Oct 29, 2014

Inside an Ebola Treatment Center

We arrive at the Emergency Ebola Treatment Center unannounced, expecting to get no more than a picture of the buildingPPE-clad Emergency center worker and, perhaps, an interview at the gate. We tell the gatemen we have come to find out more about the newly-opened center and would like to talk with one of the doctors. We are asked to wait outside the gate and we discuss whether and how we can get material for our story as a full PPE-clad worker sprays himself methodically with chlorine nearby and prepares to enter the facility. After a short while a lady appears at the gate, smiling and speaking with an Italian accent. She tells us she is Gina Potella, and is in charge of the facility. We tell her our mission
"Perhaps you would like to come in and see for yourself?" she says.
We look at each other, startled. This was not quite part of the plan. We had wanted to find out about Ebola and Ebola treatment; we hadn't really bargained on getting close to Ebola.

We go through the gates. The gateman turns on the chlorine tap for us, and our temperatures are checked. Pulses racing, we are led into a small room, where we are asked to take off our shoes and appropriately sized, heavy duty rubber boots are given to us. Ms Potella, also wearing boots, but otherwise unprotected, leads us out and through a passageway with a tub of chlorinated water on the ground, into which we splash with our boots. We pass through and are told we are now in the green zone. We find ourselves in an area surrounded with tents, with hospital workers in red t-shirts busy with various tasks. We are shown the various sections, including the red zone, the tent containing the highly symptomatic, confirmed Ebola cases, separated from the green zone only by a few yards and a mesh net. We move around the green zone and talk to survivors and workers, ordinary people like ourselves, all dressed in ordinary clothes. Their stories are below. By the time we leave the green zone our terror has been somewhat shamed into submission. We have come close to Ebola and have not been overwhelmed by it. If Italians can leave all their comforts and travel thousands of miles to fight Ebola here in Sierra Leone and young, pretty Sierra Leonean nurses with everything to live for can join them day after day, who are we to fear to spend 30 minutes to record their story. We exit the center after a final temperature check and chlorine wash.

Michel Smith

A twenty-two bed Ebola treatment center operated by the Emergency Hospital at Lakka in the western outskirts of Sierra Leone's capital, Freetown, has been helping greatly in the fight against the spread of the dreaded Ebola virus. The Emergency Hospital was established over a decade ago, to care for war-wounded during the decade-long civil conflict in the country. The newly-established Emergency Ebola Treatment Center has joined other Ebola centers in the fight against the disease that is ravaging the country.

Emergency Ebola Center director Gina PotellaDuring a visit to the treatment center we were taken on a conducted tour by the head of the unit, Gina Pottella, and allowed to talk to patients recuperating from the disease. The treatment center is divided into green, yellow and red zones; we were kept within the green zone, although the other zones were only a few feet away.

In the green zone we were shown the medical equipment in use for treatment. Gina Pottela explained that one basic treatment employed on admission is rehydration, which can involve the administration of up to five litres of water per day. When the patient shows symptoms of diarrhoea or vomiting the drug Amudarun is administered. Ebola Center monitoring stationOne of the tents serves as the facility's monitoring center, with computerized intra venous (IV) pumps and monitors capable of regulating the dosages received by patients and of monitoring their vital signs. Surveillance can thus be performed remotely, although interventions require PPE-clad health workers to enter the red zone. Potella estimated a fatality rate during their first weeks at somewhere between 40% and 60% and indicated that they were gradually increasing their patient load as they built up experience.

We were introduced to a number of recuperating patients, who were keen to tell us their experience with Ebola:

Ebola survivorsUnisa Abass Bangura was a hygiene worker at the treatment center; he thinks he contracted the disease through a laceration in his right knee which was exposed to the body fluids of a patient he was trying to assist. He subsequently developed the highest temperature thus far recorded at the center, 41.1 degrees.

Mariama Mannah is a fishmonger of Gbendembu  Village who contracted the disease while helping a friend's mother who she later discovered was infected with Ebola. She developed a high fever and diarrhoea and asked her friend, who was also showing similar symptoms, to accompany her to the Lakka Treatment Center. They found the center closed. She decided to wait and is now on the road to recovery, but the friend insisted on returning home. She died two days later.

Abdulai, another survivor, caught the disease from his wife, who in turn caught it from a female friend in a polygamous marriage where the husband had become infected. Abdulai's wife, six months pregnant, suddenly began to hemorrhage. He carried her, bleeding profusely, to the maternity hospital, where she passed away. Subsequently, he too developed symptoms.

We spoke to two young nurses, Hawanatu andEmergency center nurses Mariama. They were self-assured and quietly confident of their ability to treat Ebola patients. Mariama had been working at the Emergency Hospital for some time before transferring to the Ebola unit. Hawanatu had been working at the Kenema Ebola Center at the time Dr Khan and several of his assistants became infected and died. She described it as a terrible experience but appeared to have no qualms about continuing her Ebola work in this new center.