Heart-breaking

It might sound strange but so far I haven’t found the Ebola outbreak hugely stressful. It might be the constant work without time to reflect, it might be that it’s all building up inside, or perhaps my previous experiences of young people dying during the HIV/TB epidemic in South Africa have partly immunised me against the effects.

Despite this there are times when even the most hard hearted of people would be moved. I spend a lot of time outside the hospital gates talking to relatives who are often anxious, frustrated and desperate for news. I make an effort to give them as much feedback as possible and pass messages when I can. A pretty young woman  in a bright yellow patterned dress gave me a phone to pass on to her father inside, I knew his Ebola test had come back positive and he was preparing for transfer but I took the phone. As I stepped into the unit I heard that he had literally just died that minute. With a deep breath I went back out to the woman. She probably didn’t notice that the phone was still in my hand and came bounding up to me with a broad smile, I’m sure she was expecting some positive message back from her father. I didn’t smile back. Medical school training for breaking bad news is long an exhaustive but sometimes that just isn’t practical. Instead this poor woman had to hear the news on a crowded street outside a hospital gate. She collapsed in a display of grief that is typical in Africa and I left her with her family and drifted away into the crowd.

Later that day I was asked to see a 9 year old girl and a baby strapped to a woman’s back. A kindly local man in his 60’s with good English helped with translation; he said that as so often happens the children had been rejected by their compound after their parents had died of Ebola. Thankfully a young man had agreed to take them in but he was worried that they might be infected. Both were healthy but there was a suggestion that the girl had a fever. If truly a suspect this poor girl who had just lost her parents would have to spend at least 2 days in the isolation unit waiting for a blood result. The isolation unit must be a terrifying place for a child with faceless adults in big white suits walking around and adult patients dying in adjacent beds and this particular girl was even more vulnerable than most. She cried as we took her temperature, petrified that we might take her inside. Eventually we decided she was not a suspect and the man agreed to look after her and her baby bother. There must be hundreds if not thousands of stories like this in west Africa at the moment. This one at least had a reasonable outcome but many more surely do not.