Ebola 8

Sunday morning

Just a short one today. Amadou is getting better, the 2 year old I thought would die. It’s an achievement as infants generally have a poor prognosis, so this maybe another sign of improvement overall. I talked with Oliver, the new humanitarian director here; the signs are that survival is now above 50%, which is a landmark.

The Cuban team meanwhile had a party, which a few others were invited to. The night shift was a little harder for this, however I think they needed to let off steam so it may help bring them right back into the larger team.

We had a death on the ward yesterday just before the late shift started, a man who was clearly very unwell and getting more agitated presumably due to the encephalitis that can occur. He became a danger to others and had to be sedated, but died suddenly, another feature of the illness. I think the opinion is that a combination of electrolyte disturbances and sepsis may lead to overwhelming organ failure and cardiac rhythm problems. So I had to go in and attach a label to his body, so that the hygienists could double bag him and take him to the mortuary whilst others cleaned up the bed and surrounding area.

The six year old is still holding on. I had to use a little emotional blackmail with her older sister who is now well, making it clear her sister was very ill and needed her big sister to keep making her drink and possible eat a little. We may need to insert a nasogastric feed to build her strength back up.

Coming back to the chalet at around 10.30 pm we saw in the darkness a group of men hauling on a rope attached to a huge fishing net cast out by boat about 500m into the sea. They continued hauling until the net came in with many fish, sardine sized. During the whole process there was a rhythmical chant from two of the men, and every few seconds one would make a sudden sharp heave to pull the net in another foot or two. It all reminded me of a black and white tv series the BBC used to repeat in the 1960s, about a west African fishing village, and I suspect this way of fishing and the chanting go back a long way. It was a good haul and they were pleased. The temperature is falling to maybe 18 degrees at night, drawing the fish into shallow warmer waters, whilst the national staff at the ETC complain about the cold and wear ski jackets!

Back to bed now to get a bit of rest before the night shift this evening.