Children in the ETU and Quarantine News from Home
I knew right from the start of my clinical years in medical school that I did not wish to be a pediatrician. I cannot bear to see them suffer or dying. Adults have lived but children are just beginning their tender lives. Children afflicted with Ebola are probably one of the loneliest people in this world. When their test result became positive they were wrenched away and separated from their loved ones and led to a blue tarpaulin room, hot and humid during the day. Since day one in the ETU, they see strangers clad in full PPE with eyes peering through goggles, muffled voices through masks urging them to drink and eat or asking them how they are doing. It must be a fearful experience to confront such a person for the first time. The light in the ETU is always on, it is difficult to discern night from day if they are too weak to move to sit outside and remain in bed. Daylight only streams into the ends of the gun-shot passageway and because of the heat, the tarp window shades are often down.
For days they see no familiar faces, no loved ones to comfort them or hold their hands. The few lucky ones have relatives who have recovered from Ebola to reenter the ETU to care for them. Do they feel rejected, abandoned, confused? Feeling of desolation leads to apathy and helplessness which do not lend support to fighting the infection.
Winner, the 6-year-old girl is very ill today, swelling around the eyes is less pronounced since slowing down the IV fluid but she is barely awake, cries piteously when moved. The three other children are now roomed together, with Christine being the sickest, refusing to eat and drink seemingly giving up her fight. One wonders if her mother were here it would make a difference. Joe the 11-year-old was moved from rooming with Zonnah who took a turn for the worst now vomiting blood as well.
Despite only able to see my eyes, there must be an indication of a smile in them that drew a little one from Joe when he caught sight of me. He sat up in a chair outside reading a book. When I peered at the book, he was reading it upside down. I righted it and asked him whether he could read, he continued to flash his mysterious shadow of a smile.
It seems to take about a week for the patients who are going to recover to feel well enough to get out of bed. It is a good sign when they start moving their chairs to sit outside.
At home news of Ebola dominate the airways in addition to ISIS, here one has to actively search for them on the internet. Another volunteer from US is stricken with Ebola which heightens the anxiety level in the US even more. The quarantine of a returned MSF volunteer does not surprise me, even before I left the country for Liberia, I had entertained the notion that as events unfold and more Ebola cases are detected in the US, as a returning volunteer in Liberia, I would be at risk for such quarantine when the powers that be begin to exercise their authority to contain perceived Ebola outbreak here and to calm mass hysteria. Whether there is also an element of political maneuvering to gain public favors given the upcoming election is anyone’s guess.
Today was particularly hot. My goggles were tight and crunched against my hair clip giving me a pressure headache and they pinched my nose making it difficult to breath. I was not allowed to touch any part of my face with my contaminated gloves. Drops of sweats dripped through my N-95 and my sleeves. My mind was a little hazy. We still had to place an IV line and administer a bag of Ringer’s Lactate into Sekou; I tried to mentally push myself through. It was as though I was running a marathon on a particularly hot day. At mile 17, I began to hit the wall but somehow pushed myself to mile 20, at that point I invariably asked myself why I was running this marathon or any marathon at all. But at the stretch to the finish line and at the end, the emotional boost to have finished running 26.2 miles was just indescribable. And so I sojourned on till the last drip in the IV bag was squeezed into the patient and my partner and I went to doff. My oversized scrubs and clunky boots were completely soaked. The difference between running a marathon and doing rounds in a PPE is one cannot continuously hydrate to keep up with the fluid loss.
At the end of close to 2 hours in the ETU, I downed a liter of fluid.