Dr Juli Switala thought about contracting Ebola every single day. She had to. Her quest to help heal ill children in Sierra Leone had suddenly turned into a no-touch mission.
“The way you live in a society that is affected by Ebola is completely different to everything you do at home,” said the paediatrician from Doctors Without Borders (MSF).
“You sign a contract to say you won’t touch anybody. You don’t hug anyone. You wear gloves all the time. You can’t not think about contracting Ebola.
“You use chlorine in the water you drink, you wash your clothes with chlorine.
“If you’re cooking potatoes, you have to wash them with chlorine because someone with Ebola could have touched them before you. Ebola becomes a way of life.”
Switala returned to South Africa two weeks ago after spending several months in Sierra Leone, where she was part of the paediatric team at MSF’s Gondama referral centre, a 220-bed hospital offering emergency paediatric and obstetric services.
But then, in June, Ebola hit the region. Ultimately, she would run a 20-bed isolation unit while a new treatment centre was set up, and as the outbreak worsened, she became the paediatric Ebola referent for the hospital.
Now that she is back home, she thought her friends and family would be scared to touch her.
“I expected people to be wary of touching me but they are putting out their hands for me to shake.
“With a lot of my colleagues, people are nervous to touch them, or they aren’t comfortable if they are around their kids. I’m so glad that hasn’t happened to me. I’m confident I’m not sick, and if I was I would know what to do.”
In Sierra Leone, it’s peak season for diseases like malaria and cholera that affect children.
It should be the busiest time at the Gondama referral hospital, but instead, because of fears of contracting Ebola, it has become a ghost town, she said.
“The hospital has a capacity of 200 beds. When I left there were 50 patients. People are too scared to come to hospital. And watching that is terrible. You know it’s not that the kids are not sick, but they are dying out there from diseases other than Ebola.
“Their families are too scared to bring them into hospital. It’s heartbreaking to go to work every day and there’s three fewer patients admitted than the day before.”
The hospital’s obstetrics division had to shut because of the risk. Indeed, so many clinics have closed in the region, it is “apocalyptic”.
Expectant mothers are unable to have caesareans, and TB and HIV patients are defaulting on treatment.
Switala was surprised by how many children have Ebola: once she started to work in the isolation unit she found that a quarter of the admissions were under 18.
“It’s not a terminal disease. There is a high fatality rate but our aim is to optimise treatment to patients who can be cured.
“When people are discharged, everyone claps for them, it’s wonderful. Tomorrow might be their turn.
“Many patients, I can see, will not make it, and then I talk to them, rub their backs, which is worth more than 1 000 blood tests and a million drugs.
“It’s about keeping them comfortable and giving them a dignified death, knowing you protected their family or others who could have contracted the disease from them.”
Solving the epidemic, she said, is “about trusting people to come forward”.
“Some patients know they are at risk and immediately isolate themselves. Then there are others who try to hide the symptoms, because they are scared.”
The world needs to step up to counter the worsening pandemic.
“There are many deaths from diseases other than Ebola that are because of Ebola, like people dying from car accidents or in childbirth because they have nowhere to go.”
Other countries should not feel immune, she warned. “West Africa is being left to burn because everyone thinks it won’t affect them, but it will.”
Switala will head back to the hospital in two weeks. “I have no romantic ideas about Ebola. But I was there when it started with the staff and I want to see it through.”
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- Saturday Star