Ebola 3
I saw up to 8 critically ill patients tonight doing a round inside the red zone with the chief nurse, an absolutely incredible Serbian guy called Milos . Most of the population in Sierra Leone are beautiful, young, vibrant and fun loving, but desperately poor; the life expectancy at birth is 53.
Imagine a healthy 25 year old becoming close to death with pneumonia in the pre antibiotic era. You went into what was called a “crisis” of sepsis, and if you were lucky you pulled through. That is what Ebola is doing. I expect at least 2 to die tonight, but I thought this last night and nobody did. One died unexpectedly though today.
I’ve admitted a few to the centre now, trying to find out how they became at risk and it is all too obvious that the message about not having physical contact with Ebola sufferers or dressing and hugging the departed wives, husbands and children is almost certain to cause further spread, is not being taken on board. It must feel inhuman to ask the local Ebola burial team to come and take your closest relatives away without a proper goodbye.
The ethos of “Emergency” is to treat as vigorously as you would in Sheffield, or London or Glasgow , and so a large tent has 6 beds with machines that can monitor vital signs, deliver oxygen via concentrators, and insert central intravenous lines. Managing such patients whilst wearing PPE is unbelievably difficult. As soon as you put it on in this heat and humidity you sweat profusely whilst standing still, so after one hour you put your hands down and feel the sweat pour into your gloves.
The national staff (the local Sierra Leonians ) are very friendly and hard working , but i suspect there has not been enough time to explain in detail why infection control is so important, however our paramedic colleagues have been watching closely and gently encouraging good practice and are already having an impact. Several national staff are watching several members of their own family die.
J So we are all starting to settle in and will hopefully become more useful now that we can perform clinical duties inside the red zone. I do feel safe with the system preset. But remain paranoid about what my hands touch.
Over the next 2 weeks we need to develop systems that can expand this car from 22 beds to another 30-100 over time. It’s a tall order and I sense a lot of political discussions will be needed.
Dr Michael Boyle said:
Dear Charles , sounds like you are doing an incredible job ! The patients are intrigued about what you are doing but very supportive in fact . You got a mention at Patient Participation Group and a commendation at our 50th in Sheffield last weekend ! Best Wishes and take care Michael
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Jackie Weston said:
Hi Charles,
your blog is really interesting and informative. Keep them coming. You are always in our thoughts.
Warm regards
Jackie WEston
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chris kearton said:
thanks Charles, gives a real sense of the situation.
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Dawn russell said:
Dear Charles, reading your blog puts a lot of things into perspective about our own lives! It all sounds incredible and hard work but I’m sure the feeling of seeing that you can make a difference makes it worth while.
I look forward to reading your next instalment, and as Michael commented the patients are very supportive and proud! As we all are xx
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Sue Laing said:
Hi Charles – you are an amazing person – what you are doing is just incredible! I do hope you can find the time to keep your blog going it has brought a sense of reality of the situation home.
Best wishes – take care.
Sue Laing and colleagues from the CSU.
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Steve Thomas said:
Hi Charles – thanks for this (the blog) and for doing what you are doing. Praying for you, your family and the situation as a whole. Your absence is very apparent (in a good way!) and we can’t wait to have you back safe and sound.
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dilys noble said:
Hello Charles Your work is vital , and you are part of an amazing team. Take care ++ and stay safe Dilys
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