Ebola was not part of the plan

By Dr Marta Lado

Three weeks ago, I flew from Madrid to Freetown to start my new role with King´s Sierra Leone Partnership at Connaught Hospital. I was nervous and excited about what was ahead - but my Terms of Reference made no mention of what I was about to be involved with. 

 Taken the week I arrived at Connaught

The day I landed news broke about an Ebola outbreak in Sierra Leone’s neighbour Guinea. As a specialist in infectious diseases, being involved in an haemorragic fever virus outbreak response is both an incredible and threatening experience.

Fortunately, we have not found any confirmed cases yet in Sierra Leone, but being part of the National Ebola Taskforce within the Ministry as a KSLP representative is fascinating, but also quite daunting.

This role puts me at the forefront of the preparedness response. The Taskforce is regularly updated on the current outbreak and we participate actively in the preparation of the population and of health care workers in case the disease spreads to Sierra Leone. We gather at least once a week to improve the communication between the different health care units and prepare training courses for health workers.  

 A lecture presented to staff at Connaught and students from COMAHS by WHO Ebola expert

Arranging isolation of suspected cases and preparing personal protection equipment (PPE) for the health care staff is very challenging in this setting and especially in rural areas, where basic equipment like gloves and gowns can sometimes be hard to get hold of. Our work must be therefore focused on adjusting all the protection and management protocols to a specific low resource setting but without underestimating the risk and the importance of every measure.

 Gloves are some of the supplies that have been pre-positioned in readiness for a potential outbreak.

It is also critical to supply healthcare workers with extensive information through basic guidelines as well as sanitation and isolation PPE kits to reduce the risk of transmission. Ebola is transmitted by body fluids (blood, excrement) and therefore protecting every centimeter of the body and skin when a care giver or health worker is looking after a sick patient is essential. 

 An isolation room has been set up at Connaught Hospital in case of an outbreak

According to our current guidelines and the WHO protocols, a suspected patient must be immediately isolated.  The doctor in charge must then communicate nationally and coordinate for blood samples to be taken. The patient is to then be referred to the Lassa Fever Centre in Kenema District to be managed by experts in haemorrhagic fever syndromes.

While this unexpected role has been extremely challenging, I have also learned an enormous amount and gained invaluable experience. We hope that the efforts made will help to prevent the spread Ebola in Sierra Leone and we will be on hand to support and counsel at any situation that arises during the next months.