Training day 3

Training, day 3. Most of the day was taken up with very useful and important protocols for treating Ebola patients, but by far the most striking aspect was a panel of Ebola survivors. The first time you hear someone say “I was taking care of my children, and after they all died, I became sick,” or “when I returned home from the treatment unit, I learned that my mother, my father, my brother, and my elder sister had all died” – it kind of takes you aback. I mean, all that stuff you read about, 20 people in a family dying – it actually happened. A stupid thing to say, maybe, but hearing someone sitting in front of you, whose individual face you are looking into, say it makes it more real.

One of our group commented on how traumatized the whole country is, and you begin to see it. To begin with, the survivors themselves – the man whose kids all died said, when we were speaking with him afterwards, that when he’s doing events like this he feels okay, but when he goes home he gets depressed. Yes…. He wished there were more psychological supports. He also said that men need support/somewhere to go when they come out, since they can’t have sex for 90 days after they’re cured because there is still virus in semen. On the one hand, this seems kind of a minor concern – but, on the other, I can imagine that, after you thought you were going to die, were tended to by strange people in moon suits in a treatment area where you knew no one, got unexpectedly better, and came home to find that your partner was, amazingly, still alive – you might really, really want to have sex!

But the entire health system is messed up, too. First of all, any condition that is NOT Ebola has been completely neglected over the past several months, so the general level of health has probably declined, and there will probably be a backlog of people coming in trying to get services once they feel safe (and once normal facilities are open for business). Second, a lot of healthcare workers have died, and as a result of this (and of fear), the system has just come apart in some places. But also – the thing about Ebola’s “presentation” (i.e., what people look like when they come in for care) is that it is more or less the same as “feeling sick.” People have headaches, achy joints, red eyes, abdominal pain, fever. How many other illnesses can you think of that make you feel like htat? If they are a little sicker, they might also have vomiting and diarrhea and feel weak. Again – is there another illness or 50 that makes you feel this way? So imagine what happens in 6 months: A woman has malaria (headache, fever, achy joints) and comes to the hospital. Whereupon everyone becomes terrified she has Ebola (headache, fever, achy joints). Will they care for her? Will they kick her out? Will they run away? Those are going to be the questions from now on.

I’m glad to say that, once the Ebola crisis has been contained, Partners in Health is first and foremost committed to rebuilding the health system. It will need it.

A word about Freetown: If it were richer, it would be San Francisco. I keep noticing this. It is situated on these lovely, steep peaks right over the ocean. (And apparently the beaches nearby are BEAUTIFUL, too.) The general sense of poor-country dilapidation changes the impression – although mostly what makes it seem less lovely is the Harmattan (wind carrying dust off the Sahara at this time of year) and the perpetual burning (garbage? Cooking fires? Field clearing?) – also a common developing-country phenomenon. So the air is always kind of brown and hazy (at this time of year, anyway). Still – the views from our hillside house are kind of breathtaking.

A beach more or less in the city of Freetown - nice swim!

View from our apartment - morning

View from our apartment - evening