Working to strengthen health care systems in Ebola-affected countries

Publié: 20 août 2015 6:40 CET

Karen Page is head nurse at the IFRC Kono Ebola treatment centre in Sierra Leone. She is currently on her second deployment. Her first mission in December 2014, through the New Zealand Red Cross, was at the peak of the outbreak in Kono and is in stark contrast to her present deployment. Karen reflects on her two rotations, of the friends she has made, and the growing confidence of her Sierra Leonean colleagues to deal with any possible future outbreaks.

What first motivated you to work in the Ebola response?

I received an email from the New Zealand Red Cross requesting me to go. I jumped at the chance. I had wanted to do something for a long time. I wasn’t anxious about going, but after the pre-deployment training in Geneva I was more worried about having to use the protective suit (PPE). As soon as you put the goggles on, they fog up. I was more worried about being able to do the work in the PPE rather than the actual risk. The Red Cross has been working in emergencies for many years, so I was confident of the training and that we would get looked after.

What was the situation like for your first deployment?

I was initially tasked with being a clinical nurse at the Kenema Ebola treatment centre (ETC) but after ten days I was transferred to Kono. This was in mid-December when the crisis just kicked off in Kono. Most of our patients in Kenema at the time had been coming from Kono. I was working in the temporary holding centre that the Red Cross had set up on the premises of the local hospital (to separate potential Ebola patients from others). It was pretty hectic; some days there were ambulances, some days none. Kono is three hours away from Kenema, so we had to wait for blood test results. All we could do was try to keep people comfortable and get them to Kenema as soon as possible.

What was your reaction walking into this emergency?

The Kenema ETC had already been up and running for three months, so it was busy but pretty well established. However, we still had huge death rates because people came forward later with their symptoms. Because of working in the PPE, you only had an hour to look after the patients. It was demanding both physically and emotionally.  The patients had the look of fear when they received the positive test result and you would do what you could to reassure them.

At the holding centre, we had a fantastic but small team in Kono and were extremely supportive of each other. Everyone had times when they were tearful. As the ETC was being built in Kono, I helped out with the administrative side to keep construction on track. The ETC was built in three weeks and I was extremely busy, working 12 hour days.

What prompted you to come back for a second rotation?

I was envious that colleagues who I had worked with had already gone home for a debrief and then gone out again on a second rotation. It was great to go back because most people were only here for a month and you have a constant turnover with people learning from scratch. I think people came back for a second or sometimes third time because they found the experience moving. It was so rewarding doing the work and working with such a great group of people. Everyone was working at the top level and it was really inspiring to be within a team like that. I also wanted to see the national staff again and see how the situation had changed.

How does the present experience contrast to your past experience?

It’s completely different. Before we were extremely busy all the time, doing long hours and with a lot of stress. Now, the hospital is very quiet We haven’t had any Ebola positive patients for over a 160 days. We normally have around 1 to 4 suspect Ebola patients in the ETC, so we spend a lot of time supporting and training the local staff. We have been doing an infection, prevention and control training programme to maintain standards and strengthen their capacity.

What are the objectives of the training?

The objective is to increase the knowledge and skills of the local staff. We will specialize in a topic such as typhoid or measles and do a presentation to our colleagues. There is such an interest from our national colleagues to learn. For example, those working in infection, prevention, and control will insist on joining the nurses in the training. For them, it is an opportunity to learn.

Do you think this training will help in the long-term for other infectious diseases?

Definitely, the standard operating procedures for infection, prevention and control will help in the future. We had a lot of brand new nurses, so this is an opportunity for them to be really engaged and benefit from a skill-swap with international staff who are very experienced in their field.

I think Sierra Leone is in a stronger position to respond to any future outbreaks in comparison to December last year. You now have this pool of well-trained people who have management experience.

What will be your memory of Sierra Leone?

I will remember the courage and strength of my national colleagues. I think especially of the guys working in infection, prevention and control who came at the start of the outbreak from Kenema to Kono to help and who saw some terribly sad things. They really made such a difference. We, as international staff, do a short rotation of maybe four weeks, but these guys have been here the whole time. It has been such a privilege to work with them and they were my main reason for coming back for a second time.