Trish Henwood is an emergency room doctor and Director of Global Health Initiatives in the department of emergency medicine at the University of Pennsylvania. She is in Bong County, Liberia, working at an Ebola treatment center run by the International Medical Corps. She filed this report:.
'Wash your hands, don't shake hands . . . protect your family, protect your community,' children sing on the radio as we rumble down the rutted road. I'm out directing the ambulance crew, a convoy of 4 pickup trucks. Flat tires are a daily phenomenon.
Each day we care for 25 to 40 patients with suspected or confirmed Ebola infection. We have a staff of 160 Liberians as well as 20 international employees and volunteers. We have admitted more than 150 patients since opening in mid-September. Following strict safety protocols, all staff members remain disease-free.
The number of new cases has decreased significantly in Bong County. Our goals of reducing new outbreaks and delivering quality patient care seem to be working. At the same time, there continue to be many new cases popping up daily in Margibi, a county to the west with no Ebola facility.
Today we pick up patients from the town of Kakata, in Margibi County.
The first is Alex, 34, with one week of fevers, headaches, and nausea. He was involved in the burial of his niece two weeks ago and had direct contact with her body. This leads me to classify him as a probable Ebola case. He continues to look well overall. I'm hopeful for him.
Our second patient, George, is waiting in front of C.H. Rennie Hospital, which was devastated by the loss of more than 20 health workers early in the outbreak.
George, 26, reports weakness, nausea, diarrhea, and fevers. He looks unwell, with beads of sweat across his forehead. I note his tachypnea, meaning he is breathing quite fast. This suggests he is losing his battle against the virus.
Fortunately, he has strength to climb into the back of the pickup, so nurses and chlorine sprayers do not need to put on full personal protective equipment (PPE) and risk direct contact. Early on our 2-hour trip back, George vomits repeatedly, making him a higher-risk patient. He also becomes increasingly confused - another bad sign. Some confused Ebola patients have jumped from ambulances, and we need to make sure George stays safely aboard.
The convoy stops and I speak with George, trying to calm and reassure him. Our Kenyan flight medic and nurse extraordinaire, Elvis, doing his MacGyver impression, rigs an orange tarp to prevent an unexpected leap. Finally, we arrive at our treatment unit.
The sprayers get to work decontaminating the back of the ambulances while our triage team admits the patients. The triage nurse, Bridget, reports that while both patients were settling in with blankets, dinner, and medications, George started weeping. He said it was because he was so grateful. It was the first time anyone had touched or cared for him since he fell ill.