Missive #3 – December 13, 2014

Human traces

It’s Saturday, December 13th and I’m on the afternoon shift – 2-10pm – but I’ll go to the EMC at noon for a group picture on the helicopter pad. Several MSF projects around the world have sent along pictures of their group with good wishes to MSF – Bo and we are reciprocating. It is cloudy right now and hope it stays that way. We have five doctors and one physician clinic manager at the Bo EMC – three from Holland, one from Germany, one from England, and me. The five doctors rotate between morning shift (8am-3pm), day shift (10am-5pm), afternoon shift (2-10pm) and the MSF staff clinic (9am-2pm). After eight days and eight shifts in a row, we get a day off. The Bo project is now operated by MSF Holland but we took over for MSF Belgium who were here for 10 years doing pediatric care. MSF delivers health care to all of our national staff, all of their former national staff and their families. Most care is done by national doctors working for MSF and one of the expats attends the daily staff clinic for advise and to make sure nobody with possible Ebola gets overlooked.

Patients admitted to MSF's Ebola Case Management Centre enter a triage tent. Here medical teams try to determine the severity of their symptoms and assess their contact history. Patients are provided water and snacks and a chance to catch their breath after their long and difficult journey on very poor roads. ©Fathema Murtaza, MSF

Patients admitted to MSF’s Ebola Case Management Centre enter a triage tent. Here medical teams try to determine the severity of their symptoms and assess their contact history. Patients are provided water and snacks and a chance to catch their breath after their long and difficult journey on very poor roads. ©Fathema Murtaza, MSF

My first experience as the day shift doctor went fairly well yesterday. I admitted three patients around 4 pm. My first admission was a one week-old newborn with Ebola whose mother had died of Ebola in childbirth – Borbor Winston. He appears to have no family or at least no one was accompanying him except for two unrelated Ebola patients from the same hospital, in the same ambulance. He weighs around 2.5 kg and seems to be in good condition. His only known signs/symptoms are fever and hiccups. The latter is a bad prognostic sign. As far as I know, only one child born with Ebola has ever survived so there is little hope for him, but he is feeding well and who knows what will happen. Ebola in pregnancy is devastating. Pregnant Ebola patients usually have a miscarriage and the products of conception have extremely high Ebola viral loads similar to a corpse.

We also admitted three sisters with Ebola – 15, 11 and 9 years old. They are very cute and seem to be doing well. They are sleeping in the same cubicle and are always together. It is impressive the way the adults in the EMC take care of the children and each other whether they are related or not. For example, we have a 15 month-old baby girl who recovered from Ebola a couple weeks ago and who is living in a small MSF house just outside the EMC but still inside the gates. His mother died yesterday and he is being taken care of by two women who recovered from Ebola but lost children to Ebola themselves.

When times become desperate, I am impressed how so many people step up to the plate.