10 January 2009

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 ...