Daily Mail – by Anna Hodgekiss
A British doctor working in Sierra Leone has described the horror he and his team have witnessed since the deadly Ebola outbreak struck.
Dr Oliver Johnson, along with a team of British medics, was working to strengthen the health system in the country’s capital Freetown when the crisis took hold earlier.
When disaster struck, they decided to stay and ‘do everything they could’ to help – despite health workers being among those most at risk of contracting the virus.
Today, Dr Johnson, 28, described the crippling conditions the team work in – and the opposition they face from locals who believe the disease may be a government conspiracy.
He said: ‘We’re all aware that there is a risk and that we have to be extremely careful. However, we also know that if we wear the protective equipment properly and follow the protocols then we’ll be OK.
‘That doesn’t leave room for error, however – such as an accidental scratch of the face or forgotten hand wash.
‘As we get used to it, we all begin to relax – the risk then is making sure that you don’t cut corners or get too confident.’
But he admitted the working conditions wearing the suits were far from anything the team had experienced before.
‘I first wore the protective suits during a bit of an emergency, so didn’t have much time to reflect on it.
‘The heat of the suits is quickly overwhelming, as your goggles steam up and you feel the sweat dripping underneath. And the smell of chlorine is intense.’
Dr Johnson, 28, is working in Freetown as part of the King’s Health Partners scheme. The initiative is a partnership between Guy’s and St Thomas’, King’s College Hospital and South London and Maudsley Trusts as well as King’s College London.
He added: ‘What shocking is how healthy the patients look before they die and how quickly they decline.
‘A number of the Ebola patients I’ve seen look quite fit and healthy and can be walking around until shortly before their deaths.’
Dr Johnson also described the difficulties of working in the country – which is recovering from years of brutal civil war – because many thought the illness was a government conspiracy.
Deep fear among patients and their families saw some trying to escape hospital, he said.
‘Ebola is a new disease in Sierra Leone and when the first cases emerged, many people thought it might be a government conspiracy to undermine certain tribal groups, steal organs or get money from international donors.
‘This links to widely held scepticism about Western medicine and traditional beliefs and practices.
‘Relatives don’t get to see what happens to patients when they are isolated, so some expressed fears that they were being taken away to be killed by doctors.
‘They don’t get to see the good facilities and great care that patients I see every day receive.
‘That meant some patients resisted being isolated and would try to run away or be carried off by family members.
‘This is a constant challenge even now, and presents real ethical dilemmas about whether we can or should restrain patients – and logistical ones about how it’s even possible to safely restrain an infectious patient without putting yourself at risk.’
He admits he ‘definitely hesitated’ when he was first confronted with a probable case of Ebola (it takes a few days to get lab confirmation).
Where a victim has breaks in the skin, blood seeps out, as the disease takes hold. The virus has a death rate of up to 90 per cent, and is highly-contagious, spreading through contact with an infected person’s blood, secretions, organs and other bodily fluids
‘Your instinct as a doctor is to rush in and help, but you know you can’t touch a patient until you’re fully protected, he explained.
‘Our families are often very concerned, and convincing them that we’ll be okay can be hard.’
Before the outbreak swept the country Dr Johnson, from London, had worked with African colleagues to help prepare for the worst – advising how to identify cases, set up isolation units, how to protect staff and providing refresher training for local health workers.
When cases started to emerge, the team had to ask themselves whether or not they should stay in the country to help with the response – their initial mission was to help strengthen the health system, not to provide a humanitarian response to an epidemic.
The team is made up of two consultants, two junior doctors, two nurses, a pharmacist and a hospital manager are all staff and volunteers. They chose to stay and help local health workers.
Dr Johnson said: ‘From the moment we heard about the first Ebola cases, all of our instincts on the team here and back in London were to do everything we could to help our colleagues overcome this new challenge.
‘We have very close relationships with our colleagues at Connaught and the Ministry of Health and always try to respond to their requests for support.
‘It was also clear that this new threat was something that they hadn’t faced before and would require technical advice, extra manpower and trusted friends.
‘We’re not a humanitarian non-governmental organisation however, so of course we then had to go through the process of articulating this and agreeing it as a group – there was never opposition though and we’ve always had consensus.’
Latest figures from the World Health Organisation show the outbreak of the deadly virus in western Africa has infected more than 1,300 people
Latest figures from the World Health Organisation show the outbreak of the deadly virus in western Africa has infected more than 1,300 people and killed at least 729. Ebola has no vaccine and there is no cure.
The outbreak has centred on Sierra Leone, Liberia and Guinea. There has also been particular concern after densely populated Nigeria reported what is thought to be its first death from the disease.
The team have been based at Connaught Hospital in Freetown for the last 18 months. They were initially working to help strengthen the health system of the country through improving aspects such as training, health policy, research and hospital management, before the first cases of the deadly virus started to emerge in neighbouring Guinea and Liberia.
Dr Johnson said that it was hoped that the country had ‘dodged a bullet’ – but Sierra Leone confirmed its first ever case of Ebola on May 25.
‘Even as the outbreak spread to Liberia there had been some hope that it might pass us by,’ he said.
‘We’ve now been hit hard though. Initially the disease was relatively well contained in the east but we’ve now seen cases in 1 districts. Hopefully these are isolated cases, but it’s still a bit early to tell for sure.’
For more information about King’s Health Partners and the work in Sierra Leone visit: http://kslp.org.uk/
Read more: http://www.dailymail.co.uk/health/article-2715647/Whats-shocking-Ebola-patients-look-die-British-doctor-working-Sierra-Leone-describes-horror-deadly-disease.html#ixzz39XJpUfAy
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