Expats helping to fight ebola in west Africa

Saturday 29th November 2014 14:30 EST

When ebola broke out in West Africa, some have sent money to the crisis appeal; many will buy the new Band Aid single; others simply fret more about it reaching the UK or dismiss it as “west Africa’s problem”.

There are some people, however, who go the extra miles and serve the victims. What if you had just happened to be in Sierra Leone when the crisis erupted last May? Would you have got the hell out or stuck around to help, putting your comfortable home life on hold? These people chose the latter path and now man the country’s front line against ebola. Some don’t even have a medical background but pitched in offering other skills.

Here are some of their stories.

From the musical Wicked to running an ebola centre

Until recently Amardeep Kamboz worked for a London theatre production company managing big West End shows such as Wicked, Charlie and the Chocolate Factory and Shrek. Difficult to imagine a more dramatic contrast to the job she is doing now. Kamboz, 30, is a volunteer at the command centre in Freetown, co-ordinating the response to the ebola crisis. She helps manage the flow of patients and ambulances to the isolation units and is described by colleagues as a “powerhouse”.

When she went there in May for a career break and to “recharge her batteries,” she had no idea she would end up in the eye of the worst ebola epidemic in history. She intended to stay for a few months teaching children in a Freetown slum school, but the first case of ebola happened in her first week and as the crisis escalated her instinct was not to get out but to stay put and help. “You really get to care about people here,” she says.

Initially she educated community children about ebola, using games to teach them signs and symptoms; about hand hygiene and raising the alarm if they see anyone suspected of having the disease. The sad reality in the slum, though, she says, is that washing with clean water just isn’t possible for many. She then helped set up a command centre, pulling together various systems into one overarching facility.

“It is very intense every single day,” she says. “The phone is going every three minutes for twelve hours a day.” She begins at 7.30 am with a team of five or six people, establishing which isolation facilities have beds and getting lab results. The biggest problem is lack of beds, although this is improving and she says that on average there are 40 people waiting in the community for one to become available. “The worst part of my day is watching the list on my whiteboard growing and not having anywhere to put people,” she says.

The board charts those who are suspected of being ebola sufferers, but who haven’t yet been tested. “There are times when the district surveillance officer reports ten possible cases in a single house. You desperately hope it’s not but in the back of your mind you know it probably is.” Yet she has noticed that Sierra Leoneans are more resilient, physically and emotionally, than Westerners. “I come from a world where there are very few problems. This isn’t the first or last time they are going to face disaster on some scale, yet they take it in their stride. That really strengthens me. When you are frustrated because the power has gone off, you don’t have enough ambulances and your phone’s not working, the people around me say: ‘It is what it is. We do our best.’ ” Many are stigmatised for working in the ebola ward yet they still turn up every day.

“There’s never been a point here when I’ve felt at risk,” Kamboz says. “I keep it in perspective; I’m not actually treating ebola patients. All I need really is good hand hygiene and if someone is visibly sick you don’t go near them. It doesn’t feel more dangerous than that. If you have ebola you’re only infectious when you’re showing symptoms and the symptoms are pretty aggressive. Generally now there is a more robust culture of not shaking hands, hugging or touching.”

She recently returned to London briefly and was struck by some people’s disproportionate fear of ebola. “What saddens me is lack of knowledge. I think people don’t register the wider impact that fear has. If borders are closed, if flights are cut, all that does is make it harder for people like us on the ground who need supplies and volunteers. If you’re careful and the proper procedures are followed the risk level is low. We need to keep a sense of proportion.”

Kamboz is keen to emphasise how strangely “lucky” she feels to have been in the right place at the right time to help. “Maybe I have an optimistic view of the world but I’m sure there are many people who would like to help but don’t know how to. You don’t need to have a medical background. Doctors and nurses need people behind them, need back-up. Just get out there and get involved. I don’t think I’m ever going to see my life in the same way again. Life is weirdly easier now because I don’t worry about things in the same way I did.”

From the front line in Afghanistan to technical adviser

“The hardest part for me is dealing with the children,” says Andy Hall, 25, a military nurse who served on the front line in Afghanistan, attached to the Parachute Regiment. “As patients they’re a lot more demanding than adults; they need you more on the ward. They need affection and contact and this means you build a stronger relationship with them, so often you build these relationships and the children die and it’s devastating.” Hall has been working in Sierra Leone as a King’s Volunteer since August. Already he has designed and built three new isolation units, assisted by local contractors and funded by an Irish NGO, creating an extra 30 isolation beds in Freetown. He is also acting as a technical adviser to the World Health Organisation (WHO) and the Department for International Development, and recently briefed Justine Greening, its secretary of state.

He originally came to Freetown to run a brief trauma-training programme for local A&E staff, intending to return to the UK to take up a job in oncology at Guy’s Hospital in London. He ended up running the training package for ebola control and now works on the ebola ward at the Connaught Hospital every day. “When I came in August it was supposed to be for three weeks, but it looks like I’ll be here until next August at least,” he says. He has seen three colleagues and close friends die from the disease.

Initially, when there were fewer volunteers, Hall started at 7.30 am and often didn’t finish until 10 pm, wearing the white plastic body suits (personal protection equipment - PPE) that make conditions even more exhausting in the sweltering heat. Now the situation has improved and he spends eight hours a day in the isolation room but still has construction and training work to do besides. “Every time we go into the unit we lose about a litre of fluid,” he says. “You spend the whole day completely dehydrated. It’s pretty horrific, to be honest.”

When he returned home to Maidstone, Kent, for brief recuperation he ended up in hospital with a kidney complaint probably caused by dehydration. How does working here compare to Afghanistan? “Putting on the PPE is comparable to putting on protective body armour, but from a personal point of view I feel safer here than I did in Afghanistan, where you don’t have any control over whether an IED is going to go off.”

He is diplomatic but clearly frustrated by the slow international response to the crisis and would like to see the military setting up hospital field units in west Africa. “We need to tackle the situation here now, not wait until it reaches the UK. Ebola is going to kill upwards of 100,000 people in west Africa, although deaths will be 20 times higher because people will have reduced access to healthcare.” Hall would like to see more units on the King’s model rolled out across the country if the government would be willing to send teams led by British Army clinicians and environmental health technicians.

Because of the physical contact children crave, the risk of caring for them is higher. “But it’s not, in my opinion, good enough not to provide the care needed just because you’re scared. For me that’s what sets the local staff apart: they carry on and continue to work despite that fear. That’s real courage. If I get infected I know I’ll be repatriated and receive world-class care, but if they get infected they will remain in Sierra Leone.” Does he have any regrets about not taking up the job in London? “No, it was a no-brainer. I can’t imagine now ever doing a normal ward-based job in the UK.” He turns 26 next month. “I spent my 21st birthday in Afghanistan and I’ll be spending my 26th in Sierra Leone. I wouldn’t be anywhere else.”

Working alongside Hall on the ward is Sewa Lehai, 21, a first-year medical student. His classes were cancelled owing to the emergency but instead of returning to his family in the Koinadugu district of Sierra Leone he volunteered. On his first day he suffered a panic attack. “I went in with nurse Andy from King’s to Ward 8 with two other cleaners. We had to move a patient who couldn’t walk. The face mask was so tight I couldn’t breathe. I felt like I was suffocating,” he says. “I came back the next day and I was OK. I have only had one day absent since August because my younger brother was involved in an accident.” The worst part of his job, he says, is taking dead bodies and putting them in bags.

“I feel so fresh when I finally take off the PPE. It is very, very hot and sometimes when you sweat a lot your mask becomes like snow and you can’t see. Sometimes new patients from outside want to run away when they see you in PPE. I have to explain to them why we wear it.” Volunteering has come at personal cost to him, as previously he and a colleague were staying with his uncle in Freetown. “The day he learnt that we are working in the ward he told us to leave the house. He was scared. The hospital gave us rooms to sleep in. My mother and brothers and sisters don’t know what I am doing. I know if I tell them they will worry and my mother will come and take me back to my village.”

From fashion blogger to hospital co-ordinator

“It’s hard being here at times but I don’t know if I could be anywhere else right now,” says Jo Dunlop, who is communications manager for King’s, as well as a fundraiser. “I love this country. Seeing [it] decline into a state of emergency has been utterly heartbreaking.” Dunlop, 39, from Australia, came to Freetown three years ago to work on a project providing free healthcare to mothers and children. She then began freelancing, started a fashion blog and her own project supporting young athletes in Sierra Leone. She has even written a blog post detailing Freetown’s various stylish medical uniforms. “I didn’t come here to blog about fashion but when I arrived I started to notice all the incredible style around Freetown. This is a country where people generally don’t have a lot of money to spend, but their resourcefulness, dignity and self-expression around clothes is just wonderful.”

She has been part of the King’s team for 18 months (she is staff, not a volunteer) and is based in the main hospital. Her worst moment so far was learning that a health worker she knew was infected. The woman died soon afterwards. “She was so brave and committed. She was someone I only met a few times but she left a real impression. She was this beacon of resilience.” The health worker died at a time when “it felt like the world was ignoring this humanitarian disaster” and “somehow her death seemed to highlight that. How could we let this very, very important person who had saved so many lives die?”

Dunlop is continually impressed by local health workers and nurses who defy the stigma associated with ebola work. “Often it is the people at the lower end of the hierarchy within the health system who have stepped up to take these roles — nursing students, cleaners and porters. I know a cleaner whose wife asked him to leave until ebola finished,” she says. International health workers face it too. “I know health workers whose families want them to keep their distance when they return. This is really disappointing.”

Sierra Leone has lost more than 100 health workers to ebola, disastrous for an already fragile health system. “I hope when this is all over we can all step back and take time to reflect and honour these incredibly brave people,” Dunlop says. She’s unsure how long she will stay. “I would love to be here the day [the] WHO declares Sierra Leone is ebola-free.” Although medics are desperately needed, she says there is also “a need for logisticians, social workers, public health people. Working on any humanitarian disaster can be an incredible experience.”

Those in the first world worrying about their own risk should know “it’s extremely unlikely they will ever contract ebola . . . If anyone is sitting in London feeling nervous, perhaps they need to shift the focus away from themselves and think about the 5,000 people who have died in west Africa. Imagine how it feels to lose your whole family, to be stigmatised by the disease,” Dunlop says. “People need to think about the risk scientifically, not through the lens of sensationalist media coverage, then perhaps deflect some of the concern towards the people who are really suffering.

Dr Aatish patel (from Bhadran ) is flying to Sierra Leone on 5th December with British government aided support to help with Ebola outbreak. He will be there for about three months, he will also train community healthcare volunteers to help prevent the spread of the disease by educating them about personal protective equipment etc.Aafter the first phase of education is over, he will then go to Masanga which is three hours from Freetown city. They will go and reopen the Masanga hospital and treat those with the disease.

Masanga hospital is situated in the middle of the Sierra Leone jungle and provides a vital healthcare to the people of Tonkolili District. It is a 100 bed hospital with emergency, paediatric, maternal and surgical facilities. Due to the outbreak ebola the hospital has unfortunately had to suspend clinical activities. However, Masanga is about to reopen its doors under an exciting new banner – Masanga Mentor Initiative. This is a new training programme aimed at reducing transmission rates of the deadly disease. The challenge is to facilitate Ebola safety training for 450,000 Community Health Volunteers in 15 countries across West Africa in the next 3 months. We will use immerse technology to create virtual simulations and web and app based animations to help spread messages relating to safe PPE use and community health and hygeine.A donation of any amount would be really appreciated and will go long way to help needy people out there.

To donate please follow the link below


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