Family matters

January 12th, 2009 by evelynef

Last night we admitted two new patients suspected with Ebola: the daughter (3 years of age) of a woman who died in Kampungu at the start of the epidemic and her aunt who was taking care of her. They are both doing quite well, it would seem, and the disinfection of their house was easier to arrange since the members of the household must have performed the same “ritual” when the mother died at the end of December. Of course, the father is very shocked, given the death of his wife and now the isolation of his daughter. It is not an easy situation to deal with. But he remains very calm, asks all the questions he has and respects our work.

The same cannot unfortunately be said for everyone. Many think that the disease we call Ebola does not exist, that it is no more than witchcraft. In addition, the fact that there is no treatment makes the population doubt our ability to help them in real terms. Today we visited a little 8 year old girl who is the sister (and, therefore, a contact) of a patient who died from Ebola. She started to get a temperature this morning but her father refused to allow her to be put in isolation. This afternoon, the little girl still had a temperature, despite the anti-malaria treatment, but her father did not want to see reason. He even refused to accept my leaving some protection equipment, so that he can give care at home without putting his health and that of the members of his family at risk.

He is absolutely convinced that he is combating witchcraft – in which case no-one can do anything; or that it is simple malaria – and our doctor has obviously muddied the waters with the anti-malaria treatment.

Jonas, our doctor, was ready to bang his head against the wall… and I must admit I was ready to join him in this highly constructive pursuit, when after fully explaining the precautions to take so as to safeguard his family, the father told me that he would do nothing of the sort and that everyone would be sleeping in the same bed tonight. It was like a threat, a way of showing me to what extent our words were of no value to him!

In short, a very stubborn father but also a reflection of what may be being said in the community … Tomorrow a team will go back to see this family, and we have all our fingers crossed that the little girl’s fever will go down, and that we can rule out the possibility of Ebola.

For my part, I will be spending the day in the isolation centre, unless new suspected patients are sent to us.

Disinfection

January 10th, 2009 by evelynef

After a few days of calm, once again we’re seeing some action. At the beginning of the afternoon, two nurses and I went to check out new case alerts we had been informed about. We decided to admit one person into the isolation zone.

A new admission means that both the medical staff and the “watsan” (water and sanitation) have a whole series of tasks to perform. First of all, the isolation zone must be prepared: a thorough disinfection of the area and everything in it, plus preparing all the various chlorinated solutions that will need to be used both inside and outside the isolation unit.

And then there is also disinfection work in the home of the newly-admitted patient, to ensure that the changes of further transmission are immediately stopped. First of all, we have to explain why we need to carry out the disinfection to the patient’s family so we can obtain their consent.

It is all quite astonishing. Even more so because on our way to the house a whole group of curious onlookers (mainly children) followed us and stayed watching us for the whole time we were working.

Both I and the other “watsan” and myself went into the house to disinfect it, wearing our full “astronaut outfit”. We drew a circle to separate the infected zone from the ‘clean’ zone before putting on our suits.

The protection needed in the house is the same as when going into the isolation unit: suit, mask, hood, double gloves and ski goggles.

We arm ourselves with a vaporizer and chlorinated solution and douse anything that may look suspect, i.e. anything that may have been contaminated by the patient or even just touched. With the “audience” following us from beginning to end, commentating on everything that we do, it’s rather awkward upon leaving the house, especially for the family. But it is essential to do this in order to stop the transmission chain.

For me this was the first day’s work outside of the isolation unit and it was really pleasant, despite the heat (when I got out of my suit after disinfecting the patient’s house, I was soaked through!).

More news tomorrow, hopefully with good news about our little patient …

Isolation

January 8th, 2009 by evelynef

Hello everyone,

So here I am in Kampungu, in the Western Kasaï province, in the heart of the Democratic Republic of Congo (DRC). I’d heard so much about this place from colleagues I met on past MSF projects, who had worked here during last year’s Ebola epidemic It’s so interesting to finally see everything in person.

It’s also my very first mission in a forest, and though it’s not of those deep forests, where you can hardly see your hand in front of you, it’s still much greener and more humid that anything I’ve experienced up to now!

I went into the isolation zone when our last patient was inside. Donning the full suit is a saga in itself, but it is nothing compared to taking it off again. When removing it you have to be so careful, because you are leaving « isolation » — i.e. you leave the contaminated zone and move into the ‘clean’ zone. A guard waits for us at the exit and guides us, stage by stage. It is quite an art!

The patient, a young boy, seemed in great spirits! He was clearly very happy to come out and finally go back home. He seemed to find all these white suits rather amusing, especially when he witnessed everyone getting undressed with such care.

Tomorrow the Ebola treatment centre will be empty and we will disinfect everything, while strictly sticking to all the safety rules, so we are ready, just in case. We will take advantage of the calm period to train the staff on the various tasks to be carried out in the isolation centre, especially dressing and undressing. We will also provide general information about what Ebola actually is, how to avoid it, how it is transmitted, and so on.

It looks like rather a calm day is on the horizon!

Biography: Evelyne Frauman

January 6th, 2009 by MSF Field Blog
Evelyne Frauman, MSF

Evelyne Frauman, MSF

Evelyne Frauman, 28, is a bioengineer and comes from Brussels, Belgium. In DRC, she is doing her third mission for MSF, after working in Southern Sudan and Myanmar (Burma). Evelyne is specialised in water and sanitation, a highly sought after profile on projects such as Ebola outbreaks, which require strict hygiene measures and rigid protocols to avoid any contamination.