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Dr Vicky Lavy

Ebola: Christmas is cancelled

Dr Vicky Lavy worked for ten years in Malawi, setting up a palliative care programme for children. She now works for CMF as Head of International Ministries.
The views expressed do not necessarily reflect those of CMF.

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As many of us stop work and get ready to enjoy Christmas, let’s spare a thought for the people of Sierra Leone. Christmas celebrations and parties have been banned in an attempt to prevent the virus spreading when people get together. Christians do have special permission to go to church, but must come home straight after.

CMF member Sam Dunnet is still in Sierra Leone, working as Staff Health Manager for Save the Children. Here are some further excerpts of her facebook updates – they give us insights into the situation there.

December 6 – mass malaria campaign

I’m busy organizing our part of the mass distribution of antimalarial treatment taking place this weekend. The Ministry of Health is targeting 5 million people(!!) in Ebola hotspot zones with a full treatment course for malaria. This is because:

1)people are suffering and dying at home from malaria because health facilities are closed or they are afraid to go there

2)someone with a fever and malaria symptoms has to be treated as an Ebola suspect which causes unnecessary fear and is overwhelming Ebola isolation facilities.

So there is a massive door to door campaign to treat everyone with a repeat course in 1 month, with the hope that people will be protected throughout the high risk malaria season. It‘s really an impressive effort (with plenty of help from partners)

Last night I watched part of a film and in one scene, 2 men shook hands. It really struck me, having not seen that for several weeks. It seemed taboo, almost reckless, to do that. Here, we don’t touch at all. I am amazed how quickly our norms shift.

December 8 – new staff arrive

I briefed nine new medical staff today who have just arrived from the UK to work at Kerrytown. They were literally diverted overnight from another treatment centre which had had some safety concerns flagged up. We are certainly happy to have them, especially since we’re now up to 40 beds and were struggling without enough staff. 
Sadly three Sierra Leonean doctors died here over the weekend. Freetown continues to be the epicentre of the epidemic with many new cases every day.

December 12 – side-effects

I have distributed about 300 antimalarial treatment courses at the ETC in the last few days. Discussions and complaints about the side-effects of the amodiaquine component have been prolific in communities and even on the radio! It commonly causes weakness, sleepiness and sometimes headache and vomiting. Of course there were the usual rumours that the government is trying to harm people. 
There was a man lying across the road outside the treatment centre yesterday, blocking traffic. We first assumed he was an Ebola patient wanting to be admitted but it turned out he was just suffering from the amodiaquine side-effects and was so tired he just lay down in the road! Thankfully the symptoms only last a couple of days, since they’ve been distributed to a few million people this week. 
It should be a huge benefit in reducing deaths due to malaria.

December 14 – a long journey begins

So this week we start the campaign “Western Area Surge” which is a big multiagency effort to stop the spread of the epidemic in Freetown and the surrounding area (aka Western Area) and involves extra burial teams, decontamination of houses, ambulance management and more resources for the emergency hotline. It will run for 6 weeks.

Meanwhile I am travelling to the two field offices this week – the first is Kailahun where the outbreak started on the Guinea / Liberia border. It’s 9-11 hours drive from here – depending on how many punctures! From there I’ll travel to the other office in the southeast. Looking forward to seeing more of the country and working with the staff – not looking forward to the journey!

December 19 – bumpy roads and military checkpoints

Back from my visits to the field offices. I’ve been assessing and supporting the physical and psychological health of the 80+ local staff working hard at these sites to implement infection control practices in health facilities as well as their other programs. It’s meant long bumpy journeys and frequent military check points with handwashing and temperature checking – you have to get out of the vehicle and walk a few hundred metres at some of them because apparently people are trying to smuggle dead bodies in vehicles or hide sick people. The countryside is hot, dusty and poor but quite beautiful and densely forested. The schools are deserted and problems like teenage pregnancy and child labour are increasing.

December 20 – back home, the situation even worse

Although I’ve only been away from Freetown for a week, there is a tangible difference in the impact of the epidemic on people’s daily lives. Now, everyone has to leave the office earlier as all shops close at 6pm and barely open at all at the weekend. Most restaurants are closed, there are no parties or music. 
Statistics show that: “In a period of 4 days, the total number of confirmed cases in the W. Area has almost trebled from 577 to 1,302”. This is not somewhere ‘out there’ – it is all around us here and particularly the area between here and Kerrytown which I travel through frequently. They are stepping up the numbers of ambulances and burial sites as well as broadcasting key messages like “honour the dead by protecting the living”. We expect the numbers of cases to go up even more as sick people are identified in house to house searches.

Let’s keep praying for Sam and all the other health workers, national and international, who are struggling to care for Ebola sufferers.

Posted by Dr Vicky Lavy
CMF Head of International Ministries

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