How was your first day?

For once my preconceptions were actually pretty close to the mark. There was evidence in Freetown that Ebola is around, with symptom and temperature checks on arrival at the airport and public health billboards around the town, but overwhelmingly you get the impression of life going on as normal. It shares characteristics with other African cities I have visited in recent years such as Addis Ababa and Blantyre. There is hustle and bustle on the streets; women with strong arms carry their wares in big containers on their heads. Feral dogs duck for cover as cars weave around potholes and pigs feast in the litter strewn waterways. Big white 4X4’s with NGO logos jostle for space with local taxis as the odd blacked out Mercedes speeds by. Young men wear shirts from European football teams, usually with names like Ronaldo and Drogba across their shoulders. And boy is it hot! Something like 25C at 3:30am when I landed with high humidity and no respite.

I had seen pictures of the hospital so had some idea of what to expect. Contrary to my fears there is still a fair bit going on besides the Ebola work. Elective surgery is on hold and there never was a Maternity unit there but the standard medical wards are open for business. All patients are screened for Ebola symptoms at the gate and those deemed not to be suspects proceed to the Emergency Department and then if necessary to the wards. I’m told that the wards are quieter than normal but they certainly not as desolate as I had feared.

Those who fit the definition of suspected Ebola move to the isolation ward for testing and treatment, at least the lucky ones do. It is not safe admit more patients than there are beds so if the unit is full the patients have to wait. They may even have to go home if no alternative bed can be found. That's got to be heart-breaking news to deliver however hardened you becomes.