Admitting whole families to an Ebola treatment centre and seeing only one or two of their members leave is one of the saddest parts of the job that Gabriel Fitzpatrick, a public-health doctor and epidemiologist, has just been doing in Sierra Leone.
Going out into the community and separating families to bring some members into the centres is another difficult task. “People know that their chances of coming out alive from an Ebola treatment centre are low, so often they want to keep their family members with them, but we can only stop the spread of the infection by bringing sick people to the treatment centres,” says Fitzpatrick, who chairs Médecins Sans Frontières – aka Doctors Without Borders – in Ireland.
The medical teams work in a group of white tents in a jungle clearing. “We have 10 core tents which act as a hospital: tents for confirmed cases, tents for probable or suspect cases, tents for medical and nursing staff, tents for disinfecting equipment and clothing, a morgue and a tent for bodies waiting to be transported elsewhere.”
People are admitted with symptoms as wide-ranging as headache and flu-like fever to bleeding gums, high fevers, diarrhoea and vomiting. The virus is spread by exchange of bodily fluids. “There is no widely available treatment for Ebola, so we offer medical support with antimalaria and antibacterial treatments – some patients have malaria and chest infections as well – fluid replacement and pain relief,” says Fitzpatrick, who spent a month in Sierra Leone, based in the town of Kailahun; at home he works for the HSE’s Health Protection Surveillance Centre. “Some patients who are on the edge of survival can be pulled back to beat Ebola with this medical support.”
It's intense work with a small international team working with local staff. "The problem with countries like Sierra Leone and Liberia is that the civil wars left their healthcare infrastructure in pieces. The normal infection-control procedures were not being carried out before Ebola arrived, and the virus spread rapidly through healthcare workers and patients."
Médecins Sans Frontières runs six Ebola treatment centres in west Africa. “There have been over 5,000 cases of suspected or confirmed Ebola in west Africa, and almost 3,000 people have died. This is an underestimation of the true picture, as we have found multiple cases in villages that haven’t even been reported.”
Fitzpatrick says the task of preventing the spread of the virus is beyond the capacity of nongovernmental agencies. “The level of intervention needs to be at government level . . . The American government is sending 3,000 troops to build 17 Ebola treatment centres in Liberia. We need other large western countries to rapidly escalate their intervention.” Also, “We need to treat those infected with Ebola, and we need to go out into the villages to find other cases and bring them for treatment. ”
