Monday, January 26, 2015

Last Days

This is my last blog post from Kakata, Liberia. I will soon be headed home. Back to what I thought was covered in snow but just learned it has all melted and this makes me a little disappointed. I was looking forward to some down time in my house, painting my kitchen cabinets and watching the snow fall. Winter is not over so I can still dream of this happening.

I wanted to thank you all for your prayers and support during this time. One of my main reasons in wanting to come work at an Ebola Treatment Unit (ETU) is that I wanted to bring awareness that ‘Ebola is Real’ (the slogan for Ebola here in Liberia), and that ebola is still very active and is still causing havoc in West Africa. You would not know this by watching or reading the news because it is not there. Some people were surprised I was coming because they thought the outbreak was done since they had not heard about it on the news in a long time. It is still very active and although the numbers have decreased dramatically, there is still the fear that it could spring up again. Fear that people will become complacent and not be as vigilant anymore in not touching or watching what they eat or question why this person is sick or go to a funeral and touch the body. There are still people dying. There are still hospitals running off of fear of any patient who is brought in. Patients who are not getting adequate care in clinics or hospitals because at one clinic close to here, over 20 healthcare workers died of ebola. The fear is real and patients are dying because of this. 

Two nights ago I had my first patient death on my shift. In the last six weeks since being here, there have been about seven deaths although none from ebola. All from things we can not give a definite diagnosis to. This man came in very sick. He was admitted at eight in the evening and was gone by six in the morning. It is so hard to imagine dying in an ETU with no family or friends around. Alone. In a small room with grey tarps for walls. Poor lighting. Bugs flying everywhere from the quick dump of rain a day ago. This man was brought in pretty unresponsive although he would fight us when we were trying to get an IV line placed. We checked on him throughout the night but beyond giving fluids and a very limited amount of medications available, there was nothing else to be done. I tried washing his face but that made him more agitated. He was incontinent of thick, black, tarry looking stool. This would assume blood, but no way to definitively test for this. Checking the inside of your lower eyelid can also give you an idea of what your blood levels are. His were white which means he had lost quite a bit of blood, but again, no way to know for sure. (I have met many doctors throughout my time working in West Africa who can give a accurate blood count level by pulling down and looking at the color of the inside of the lower eye lid.) Because of his fever, possible bleeding, weakness, and patient condition, he was brought to the ETU under suspicion of ebola. I was called into the ETU early in the morning to confirm that he had passed. He had. The viral load on an ebola patient after death is extremely high and because we still did not know his status, we had to treat him as though he was positive. The sprayer sprayed him with the chlorine solution and we covered him with a paper sheet. There is a team who deal sole with patients who have died, so in the morning the burial team came in and put him in two body bags, spraying each with chlorine before taking him to the morgue. The county and family then decide together where the body can be buried as we do not have a burial site on our land. By the afternoon we received the blood results and the patient was not positive for ebola. That was good new for the community and all that had cared for the patient in his home and at the other clinic. The family will never know what exactly this man died from. Lassa hemorrhagic fever and ebola have very similar presentations so there is thought this could have been it, but we will never know for sure. 

Please keep praying for an end to this ebola outbreak. Not just here in Liberia, but also in Sierra Leone and Guinea. Pray for these countries as they will have to learn to deal with what comes next. How to move from a state of fear to a state of rebuilding the healthcare systems. Rebuilding families who have lost so many. Children who have lost both mother and father. Pray for those who have survived ebola and their continued reintegration back into their communities. Pray for healthcare that can meet the needs of the people they are here to serve. It’s heartbreaking knowing what can not be offered. 

I wanted to say hi the all the kids at Sandhill Elementary! My mom has been reading this blog to her students so I just want to say: read the news. Get good grades. Learn about what is going on in the world and see what you can do to make a difference in your own community…and give my mom a hard time. You are all very fortunate to be able to get the education that you do! 

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