts, UNICEF is collaborating with the Ministry of Health and Sanitation, World Health Organization and other partners to support the medical response and to strengthen social mobilization and messages around prevention to reduce the spread of this deadly disease.
To date, 214 people have been confirmed dead out of a total of 591 cases, while 161 have survived and have been discharged from treatment facilities.