My hands smell so strongly of chlorine. I can't recall
how many times I've washed them today. Thermometer guns
are at every building.
Spent the morning at meetings.
Followed this with a lunch meeting to talk
about the recent death of a staff member - and the consequences. I
later got to see how at risk I am myself.
The clinic I was in has now been taken apart and burnt.
Later - productive meeting at Unicef.
Then I arrived at the Connaught hospital. This
was scary. Arriving at the front gate with lots of people around,
I'm aware that people close by have been turned away from
the hospital due to the severe shortage of beds.
I'm struck by the realisation that this must
be one of the most dangerous places on earth.
It's hard to remember never to touch
Now low risk contact – official. On contact
Talking to someone doing contact-tracing.
People don't tell the truth. Even someone who was quarantined did
not tell his wife until nurses were visiting him at home.
Meeting today with nurses who will hopefully
be deployed throughout the country. Then dash off to UNICEF to meet
with stakeholders from almost all psychosocial input to create a
national psychosocial response to Ebola.
They actually felt that the people in quarantine were there as
a result of punishment from God.
Doing what is needed, if a bit dull – working
with partners on mental health and psychosocial strategy. But
it's productive and hopefully will help people of Sierra Leone
ultimately and very soon.
Documents enable work to happen.
Lot of discussion on survivors, peer support,
district plan etc.
I returned to clinic where I had been on
Saturday. The holding unit has been burned. But the clinic was
pretty much as it was. I'm reassured that it probably
wasn’t real contact or at least indirect. A patient died when I was
there but not in the direct vicinity. The staff are ok thankfully
but the clinic is still closed. We had been told that the
chairs we were on had been burned, but this wasn't the case.
I hear that 75 to 100 people a day are
recovered in Freetown at the moment.
My hands smell so strongly of chlorine. I cant
recall how many times I've washed them today. And the temp is
37.01 from the laser thermometer gun. Thermometer guns are at every
Mammy queen and Daddy kings – these are local
wise villagers and potential important community supports.
How to survive Ebola: Secret is, I
believe, copious fluid from the beginning. Maybe up to 5
or 6 litres. You become fluid-overloaded which effects heart,
lungs etc. and there's swelling everywhere, but this is way to
survive. If not, by day 2 or 3 you don't feel like drinking
anything and by day 4 or 5 you're too weak. Usually death will
take place by day 6 to 8. After that you may survive if
you've lasted that long. Informally after contact, if you don't get
anything within day 8 then you're ok - probably. For me this
is Day 5 – and still no temperature.
Beautiful Freetown day.
I attended a large meeting of Psychosocial,
gender, child protection pillar. We used to talk about clusters
but now coordination is with pillars. There's a lot
of information missing on cases and a risk that children who are
orphans may be lost to services. I hear about problems in the
Feedback from the survivor conference . Some
harrowing stories are relayed. Lots of survivor guilt and feelings
they had caused the spread of Ebola. There are unbelievable numbers
Next conference is cancelled as the area is not safe with too
much Ebola. We hear a story of 1 survivor who was body bagged while
still alive. About 70% of survivors have poor vision and muscle
pain. The government is trying to get free health care for
survivors. There is a need for survivors to reintegrate into
life and into families. Most are jobless. The experience of being
in this treatment centre is quite harrowing.
Later I head to the Connaught hospital. I see three of the
nurses who are pivotal to the mental health system. We have an open
discussion of the plan and what is needed. I leave by the main
entrance again and walk past a corpse on a trolley that is waiting
for the burial team. No one seems to be paying any attention to it.
Outside again I feel so guilty about wanting to be distant to
the people outside waiting to go in.
My driver tells me story of a burial as we
pass by a funeral – incidentally the most dangerous activity of all
– where the family dug up the body at night to wash it – again
highly dangerous and a sure way to get this very, very sticky
The end of the day and a glorious beautiful
sunset in a blighted land.
I will be monitored by a nurse but I'm still
low risk contact.
Frustrating meetings this morning. It is
hard to make things happen quickly.
Very nice staff support session at UNDP.
But there is a lot of terror about Ebola and somatic symptoms.
Light-hearted but deadly serious at the same time. There is no
getting away from Ebola from waking up in the morning to night
time. Lots of insomnia. One lady reported her children are
behaving differently, and not eating so well. They're not
asking about Ebola but it is everywhere. But we all have to move
together and try and lead as normal a life as possible and keep
safe at same time. Everyone has stories of people they had
A quick lunch before heading off to city
of rest. This is a private donations supported addictions centre at
the edge of town. It is very firmly religious based. We arrived as
they were having an assembly. Patients or 'candidates' as they were
called are actively involved in a religious type affirmation
session. The pastor there leads. We are taken aback as he then
touches the forehead of every ‘guest” in turn. We are further
astonished when he shakes hands with us. This is the first human
contact I have had in over a week. He says he doesn't have Ebola
and Ebola will not come in because of God. They are no longer
accepting admissions is one allowance to Ebola. It has been the
only place I have been so far where I haven’t had my temperature
taken on the way in. There is a significant addictions problem;
cannabis, cocaine, alcohol. Freetown was on a drug route
apparently, although nowadays you wouldn't think so.
25.10.2014 a weekend of
writing proposals and paperwork.
Went for a walk for first time. It's
surreal as the thing that is on everyone’s mind is do I, or do you
carry Ebola? The most terrifying thing is if anyone touches you.
Even children keep their distance. Lots of dogs around as well –
rabies or Ebola – hard to choose that one.
We pass a church and a mosque. Attending
either of these is a risky endeavour these days. I certainly
There are lots of market stalls on the way but
it is a very subdued atmosphere really. A few hellos, but no
one tries to sell us anything or ask us for anything. It's now
quiet as the sun has set and there's little electricity around. The
fishing boats still go out even when it's completely dark and they
are almost invisible. I have seen some large container ships to and
fro today and am really hoping that they are bringing supplies to
Sierra Leone such as protective gear etc. as it is so
A few of our group have left today and am sure
there will be others to replace.
I'm beginning to hear stories of the stigma us
volunteers to Ebola regions are facing. Children are being teased
and isolated even before mothers are deployed. Someone was
told not go to certain shops or do things he used to do back in his
hometown. Ebola is a terrible disease but so is the ignorance and
misinformed fear. Ebola is easy to catch and very easy to
I should be contacted each day to give my
temperature, but that hasn’t happened yet.
One of the mental health nurses has sadly died
of Ebola near Freetown.
We plan for training. Lots of meetings. Not
very exciting, but necessary. We meet with IsraAID.
This is really what development work is like.
Running up and down stairs, organising certificates at
the last minute, training materials etc... The printer can't
do it, the budget is wrong. There are all sorts of obstacles and it
feels so good to be back in this familiar situation. Trying
to organise training overseas is less about the content but more
about making sure that the lunches are there, the per diems, the
pens, and notebooks. All the things that people expect. As we speak
the printers are working late to produce 3 books per participant of
notes. PFA and mhGAP. Participants are on their way from all over
country for the training.
SKYPE meeting with London at Kings.
Usually I have been in the London office and watching the people on
SKYPE in Freetown. But I kept forgetting the microphone was on
and being careless with my speech.
Last part of the day today was with the
printers . I was driven down to the centre of town to the printing
shop. This is where you can get so paranoid. I felt so
uncomfortable moving around in this unfamiliar environment and
having to touch things around e.g. the walls, another phone
I'm now beginning to think of my journey
back, which is only a short while away. I was talking to a
colleague just now who was saying that when she leaves Sierra
Leone, she would be here 3 months; many of her friends with
children have asked her to stay away. In Geneva I heard WHO
has been asked to discourage people from West Africa staying in
hotels for fear. There is so much fear and ignorance. The feeling,
more or less, is if you have no temp you are ready to go
anywhere and no risk.
This day is a joy for me. I am doing what I
love to do and in my natural environment training. I loved the day.
I started off with running around for stationary that wasn't ready
the day before and racing to the printers for hand outs.
Instead of 50 we have over 60 attend. These
were nurses, social workers, and doctors and delighted to have a
survivor health worker present.
We start with remembering those who have been
lost to this disease and includes recently one of the psychiatric
We cover communication skills, psychological
first aid and stress module of mhGAP WHO curriculum. It was a very
interactive group. All are so stressed by Ebola and all in the day
was prismed through the terror of Ebola.
Some myths that we struggled to clear include
that stress can cause you to have a temperature rise. Well-done
team! Good work. Investment in these 60+ people to go out
with this knowledge and train others and use in principle. There
are so many applications for these basic ways of psychosocial
support – burial team, 117 emergency phone line, workers in
isolation units, bereaved, the scared, the orphans… It goes on
and includes us lot, health workers.
A survivor health worker had gotten over Ebola
but he still had family in quarantine and in isolation unit. He
spoke about how horrible the experience was so harrowing. Now he is
desperate to see his family who are in a quarantined area so he
hasn't been able to get permission to get there yet. It
was a privilege having this man speak to us of the stigma he faces,
isolation and prejudice.
Temp this am 32.4
(Maybe I shouldn't rely on my thermometer so
Meeting of Psychosocial Gender Child
protection Pillar today. This is basically a meeting of all
stakeholders in this area. Lots of people attend doing psychosocial
in this country but lots of stories that are horrific. Children
whose parents test positive for Ebola are kept with them in
an isolation unit and destined to catch the virus for sure.
This is anecdotal but is definitely happening. Lots of
The Minister of Social Welfare arrives to tell
us work together. But in truth I have seen a lot of coordination in
a constructive way. Sure there is duplication sometimes but at
least we have some way of mapping and seeing it. This is nothing
Meeting in eastern district so we drive across
town – all is going on as normal. Markets, shops, traffic. Its only
when I go to the hospital, talk to local people and colleagues that
we realise how terrible the situation is and we remain a hot spot
here of cases. No cases amongst our staff in a few weeks, which is
most reassuring. We are all following strict guidelines on
infection control. I now know there is a speciality of infectology
and lots of epidemiologists and surveillance happening.
Temperature ok but the driver next to me has
low-grade fever. So I get out of the car and have just
drenched myself in alcohol and put all the clothes in for
a wash. This is amazingly enough to protect yourself from this
lethal but fragile virus. Detergent, chlorine, soap can really kill
this deadly bug.
Another hot day in Sierra Leone – hot in
weather and hot in terms of new Ebola cases.
And yet frustrating to be caught up in so many
But we met the mental health coalition. These
are the Sierra Leonean mental health players and it's really
important that they lead on the psychosocial strategy and
implementation in the country. I was hearing the story of a
survivor from a treatment unit. They described the inhumanity of it
but there was one health care provider who used their name each day
and that really made a difference. The other staff just left food
and water nearby and denied them any human contact. PPE – (personal
protective equipment) is bad enough but this is just lack of common
humanity. Survivor I met the other day - I now realise he
lost his wife and daughter. This disease is so devastating. He
wants to visit his family who are ion a quarantine area. They don't
believe that it is him on the phone. There are myths going around –
that chlorine can cause Ebola. There is such a lot of hysteria in
I was sitting through another meeting and
thought that this is really frustrating and starting a nurse
led clinic is going to be drayed so long . So have started a little
informal fundraising to get chairs, desk, fan, basic stuff for a
clinic. A quick email and have already got pledges of several
hundred pounds. Humbling and so rewarding as this will really
make a difference.
Latest figures 1,510 cases of lethal Ebola in
Sierra Leone and double the sickness rate. No sign of any reduction
Heard a chilling story about ambulances.
Drivers wear Personal Protective Equipment. The ambulances are
often not washed so I'm guaranteed to get Ebola if take an
Today I went with some WHO colleagues down the
road on Sunday to a little market. There are no longer tourist
visits but the market stalls still sell, or try to, with the
diminished trade. Lots of fish for sale and fruit, as well as
usual tourist stuff in Africa. I came back to hotel and showered to
clean myself after this. Temperature was 37.7 on arrival to
hotel. But had been walking in the sun so I managed to check again
and I was back to 36.5.
It was interesting that at a sensitisation
exercise with religious leaders a colleague was telling me how they
were angry at the message that God doesn't cause Ebola. They
actually felt that the people in quarantine were there as a result
of punishment from God.