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Counting the days following an Ebola mission to Sierra Leone

NOVEMBER 10, 2014 By Helena Humphrey, IFRC

Health Minister, Dr. Abu Bakarr Fofanah
Health Minister, Dr. Abu Bakarr Fofanah

It is the size of two football pitches, composed of four thousand wooden sticks, and took three weeks for a team of dedicated locals and Spanish Red Cross delegates to build from the amber-coloured earth up. The International Federation of the Red Cross and Red Crescent Societies’ Ebola treatment centre in Kenema, Sierra Leone, has 60 beds for suspected, probable and confirmed cases of this deadly disease, divided between low- and high-risk wards.

Kenema is an area hard hit by the Ebola outbreak, and those 21 days of effort were about to make a difference.

For Cristina Castillo, deputy team leader from the Spanish Red Cross during the mission, 21 days has assumed the qualities of a magic number. Now back in Madrid, she has passed the infamous 21 day mark during which Ebola symptoms might develop. She knows that she is Ebola free.

But the mission is etched in her memory. “It was frustrating at first,” she said. “Unlike other emergencies, we couldn’t start treatment until everything was in place. We had to adhere to strict protocol and couldn’t afford to put a foot wrong.”

Most important in getting the treatment centre up and running in good time was collaboration with local workers. “We worked with community leaders from the outset, to win their trust,” Castillo said. “Without the support of local workers – the plumbers, electricians and carpenters – we wouldn’t have been able to do it.”

A pandemic of fear

With the keys handed over to the IFRC, local staff are also employed as health care workers, psychologists, maintenance providers, cooks and drivers. All have been trained about Ebola and the principles of the Red Cross Red Crescent Movement. They number around 100, but despite their commitment to fighting this disease, it is the kind of work that comes with consequences: some have found themselves shunned in their communities from the fear that they will bring the disease back home. Some have had to stop working at the centre. “Stigma is a problem in Sierra Leone,” said Castillo. “But it’s an issue here in Spain, too.”

Spain has lost two of its own to the current outbreak – priests who were infected with Ebola while working as part of the response in West Africa and died back in their country of birth.  The media in Europe reports extensively on the disease, but despite the proliferation of news – in stark contrast to many villages in West Africa – Castillo questions whether it is the right information. “People in Spain are scared,” she said. “Colleagues come home after stints in the field to be told by family members and friends that they will see them once the 21 day incubation period is over.”

Indeed, Castillo says she felt sting of this stigma herself, when those around her questioned whether she should be swimming in a local pool, although the disease is not being waterborne. Her mother was told to avoid telling people her daughter had been to Sierra Leone.

The Ebola outbreak is not a pandemic, but it appears that fear and stigma about the disease may be.

The Spanish Red Cross is trying to combat this. Delegates deployed to Ebola affected countries – and their families – have access to a 24-hour hotline providing psychological support, before, during and after their mission. On their return, delegates also have their temperature monitored and recorded by a medical team twice daily over those 21 days. If their time spent on the ground is intense, their home-coming, and that three weeks of waiting are also not easily forgotten.

For Castillo, at least, it is over. But still, she said, the whole team has been holding its collective breath in anticipation of a really important event. “We were just waiting,” she said. “Waiting for the first Ebola survivor to come out of the treatment centre that we built together in Sierra Leone.”

On September 26, the news came through: the first two patients were discharged to return home Ebola-free.

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