6th February 2015

Breaking News…

“An Australian died today in Sierra Leone.  The first Australian casualty of the Ebola crisis.  The nation is in shock and mourning alongside the family.  Sarah Newton, a doctor, was with the first batch of volunteers sent after the Australian Government finally relented to international pressure.  Despite Australia having the agreement with the UK government to evacuate any Australians, Sarah was too sick to be airlifted.  Instead she was treated in one of the purpose built clinics for volunteers.

Interviews with fellow medical staff said that Sarah had been confident that despite continued staff shortages and battling fatigue she had taken every safety precaution.  When she showed the first signs of a fever she assumed it was the result of something else, possibly malaria. Consequently she had not reported to sick until she had started vomiting.  While they gave her the best possible care and worked around the clock to save her, she passed away in the early hours of the morning.

Back in Australia, Sarah’s family refused to talk on camera, preferring mourn their daughter in private.  They describe Sarah as a hero, who has always put other people’s care before her own.  They are distraught at her loss and now due to restrictions regarding Ebola related deaths they will not be able to bring her body home for a family burial.  Sarah’s body will be cremated in a service with her colleagues in Sierra Leone.

A memorial will be held next Saturday at St Thomas’s, Church in Nth Sydney.”

As I watched the news cast I felt relief, guilt and empathy for Sarah’s family.  Grateful it wasn’t my friend.  As much as I tried, I could not contain my tears.

I was late for work this morning.

1st February 2015

After the swim, and while the kids were watching Frozen, over a few glasses of wine Juliet relayed some of her experience on the ward in Sierra Leone.  It was sobering.

“Each day brought new cases, people didn’t stop coming.  Men and women; young and old, wealthy and poor; black and white.  If you were breathing, you were at risk.  Everyday, became about ensuring you were protected.  It was the only thing keeping you from becoming infected, so you’d get paranoid.  We developed a ritual about putting on our PPE gear.  Put it on, check for gaps and holes, then check again.  Then get someone else to check for you.

All through out the day you would check for holes and bare skin.  It was like being in a sauna.

It was worse when they brought in small children, it made me think of Sophie and Daniel…

You could have two children come within a couple of days of each other, about the same age and progression of the virus.  You’d treat them in the exact same way with fluids, the high protein peanut paste and you’d still loose them.  And there was no telling which one might pull through.  Sometimes the ones you thought were sure to die, pulled through.  Others, who should have had a fighting chance, died.  It was heartbreaking.

And the smell.  Burning bodies, chlorine and death.  Nothing gets rid of it.  It permeates the very air you breathe.  It gets into your clothes, your hair and your skin.  I had to burn all my clothes before I left and when I finally got home I soaked in the bath for hours, I thought seriously about shaving my head.

In the end you just get numb.  Numb to all the death.  You turn into a robot just to get through the day.”

I would have believed her, except for the tears rolling silently down her face.

31st January 2015

It’s been an interesting day.

Mum asked me to take her to the supermarket to help her get what she might need in case she and Dad go into isolation.

The weird thing was not that she asked me to take her.  It was that, when we were half way through, she said she was going to get some UHT milk and didn’t come back.  I had to leave the trolley half full with groceries, in the middle of the supermarket, to go look her.  I found her 20 minutes later in one of the other shops in the mall buying something for Ella.

I managed to convince her to go back into the supermarket to pay for her groceries.  Once we had them in the car I took her for a coffee.  I think Mum would have liked a shot of something stronger in hers.  When I asked her what happened, she was reluctant to talk about it, saying that I would think she was being silly.

I told her that nothing about Ebola was silly.

She said she was fine until the trolley was half full.  Then she realised what it all meant, that we all could be in danger.  Her and Dad, her children and her grandchildren.  That it was easier not to think about it.

I couldn’t pretend, that it was all rosy.  Potentially it could be quite dangerous, but it was better to be prepared than bury our heads in the sand and get caught short.  Not ignoring it was the far safer thing to do.

But, I could tell she wasn’t really listening.  I might be easier for me to get them prepared than to get Mum to think about it again.  Otherwise they might not do anything.

After I dropped Mum off, I stopped by Juliet’s place to give her the flowers and the card.  She looked good, pleased to be home, but still haunted by her experience.  I invited her and the family to the flat for a BBQ, movie and a spa.  Juliet suggested a swim in the ocean instead.  She said the smell of chlorine reminded her too much of the ward.  We agreed to meet at Coogee at around 3pm for an afternoon dip before dinner.

30th January 2015

So excited!

Juliet gets to leave quarantine tomorrow.  I think I’ll pop around tomorrow before I take mum out shopping for her isolation groceries, with some flowers and card.  I don’t want to impose on her first night back with her family.

I’ll see if she wants to come round for a movie, spa and early dinner on Sunday.

It will be wonderful to see her face to face.  It feels like forever.  I bet she is looking forward to seeing her family.

28th January 2015

In the news this morning they had an update on the three MSF volunteers that were on the flight back from Casablanca.  The two that had vomited on the plane had been tested for the Ebola virus and the results had come back negative.  However all three would remain in quarantine for 21 days.

I sent a txt to Ethan this morning to tell him to stockpile some food for him and Katie.

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This was his reply:

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25th January 2015

I got a phone call in the middle of the night last night from a doctor at Chelsea and Westminster Hospital.  Phone calls in the middle of the night are scary at the best of times, then when the person on the other end tells you they’re a doctor…

I knew it was going to be about Ethan and the Southwark Riots.

The doctor told me that Ethan was fine, he had sustained a couple of lacerations and one above his eye had required stitches.  He was particularly lucky the one above his eye was not more serious.  He also suffered a serious knock to the head so they were keeping him in for observation, but he should be able to go home tomorrow.

I’m glad they couldn’t get hold of Mum and Dad, they would have been beside themselves.

I was too alert to go back to sleep after the call so I got up and made myself a cup of tea to calm my nerves.  I decided to read about the riots.  Instead there was breaking news of a flight from Casablanca to New York.

“Earlier today a plane on route from Casablanca to New York encountered severe turbulence.  Consequently inducing vomiting in dozens of passengers, including 2 (of 3) MSF volunteers returning to the U.S. from Liberia.  Neither of the turbulence affected MSF volunteers showed signs of a fever.  However as a precautionary measure and in accordance with strict CDC guidelines the pilot immediately notified the CDC.  Two air stewards then donned personal protective equipment including face mask, gloves and apron before moving the MSF volunteers to seats in air crew rest area.  

Passengers witnessing the removal of the volunteers immediately suspected Ebola and messaged friends and family using the flight’s internet connection.  All three MSF volunteers were quarantined on arrival at JFK.  All other passengers have been interviewed to capture detailed contact information.  Passengers interviewed as they departed the Casablanca to NY flight have expressed their fear of infection.”

“And in related news there are now reports that airline stocks have dropped 15% in final hour of trading.”

Wow, things are really starting to heat up, I wonder what’s next?

I really must get back to sleep though if I am going to be functional at work in a few hours.

13th January 2015

I caught up with Juliet again this evening.  She sounded much better.  Rested.  There was still a sadness in her voice that was hard to ignore.  She is doing better than I would in her situation with 2.5 weeks left in isolation.  I think I would have gone slightly mad with nothing much to do except read, watch movies, or surf the internet.  And she has a family waiting for her.

For a while I didn’t really know what to talk about, so we talked for a long time about silly, everyday things like whether or not I had a boyfriend, the weather, the kids, work.  After a while our conversation drifted to Sierra Leone.  Not the horror of all the death, it was still too raw.  Too fresh. Instead we talked about the local health care workers.  Their courage in dealing with people from their communities.  Their unfailing support of victims.  Watching exhausted as everyday more people succumbed to the virus.  Juliet was impassioned about the disparity of treatment between international aid workers and them.

International aid workers are evacuated to Europe or the US.  Local health care workers are treated locally, sometimes in facilities purpose built by the US and the EU.  For a long time there was nothing.  And while lessons have been learnt and shared about the care of patients (electrolytes and intravenous hydration) the death rate of local workers is still higher.

It seemed to me, after reading the papers yesterday, that without the guarantee of evacuation, the flow of much needed international volunteers would stop.  Doctors and nurses would choose not to go.  I’m not sure that even if there was the option for the locals to be evacuated that they would take it.  In their shoes I would want to stay somewhere that I was familiar with, where by my family was close by.  So given the choice, I’m not sure I would want to be evacuated.

12th January 2015

Richard, the IT guy, was back at work today.  I caught up with him this afternoon to run through the research I’m doing on the ebola crisis and how I want to display the data when I present to the leadership team.  He was very helpful with ideas and also suggested I use the design team for the graphics.

He had so many questions about the crisis – what had been happening?  How many were dead?  Had it spread further than West Africa?  He didn’t even know about the man dying yesterday, despite it being front page news.

Has he been living under a rock??

After I gave him an update, we had an interesting discussion about the aftermath of the death of the US aid worker and the wave of volunteer cancellations.  In order to stem flow and assure doctors, nurses and aid workers, both the EU and the US have taken action: the US by committing 6 military planes and crew to evacuate any US volunteers; and the EU confirming via a formal statement, that 4 more aircraft will be dedicated to evacuate EU and Australian volunteers.

It will be interesting to see if that makes a difference to the number of volunteers.

11pm I’ve just seen this via my news feed;

The UK Prime Minister made a public statement today: “in the wake of the two Ebola patients admitted to Newcastle Royal Victoria Infirmary in December and the subsequent healthcare worker infections, we have learnt hard lessons.  We want to assure the public that new protocols have been put in place at Royal Free Hospital and we are carefully monitoring all possible contacts for the eight new London cases.”

11th January 2015

First American Aid Worker Dies in Liberian Clinic.

That was the headline that greeted me this morning while I drank my morning cup of coffee.  It was the on the front page of every major Sydney newspaper.

“The aid worker had arrived in Liberia in late December to provide relief to those already on the ground.  It is not yet clear how he contracted the virus.”

That poor man.  I wonder what happens in situations like this with the body?  Does he have to be buried/cremated in Liberia?  Or can the body be shipped home?  His family must be distraught.

The article goes on to say, that “He was the third US healthcare worker to have been treated in the clinic.  He is the only US worker so far to have died.  Attempts were made to evacuate the worker but all dedicated aircraft were already deployed evacuating other patients.  Aid agencies are now reporting a wave of cancellations from US volunteers scheduled to depart for West Africa.  One volunteer in Liberia commented she now ‘just wants to get out of there.’”

Another doctor was more explicit.

“We doctors feel the pull. But each of us has reasons to stay back, reasons that get bigger as we age: children, partners, parents, grants.  The yellow medical armor may not suffice, even when donned on our shores in the best facilities.  And the possibility now exists of quarantine when we return — no “Welcome back, our hero” signs at the airport, but straight to house arrest.  Employers are gently pointing out that if we choose to volunteer, that is admirable, but we’re effectively on our own, not covered by our health insurance.  If we fall sick in Africa, there is no guarantee of being evacuated, no promise that even our bodies would be flown back.  I fear that volunteers who get any fever out there will be quarantined with others who might be infected, waiting on the test.  And if it is Ebola, they will be moved to the infected tent — no I.C.U., just confinement.  From there, who knows.” New York Times

It must be such a tough decision for people.  To want to go to the aid of all those in need and yet have uncertainty about what will happen to you should you fall ill.  I’m glad that’s not a choice I have to make.

10th January 2015

Juliet arrived home earlier today from Sierra Leone.

I managed to talk to her for a few minutes this evening.  It was so good to hear her voice.  Poor thing, she sounded exhausted.  Wrung out.  All she wants to do is get home to her children and Justin; have a long hot soak in a bath and sleep in her own bed.  Except, now she has to remain in isolation for 21 days.  Just in case.

I asked her about going, what it was like and if she was scared.  Her response was, it’s not that she was scared so much as hyper-vigilant about her PPE (Personal Protective Equipment) being on properly, about washing and disinfecting after working, and about getting someone else to check that you secure and clean at the end of a shift.  And she knew should anything happen, she would be evacuated via Germany because of the Australian government agreement with the UK.

In contrast, the US Government has built a medical centre for international volunteers and local medical personnel.  They will be treated on site, but away from the main medical clinic.  Juliet said, while she agreed with it in principle, if that was what the Australian Government had proposed as a solution, she doesn’t think she would have gone.  They just don’t have the same level of facilities, staff, or resources as they do in Europe.

Personally, I’m not sure Justin would have let her go.  It’s just too big of a risk.

9th January 2015

There are not enough beds or aid workers.

That was the startling conclusion I came to today when I was doing my research.  There are just not enough – doctors, nurses, volunteer aid workers or beds.

Even with the 17 new centres across Sierra Leone, Guinea, and Liberia, each with 100 beds, with 8,000 new confirmed cases each week (plus the estimated 12,000 unreported), the clinics will be over-run with infected people.  People will be dying without care, without treatment.

The poor medical staff and aid workers must be exhausted.  Emotionally, physically, mentally.  I’m so pleased that Juliet will be home in a couple of days.  She’s been gone since the Australian Government relinquished and allowed our doctors and nurses to go to Sierra Leone.  She’s been over there nearly a month now and I’m so worried about her.  I’ve only had a couple of texts from her, which is unlike her.  I hope she is being careful.

I’ve talked to Justin a few times and he says Juliet’s hanging in there but she’s run down, fatigued both mentally and physically.  The medical staff work long shifts, catching a few hours of fitful sleep between rotations.  Justin is looking pretty haggard, I can’t imagine how tough this is on him with her away not really knowing how she is doing and having to keep up appearances for the kids.

I know this sounds terrible, but I am glad I’m not there.