Read an account from Plan Ireland’s Emergency Response Manager, Dualta Roughneen (pictured) who has recently returned from Ebola hit Sierra Leone. Dualta explains how Plan’s community care centres are helping the fight against the killer virus.
Plan has been operating in Sierra Leone, as well as Guinea and Liberia, for decades, having built a strong relationship with communities across the three countries that have been decimated by the Ebola crisis.
The initial outbreak was thought to be an interruption to normal work, and that regular food security, education and health work would soon return to normal. Plan is not a medical organisation- I am not a doctor or a nurse- and the obvious question for me and for the Plan team in Sierra Leone was- what can we actually do?
There is a lot that can be done, and that needs to be done, outside of direct treatment and care, to deal with both the causes and the consequences of the outbreak.
Single villages have been devastated by the virus, children have lost their parents and because of the stigma that goes with the virus, they are rejected in the community.
The regular public health service has all but collapsed. Doctors and nurses are needed for Ebola care, and many of them have died in the line of duty. With simply not enough treatment centres, hospitals and community health units cannot open for fear of introducing Ebola to un-infected patients.
The issue of burials is another complexity. Recently deceased corpses are highly infectious. Burials need to be carried out by trained and protected teams. Funerals in Sierra Leone, as in most societies, are more than simply putting a body in the ground.
It is unconscionable for the poor in Sierra Leone to let a family member die alone. Better to risk infection themselves than to isolate the sick person in a room by themselves. Until there are enough beds in a treatment centre, where patients can get basic care, families will do the best they can to give what care they can, even when fully aware of the risks.
For this reason, small community care centres run by trained professionals, which allow patients to get basic care, close to their family, are of huge benefit.
My main role while in Sierra Leone was helping to establish Ebola Community Care Units in Port Loko, about 45 miles east of Freetown.
Five facilities are now being rolled out. These are a vital step in helping control the spread of Ebola in areas with very little provision. There are simply not enough beds available at treatment centres, which mean that people with symptoms remain in their houses, potentially infecting family and friends.
Each unit boasts a triage area for early diagnosis, a ‘red zone’ for advanced cases and a mortuary. The aim is to transfer patients to a treatment unit where more intensive care can be provided by experienced medics. Plan also provided food, water, beds and other equipment, and will also manage the staff payroll.
These interim measures are a necessary function in providing care in a safe and dignified manner while reducing further transmission.
Plan is also completing an Interim Care Centre for orphaned children. We are giving basic care packages to each family in quarantined communities to make it easier for them to stay in their community and lower the risk of onward transmission.
Dealing with Ebola is complex. When a family is quarantined after having a suspected case, they are isolated for 21 days, yet they still need food, water and other basic essentials. When a community is quarantined, they still need food and water but can’t go to a market, can’t go to the fields.
Schools are closed and children are missing a full year of education. An already poor country, the agriculture season has been missed and there could be massive hunger problems in the coming months. The numbers of orphans increase daily and that will be the long lasting problem if the outbreak is ever contained.
The challenges are many, but in the next few months I hope and expect to see a downturn in the outbreak in Sierra Leone. But it is vital to avoid the outbreak going out of control. If people in Ireland want to keep Ebola out of Ireland then it has to be fought in the trenches.