Be the change you want to see in the world. ~ Ghandi

Wednesday, January 28, 2015

CURED!



I wanted to share this picture and story with you for a happy moment.  This man came to us along with his newlywed wife.  His mother had died of Ebola and he fell ill along with his brother, sister and wife.  Unfortunately, his wife was severely ill and died in a couple days despite our and his best efforts.  He and his sibling survived.
 
Today he was discharged CURED.  He was elated and spent half an hour with us saying thanks, wanting pictures taken (I asked him if I could share his picture with friends and he said yes).  He told us what he remembered during his illness:  how hard it was to drink because he was so nauseated, but he knew ORS was lifesaving so he continued to drink.  How afraid he was in the night that he wouldn't live until morning.  How good he felt every time we went in and told him he was doing well and treated him kindly.  He especially remembered me (I'm sure because the blue eyes are all that show behind the PPE) and that we'd saved his life.
 
A very happy day.  Unfortunately, some of them are so happy and dancing on their way out, only to find their homes empty, interior sprayed with chlorine and door locked, all possessions burned.  No clothes, no mattress (foam pad), no money to buy new things.  Some of the community councils are doing this which is probably going overboard, but in an effort to stop the spread.
 
Everything they bring with them into the ETC is burned.  Cell phones (we can wash the SIM card in chlorine), belts, shoes, clothes - everything.  Logistics buys clothes at the market and shoes so we try to outfit them in a dignified way for going home after a shower at the exit.
 
Today we have two little ones in Suspected that I admitted yesterday who are not doing well.  One seizing all night despite a whole lot of valium IV.  Both initially tested negative for Ebola, but symptoms began only 2 days prior, so they have to stay a couple additional days to retest.  Probably malaria causing high fevers, but we're struggling to keep them alive long enough to get that second test - then we can transfer to the pediatric hospital, but not until we confirm it's not Ebola.
 
A 17 yr old girl in ICU isn't doing well and a pikin of 8.  Two others are OK and we moved one darling boy to Oral Confirmed.  Poor dear was playing all by himself because the other children were too sick.  He is now our resident doctor (he's 5) - started hanging his toys on the IV hook and pretending he was giving himself a drip.  So cute.  Should have gotten a picture of that.
 
Celebrate the good and move past the sad.
 
Love to all,
Sue
 

Monday, January 26, 2015

More daily life in Sierra Leone...and Momo goes home!!

Hi All, 

Next pic is of me in Triage today. 

 We stand behind 2 meter barrier fences to interview patients, then come within arm's reach to take the temperature - hence the face shield (and gloves).  It's been decided that we nurses can do the triage, screen patients in or out, write admitting orders, etc.  I normally work ICU, but today and tomorrow am in Triage to cover the nurse who's working overnight shift.  I admitted one man who looked sick and indeed is positive with a high viral load, and a pikin who was limp and had a "convulsion" last night and hadn't woken up.  He might be malaria instead cuz no contact exposure.

We ended the day with 18 total patients - I think it's probably a record low.  YAY!!!  The president of SL said schools will open in late March.  Everyone is counting the outbreak over, but it's not yet.  It's not gone.  Cases are not rising nor falling, more holding steady.  I heard Liberia is doing much much better.  YAY. Today there were lots of celebrations as 3 were discharged cured.  And 5 were "no case" - in the Suspected area and blood test negative.  We all breathe a sigh of relief when a test is negative.

Yesterday I had to pronounce a 7 yr old boy dead.  It was especially sad because I'd been with him a couple hours before dripping ORS into his mouth with a syringe.  Poor little guy.

I have to tell you - I absolutely LOVE my Nokia Lumina phone.  Got it just before coming here to be able to stay in touch.  Well, the camera is amazing and I take pics all over the place, and especially for work.  Yesterday, the ICU nurses made the mistake of putting a patient chart inside the bag of medications and sent it "in.". Well, what goes "in" can't come "out" And they were averting their eyes, heads hung, hoping to not get in trouble.  I had one stand inside and hold it up page by page as I took pictures of it, then sat down with the phone and recreated it.  They saw the amount of work it took and came slinking over to apologize.  I'm guessing that's never going to happen again :)

And a prize to whoever can explain the choice of brand names for the latrine covers.


Worked on Arts and Crafts between patients in Triage today - trying to create a new system for stocking/inventory control for the items we need at a moment's notice inside ICU.  So I cut up empty gloves and masks boxes and taped them together to create my masterpiece.  Tomorrow will talk with The Powers and see if we can trial it.  Also working on a training for nurses of how to mix IV meds, hang them, count drip rates, etc.  Amazing that they don't uniformly know this stuff, but ... One of my daily lectures is about 3 way stopcocks..





The last picture is to make you smile.  This little girl was sent home yesterday cured.  All possessions taken inside are burned (including cell phones, clothing - anything that can't be sterilized with 0.5% bleach), so they shower and we give them clothes and shoes to go home.  She and her mother were admitted when I first arrived.  Mother died within days, but the pikin survived.  She will now be cared for by an uncle and his family ...

Wish I could have been there to cheer when Momo went home, but it was on my day off.

Thanks to all of you for writing and sending your encouragement and positive thoughts our way.  Day by day, we do the best we can.

Much love, 
Sue

Saturday, January 24, 2015

Another day in Sierra Leone - and some good news too

Hi All!
 
Plan for the day:  
 
1.  Sleep in.
 
2.  Go to "Super Market" - can't wait to experience a Sierra Leonean super market!
 
3.  Have lunch with an old Ethiopian pal from my mission there in ... 2008?  He was a lab tech and went to med school and is now in Freetown working in a pediatric hospital.
 
4.  Skype with Pete in the evening (morning in Seattle).
 
5.  Go to bed early and start 6 in a row before another overnight on Super Bowl Saturday (Go Hawks!)
 
Two pieces of GREAT NEWS!!!  Our 5 month pregnant patient was successfully induced and survived!!!  HURRAY!  She is the 19th documented pregnant Ebola survivor for MSF since the outbreak began nearly a year ago.  She is glowing, happy, laughing and thankful.  
 
Second thing - Momo tested Ebola NEGATIVE yesterday - WAAAAAHOOOOO!!!!!!!  He's still a bit foggy and rummy - I think still a bit fluid overloaded and perhaps a bit tox from liver and kidney failure.  His hands and feet are still swollen, so I can imagine his brain is as well.  But he's asking to move to the other tent (they all know going to the other tent is a step in direction of survival and going home) and is eating, drinking, walking without staggering, making sense, following directions and even initiating conversations.  Thanks to everyone who has sent such strong positive vibes his direction and prayers - it's all worked and he's improving right before our eyes.  From being chased back into his room with a stick to survivor.  Wow.
 
A couple pics to share with you - one of a survivor hired as a caretaker to watch/feed/clean the pikins (small kids).
  And one of a ladder - there is lots of construction going on.  Amazing these men can do hard physical labor in this heat.

 
We are now up to about 60 survivors since this ETC began Dec 10.  About 300 total patients, about 30 still in now.  The 300 includes patients that are brought into "suspect" but get ruled out with lab tests.  Probably half are discharged as not Ebola.  Some are malaria, some are just symptoms we don't diagnose a cause.  We are not a hospital nor do we diagnose or treat anything other than Ebola.  No meds, no time, no space.  We try to get the "negatives" out of the facility as quickly as possible so as to not expose them to the virus in any way.  There is always a risk.
 
Still teaching at every opportunity and enjoying seeing the nurses get a bit more empowered every day.  After all, we will leave and they will stay.  One gift is to leave behind as much knowledge as possible.  
 
Hope all's well at home.  Keep sending your happy thoughts to these people.  Keep spreading the word - Ebola is not over.  We have hope.  We're all working hard to overcome.
 
Love to all,
Sue