I know how much Ebola has been in the media lately and one of the questions I’m asked by friends and family is how do I protect myself from Ebola…?
The mission I am on is not handling Ebola patients at this time so our risk is different. Our risk comes from interacting with people who might be sick but just at the beginning of their illness when they could have fever but feel pretty well otherwise so they are working. Since we can’t “see” who has Ebola, we monitor temperatures for everyone who enters the compound to help identify if someone has a fever. I dress in my normal mission clothes (MSF t-shirt, cargo pants and boots) and no PPE (personal protective equipment). Additionally, all Expats monitor their temperature twice daily.
Our protection comes from multiple angles… no touch, give space, wash often. Pretty simple but strictly enforced… all of them… all the time… for everyone. No touch means no touch. The reason we avoid touch is simply to avoid the exchange of body fluids such as sweat (it is very hot here in Liberia). Nothing more to say there except to avoid touching, people give others space to move, ideally keeping a 1.5 meter distance from each other. This one is a bit more difficult in reality but we do try to make it happen. On the stairs someone steps aside to let the other pass. Chairs are moved a comfortable distance apart during meals and meetings. All of this helps avoid exchange of fluids such as that little bit of spit that might escape while you talk. Oh, we also don’t share drinks or silverware but that’s common sense.
The last protection are the many, many, many hand washing stations around the compound filled with 0.05% chlorinated water. As I stand in the doorway of my house I can see nine stations. I wash my hands and arms constantly throughout the day and certainly after I have had accidental contact with another person. All of the Expats and national staff do the same thing and we encourage each other to do it. One of the sayings here is that “if you don’t know what to do, wash your hands”… and that buys a few seconds to remember what you were supposed to do anyway. I keep hand sanitizer (70% alcohol) in my pocket on the off chance I can’t get to a washing station quickly.
Whenever people arrive to the compound (anyone including guests, Ministry of Health, daily workers, Expats from other MSF sections) they must wash their hands in the chlorinated water, have the soles of their shoes sprayed (with 0.5% chlorinated water) and have their temperature taken (with a no-contact thermometer). If they arrived by car, the door handles and wheels are sprayed. I think one day I had my temperature taken more than a dozen times (no joke) due to trips to our warehouse and back.
Two more important things about Ebola… it is fragile and doesn’t survive sunlight so we dry equipment outside (boots, tables, etc) in the plentiful Liberian sun after washing with chlorinated water. Additionally, Ebola doesn’t survive a good washing with soap. So in case you don’t have chlorinated water around, soap is an easy substitute or hand sanitizer with 70% alcohol.
During our distribution activities we interact with crowds of people from the community which is the same when we go into town for to evaluate a supplier or have a meeting with local officials. This is a riskier activity as we aren’t able to monitor everyone temperature so being judicious with space and washing becomes even more of a focus when in those settings.
I think there was one more thing I was going to tell you but I can’t remember so I will go wash my hands and perhaps that will help...