imageApologies for the errors in the previous post, a conglomeration of entries from last week up to yesterday. I don’t think I can correct it but never mind. The image is from the beach yesterday.

Today we visited the 100 bed ETC at Goderich, literally across the road from where we are living. It’s huge, an impressive feat of civil engineering due to be completed under the management of the British army in a total of 31 days. There were hundreds of local men involved, so ebola has brought work and training opportunities. As the demand for materials increases, so local suppliers have increased prices. Given the way the economy has come to halt during the crisis, it’s no wonder some make an opportunity from it.

from there we were driven to the existing ETC at lakka, apparently built in only 4 days. It’s a construction of concrete floors with a mixture of solid and tented areas providing space for assessment and treatment in the”red zone” with all of the supporting functions outside this, the White and green zones. It is plumbed with the essential flow of 0.5% and 0.05% chlorine that kills the virus in seconds, areas to don PPE and to doff this, and areas for medical and nursing staff to organise the care. Each treatment tent has someone watching in from the fenced 1m separation distance, shouting orders and receiving information from the health car workers inside.

We watched as a suspect case was interviewed at the assessment area, again from the safe distance. He is a 45 year old fisherman whose neighbour had died of Ebola 2 weeks ago. It wa difficult even for the local speaking Krio to establish the full facts about how he may have acquired the virus. He was clearly unwell, breathing rapidly, was weak and hiccoughing, a bad sign in this disease. He was admitted and will have been put on a drop, given fluids, antibiotics and other medicines; we will see if the ebola PCR test for presence of the virus, is positive or not. Whatever he has, we know he is very sick, with bloods indicating kidney failure.

we talked about the different ways in which different health systems manage the same problem. Emergency is an Italian organisation and its protocols reflect the patterns of care in that country. Given that few have much experience to say what is the best way to manage it, we are not in a position to question , as these brave and incredibly hard working people have been fighting the disease for three months now without any of the recognition we received on Saturday work at the airport.

The chief nurse, Milos, from Serbia , took us through their method of donning and doffing and we tried it twice. Just getting into the gear made us sweat profusely, and we saw people coming out of the red zone with soaking wet scrubs, so much so that they have to take them off and shower before putting on dry ones. We had a delicious spinach and fish curry and rice for lunch, one of the distinct advantages for the workers, the disease again providing a work opportunity for local people. We spoke to one pair of young men whose first job this had been ever, at the age of 17 and 19; I imagine this would not be a popular YTS scheme back home.

So back now to the house, for tea, for more discussion and hopefully a good sleep before we step up to more drills and actually entering the red zone.