Monday, December 1, 2014

Kerry Town - A Sierra Leone Slice Of Life

(BBC) KERRY TOWN Sierra Leone -- On a sweltering afternoon, an ambulance crawled slowly along the fresh gravel path behind Kerry Town - the centrepiece of Britain's contribution to the fight against Ebola here in Sierra Leone.
The vehicle parked at the back gate and a team of white-suited medics carried out the first of four confirmed Ebola patients onboard.
One - a 40-year-old man - would die minutes later.
"You never know what you'll find when you open those doors," said Irish doctor Carrie Garavan, adjusting the protective headgear on a Sierra Leonean medic.
Only 14 of Kerry Town's 80 beds are currently occupied
It will take time for staff at Kerry Town to adjust to what experts there say is a very dangerous environment.
The ambulance's arrival coincided with a shift change at Kerry Town - a huge logistical operation.
It takes 20 minutes for each health worker to put on the elaborate protective clothing required to enter the Ebola red-zone and its 80 beds.
"It takes time. You can't rush. You can't be complacent. The safety of our staff is of paramount importance," said Dr Garavan, who is overseeing a large team of British, Cuban, Sierra Leonean and other international staff at the green-field site about one hour's drive outside the capital, Freetown.
But almost four weeks after Kerry Town opened, there is growing concern - expressed vocally by some Sierra Leoneans, and more privately by foreign humanitarian experts - that the facility is seriously behind schedule and lacking a sense of urgency.
So far, a total of 44 patients have been admitted. Fourteen of Kerry Town's 80 beds are currently occupied.
Kerry Town is being run by Save the Children - a British charitable organisation that acknowledges it has stepped into profoundly unfamiliar territory.
We said at the outset we didn't have the right level of experience but we'd acquire it and we've hired an awful lot of really competent people and put it together," said Michael Von Bertele, Save the Children International's Humanitarian Director.
"I make no excuses. Many of the staff we've got are very inexperienced and we've got to move very slowly.
"[The French medical charity] MSF for example - they've got years and years of experience... and they make it look easy and I sincerely hope that in six weeks time we'll make it look easy. Our plan was always to scale up slowly," he said.
In the meantime, staff at Kerry Town say the criticism is taking a toll.
"A lot of the team are upset. I think it's terribly unfair and unfounded and I do hope people stop," said Dr Garavan.
But there were smiles and songs a few minutes later, when staff gathered to say goodbye to 21-year-old student Kadiatu Sesay, who was being discharged after beating Ebola. She is only the third patient to be sent home so far.
"I feel so happy. This is the happiest day of my life," said Ms Sesay, who admitted she'd been sceptical about the virus before she caught it, and now plans to convince her friends and neighbours to take every precaution.
If you're keeping score at home, that equates to a 90% fatality rate for Ebola in the field.
(3 survivors out of 30 prior patients, and 14 currently admitted = 44 patients, this facility's total).
Not 50%, not 72%. That's actual real world data there - so far.

And it explains why they're slowly taking on more of the burden, and why they haven't opened the other 66 beds, yet.

Unfortunately, someone infected with Ebola can't wait for centers like this to get their poop in a group, and so they try to find a facility with an open bed (spreading Ebola everywhere as they go, as like the mentioned example who died "within minutes", those patients are not newly diagnosed, they're in the end stages of the disease, shedding virus literally by the bucket-load).

And it's exactly the same in Guinea and Liberia, it's just the folks there have realized there's no care to be had at the ETUs, and/or no beds to find, so they're not looking, simply dying in place, unnoticed, uncounted, but still horribly infectious.

That's the real answer to how Liberia "finds" 1000 more dead people amidst a virus that continues to spread throughout the country. When they feel like noting it.

And for those who'd decry the lack of care there, bear in mind Sierra Leone has had 68,000% more actual Ebola cases than the US has in the last year, and they currently have 5000% more actual dedicated Ebola care beds than the entire US has available. (Those are the current numbers based on reports, not typos.)

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