Battling Ebola up close

An Australian nurse has flown to Kenema, Sierra Leone, to lend a hand in the Ebola-affected area. RN Sue Ellen Kovack put up her hand to go as soon as the call went out.

“The needs are massive and are increasing by the day,” said Kovack, who left for Africa in early September. “Someone has to go; we need people to put up their hands and volunteer. I guess I am a humanitarian at heart and just want to do what I can. But we have limits and most missions for staff are of one month in duration due to the demands.”

Kovack is working with the International Federation of Red Cross and Red Crescent Societies (IFRC) as a ward nurse in the new IFRC Ebola Treatment Centre, which has about 70 beds. The team involved in the opening of the hospital – including Kovack – worked from early morning until late at night to get the facility up and running. A mixture of local nurses and international staff rotate on three shifts, plus call work, to run the centre.

Kovack and the team are giving supportive care, fluid treatment, clinical management and plenty of comfort measures, all according to World Health Organization standards.

“The work is seven days a week – long days in the heat and humidity are distressing,” Kovack said, but added the environment is hopeful.

Still, she said the working conditions are difficult: “Very limited resources, minimal staff and needs that outstrip the resources.”

There is a lot of difficulty resourcing protective equipment but more is coming. “With border closures and airline suspensions, you can imagine how difficult the logistics can be, and this is only one treatment centre,” Kovack explained. “Multiply that by the countries and treatment centres involved.”

Professor Tania Sorrell, deputy dean clinical at the University of Sydney medical school, said the situation in Western Africa is clearly not controlled, as the number of cases is escalating in some areas. “The main issues are to do with fear, uncertainty and collapse of health systems in the affected countries and that’s having secondary of flow-on effects, with closing borders, for example, interrupting the flow of food supplies.”

Sorrell said this was affecting impoverished populations’ nutrition as well as health systems and the ability to handle patients with other diseases. This makes the work of international healthcare workers in the region increasingly important.

“Developed countries and countries within Africa are increasingly realising that without outside assistance they won’t be able to contain this epidemic,” she said.

Although acknowledging that money developed countries are offering is helpful, Sorrell said funding wasn’t what was most needed at the moment, rather hands on the ground to help look after patients, ensure supplies for infection control are brought in and patients are rehydrated.

“We should honour the workers who are prepared to go and help in this crisis,” Sorrell said. “It’s the commitment of the nurses and the doctors and the orderlies and all of the support staff that’s absolutely critical in this epidemic.”

Another problem emerging in Western Africa is the fear and concern that are keeping some patients from accessing healthcare, she said, making it difficult to apply infection control procedures.

There is hope. Kovack said messages going out to the general public about Ebola are having a good effect: “People seem to be respecting the rules. There are on-air songs, messages and plenty of signage and information getting to the people, so hopefully the fear of coming to a treatment centre is decreasing.”

Kovack previously worked with the Red Cross in South Sudan and Freetown, Sierra Leone, but was mainly in the operating suite in conflict situations.

“This mission is a completely new experience for me, as it is a humanitarian mission disaster response,” she says.