I arrived back in Brussels early yesterday. I have my good coffee, good chocolate and some good company. The same questions are asked to me over and again. What was it like? Were you scared? We are so glad you’re back… but I have my own, different questions.
I’ll try to explain.
Ebola touches everything. Living in the area most affected by the disease it becomes an obsession. Living, eating, breathing Ebola. I knew it then, and I know it now. As friends come to shake my hand or hug me I flinch, weeks of living with a no-touch policy has left me uncomfortable with normal social interactions.
Then there is the guilt. The guilt of not being there when the job has not even got properly going yet. In terms of this epidemic we are still standing at base camp, the summit is far in the distance, and a shortage of safety harnesses and guide ropes are hampering every step of the strenuous climb.
The last few days before my departure were particularly tough. There were high emotions and desperate decisions, where no solution would properly suffice. How do I justify leaving an epidemic?
I cannot. Then again, how do we justify the global dragging of heels whilst thousands of people die needlessly? I could feel it then and I feel it even more now. The angry frustration bubbling under my skin. International powers continue to remain limp in their response. Big statements, big ideas, but little feet on the ground. This epidemic never needed explode, the fuse was in clear sight of everyone, slow motion and totally predictable. It still is. From the outside it looks like so much is happening, from the inside though it is lonely.
I looked out over the beautiful hills of north-east Sierra Leone, mist rolling over the tree-tops, and I asked out loud: Where is everyone?
The epidemic continues to rampage through communities, and with normal health services now severely affected it is likely that even more people will die indirectly, than all those who died from the disease so far. Sooner or later the mines will be infected, then more cities, then, then, then…
It’s not rocket science. To save lives, stop the disease.
Fancy drugs and vaccines are promising but currently inaccessible to the people that need them, neither can they replace basic health promotion, basic hygiene, basic public health.
Last night, lying in bed and slightly disorientated, I let my mind drift back to the last months. The people who died, the people who survived, and mostly to the people I left behind.
The day I left the project an energetic ten-year-old boy was due to be discharged, “cured” of Ebola. He was for many of us a favourite on the ward round. He referred to himself as “The President”, often found running about with a radio slung over his shoulder at full volume playing hyper music. The President was that sort of cheeky kid that has an irresistible naughty streak. Even when I took his blood test (to confirm he was negative of Ebola) he wanted to dance around. His departure, I’m sure, gave the team an immense boost to keep going.
I already know that I will aim to return to the projects working against this epidemic. Not because I am a mercenary, because the need is huge and experienced people willing to be there are in short supply. I’ve seen the many comments about the health worker “heroes”, risking their lives to fight Ebola. I can imagine the temptation for some health workers to also want to be a hero.
The reality is this: There are no heroes in Ebola. A nurse, doctor or anyone turning up to volunteer in any of the affected countries is at risk of being a disastrous hazard as much as a help. Poor training, planning and preparation can, with the best intentions, be entirely counter productive. Health workers becoming infected not only diminishes the local capacity, but is extremely damaging to the international response. Ground force is desperately needed. But basic medical ethics prevail: First, do no harm.
Mental images float through my mind: Women with new born babies, and the women without; the operating theatre with blood on the floor and sweat dribbling down my face; the dying children and jubilant survivors. The tense concentration and the impossible decisions. I’ll keep them all, digest them, learn the lessons. And, when the time is right, return.