Mohammed Elshamy / Anadolu Agency / Getty Images

A song for the dying: Comforting Ebola patients in their final days

Despite national stigma, health care workers in Sierra Leone are proud of their work and urge others to join front lines

KENEMA, Sierra Leone — Birte Abild soaked a diaper in chlorine to wash a 5-year-old boy dying of Ebola. Then she held him close.

“I wrapped him in a big towel, and for a short while I held him,” said the Swedish nurse, who has been working in Sierra Leone for just over a month. “I sang a children’s song for him, and I knew he would die, but I had to go out. The next time I saw him, he was dead. He was alone.”

Abild has been a nurse for 34 years. She traveled to Kenema, in eastern Sierra Leone, to work with the International Federation for the Red Cross (IFRC), which opened the Kenema facility in mid-September. She knew how difficult treating Ebola patients would be, but that doesn’t make her job any easier.

“It’s hard to see people dying alone and that you can’t give more,” she said. 

The disease, which is transmitted through contact with infected people’s bodily fluids, makes it impossible for loved ones to stay close. People who seek treatment end up in isolation units. Frontline health care workers are the last people who dying patients are in contact with. 

Workers at the Kenema facility wear double-layered protective gear that includes coveralls and a hood. They can be in it no more than an hour because they get too hot and could endanger their health. With Sierra Leone’s dry season on the horizon, temperatures will only get hotter. 

While international staff members rotate through Sierra Leone’s clinics frequently, local health care workers are watching their country deteriorate in the face of the hemorrhagic fever.

As patients’ conditions worsen, they vomit, have diarrhea and sometimes bleed internally and externally, releasing contagious fluids. Amara Augustine, an infection prevention and control worker from Sierra Leone, has the grueling task of cleaning up bodily fluids.

He knew he was taking on a colossal risk but felt compelled to help anyway.

“People are dying every day, and I thought it fit I should save my people at this crucial moment,” he said. 

‘My family has abandoned me – and my friends – because I’m doing this job. I’m alone … I was sad at first to their reactions, but at the same time, patients here are being discharged. Some are getting better, so it’s worth it.’

Amara Augustine

infection prevention and control worker

Momoh, a patient at the Kenema facility, dances while staff members sing to cheer up patients.
Nina Devries

Augustine admits he was scared at first but trusts the personal protective equipment he is given. All workers wearing protective gear must be careful when taking it off to avoid coming into contact with any bodily fluids that could be on it. 

The facility divides patients between suspected, probable and confirmed Ebola cases. Augustine works in the area with those who are confirmed to have Ebola because, he said, they need the most help. 

Though he’s proud of his work, many people who are associated with Ebola — even health care workers — are stigmatized in Sierra Leone.

“My family has abandoned me — and my friends — because I’m doing this job. I’m alone,” Augustine said. “But I have decided to help my country, my people. I feel I am doing the right job. I was sad at first to their reactions, but at the same time, patients here are being discharged. Some are getting better, so it’s worth it.”

One survivor at the facility danced when she was released. Momoh, another patient, said he contracted the virus after driving Ebola patients to the hospital by ambulance. He, too, danced, as the staff sang to cheer up patients.

The Kenema area was one of the hardest hit in Sierra Leone when the outbreak appeared there in May. The facility has been operating for just over a month in a tented area several miles outside the city.

Every day the kitchen goes through 100 coconuts, more than 6,000 gallons of water, 130 pounds of chlorine and many pounds of rice. 

It’s a massive operation, and it is functioning at half capacity. There are 60 beds, but staffers can care for only about 30 patients at a time. 

At one point they were getting 70 cases a week, said Amanda McClelland, senior emergency health officer for the IFRC. Kenema currently has 481 Ebola cases, according to figures from the Ministry of Health and Sanitation. While the number of cases is starting to decrease, the local facility is still understaffed. 

A number of new workers have arrived in recent days for training, and McClelland hopes the facility will be in full operation by next week.

She added that the international response was far too long coming.

“We were there with Médecins Sans Frontières [Doctors Without Borders] in the beginning, trying to say it’s not enough,” she said. “We don’t need money or advisers. We don’t need more people to build Ebola treatment centers. We need more people to run them.”

For Canadian Garth Tohms, who does all the maintenance at the site, the experience was not as scary as he thought it would be.

“I was expecting people lying in streets, dying bodies everywhere. That’s the way some of the media was portraying it, and it wasn’t like that at all,” he said.

He said fear is stopping other qualified workers from coming, and he’s been encouraging other IFRC staffers that they will be protected when dealing with patients. 

Veronica Bull has been a nurse for three years and arrived from the country’s capital, Freetown, to work in Kenema. She admits she was scared at first to work with Ebola patients but has quickly grown comfortable and enjoys helping her country. 

“I urge other nurses to come, she said. “You cannot sit with your arms folded when you’re a nurse and while people are dying from sickness.”

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