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Amidst the gloom there are moments of light: Sierra Leone

Before leaving Monrovia I get an early morning coffee with the Australian doctor leading the UNICEF response in Liberia. He’s one of several Australians playing a key role in the emergency effort. He’s worried that complacency may set in and tells me no one can predict where things will be in six months. There’s even a possibility that we may never eliminate it, that Ebola may become endemic.

We head to the airport and board a UN flight for Freetown. UN agencies are sometimes criticised for being cumbersome or ineffective. But given that a large number of commercial airlines are no longer flying to West Africa, the work of agencies in West Africa would not be possible without the service provided by the United Nations Humanitarian Air Service (UNHAS).

In Freetown we head straight to an NGO led by an old Ballarat boy. He’d seen a news story about my proposed visit (thanks Insiders) and invited me to see what his NGO was doing in Sierra Leone. There are no protective suits or spray units here; it’s old fashioned community development and it’s done well. Prior to Ebola his organisation focussed on issues like teen pregnancy, child marriage and gender violence. When Ebola hit they scaled up rapidly and were funded to roll out a program that informed the community about Ebola transmission and to work with them to create strategies to reduce transmission.

It’s needed because there is a lot of misinformation about the disease. Early on people believed health workers were deliberately injecting patients with the virus. In other parts there was a perception that it was an organ harvesting racquet. It was only when health workers themselves became gravely ill and died that things started to change. One of the staff members here has lost part of his family but he remains determined to fight it. He tells me he dreams of coming to Australia so I give him my card and tell him I’ll do what I can to help. News comes in that another staff member has just lost a parent and he worries that he’ll lose more family members soon because they washed the dead body, as is the local custom.

Sierra Leone - Typhoid relief!
Sierra Leone gumboots

There are lots of Australians doing amazing work here. In the evening a group of Australians gather at a small bar along the beach to tell me about their work. They work at the main hospital as video-journalists and for NGOs providing education programs. Most of them were here well before the outbreak and lament its timing. “Just when we were making progress in health and education and the economy was starting to look up, this thing hits.” It’s nice to know that so many Australians are making a positive difference around the world.

Next stop is a visit to a Médecins Sans Frontières training centre and treatment facility. I meet some of the Aspen clinical team, the organisation leading Australia’s response here. They have people who have worked with MSF and have Ebola outbreak experience. I’m impressed with the quality of people we have here on the front line.

The MSF treatment centre is confronting. It’s a large maze like structure made of tents, long fenced walkways and surrounded by perimeter fencing. It’s all designed around patient flow and a two metre barrier separates low-risk and high-risk zones. Infection control procedures here are critical. It looks a lot like a field hospital but the cyclone fencing gives it the air of a prison.

We arrive just in time to see a group of Ebola survivors leave. The ‘good news’ ambulance is waiting to take them home and it’s smiles all round. But for some of them reintegrating will be tough. Despite being non-infectious they will be shunned by their communities. There’s a lot of work to do to.

Inside the centre it’s the hygienists that hold the show together. They are the real heroes, working in the high-risk zone. They are responsible for cleaning down vomit and excreta, disposing of all infectious waste and decontaminating and removing dead bodies. They do it wearing layers of protective equipment inside stuffy tents in the subtropical heat. If anyone is at risk it’s these people.

That’s what this place is like. Amidst the gloom there are moments of light.

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