Fieldset
Constructing an EMC

When I arrived in Foya, the Ebola Management Center (EMC) had already been completed.

When I arrived in Foya, the Ebola Management Center (EMC) had already been completed.

In the course of a couple of weeks, the team before me had constructed over 20 structures; some tents, some wood framed buildings wrapped in plastic sheeting. The expanse and planning of the center is quiet impressive. Unlike the only other center I’ve visited, which was unfortunately sandwiched in an existing hospital’s courtyard, this center was well defined with separate and adequate spaces for all of the different medical activities.

In my five weeks in Foya, I’ve tried to gleam the basics of ECC design, what to look out for and what to avoid. In general, you need three different spaces: Very Low Risk, Low Risk and High Risk.

The Very Low Risk zone houses things like the kitchen, visitor arrival, water chlorination and storage, and deliveries for the Logistics store and pharmacy.

Next is the Low Risk zone which has limited access; employees and accompanied visitors only. And because taking care of Ebola patients is such a staff and supply intensive task, the Low Risk zone can be larger than the actual patient ward. Space needs to be allotted for doctors, nurses, hygienists and logistic/water and sanitation offices, as well as a pharmacy and a logistic store. Low Risk also needs space for triage, a washing area, latrines, dressing rooms, more water storage and a place for staff to congregate.

The High Risk zone is divided into separate sections, based on the patient’s diagnosis. Patients who show symptoms or have had contact with a confirmed patient but are not yet confirmed themselves are kept in one building. Patients who have tested positive are kept in another. Even within these two different spaces, patients are divided based on potential to infect each other and progression of the virus.

Not only is Ebola complicated medically but it has an extremely intricate logistical set-up with issues constantly arising on how not to cross contaminate patients at all levels, from triage intake to discharge to the removal of dead bodies. As the weeks have progressed, we have been able to refine our set-up and with time we hope to establish a standard Ebola Management Center design.

I’m ecstatic that I was a part of that process.