Ebola in Uganda: “Our game-changing treatment centres will save more lives”

I worked continuously for Médecins Sans Frontières / Doctors Without Borders (MSF) between 2003 and 2017. Infectious diseases are my speciality, so I’ve worked in different outbreaks, including cholera and Ebola, as well as in malnutrition crises.

In my long history with MSF, I think the experience that touched me the most was the 2014-16 Ebola outbreak in West Africa. 

I was sent as medical coordinator to open a project in Monrovia, the capital of Liberia, at the peak of the outbreak. It was really a very traumatic experience, and very hard to provide a good level of care as we were submerged by patients. 

We saw more than 20,000 patients in one year when previously there were only 2,000 in each of the 20 previous years. However, it was a privilege and scientifically very stimulating to work in this outbreak and try to find life-saving solutions that were practical. 

It reminded me of older times when I was treating HIV/AIDS. 

I was a young doctor then, specialising in HIV. We were seeing all these young people dying, then sitting up all night talking about what we could do to improve the care. Again, it was traumatic because we had 50 deaths per day, something like a war. We worked hard to try and find clinical solutions. 

Game-changers

MSF has valuable expertise and experience in responding to Ebola outbreaks. However, we have worked to improve how our treatment centres work. This is so that medical staff can move about more easily and work more efficiently.

The problem is the thick, high-level Personal Protective Equipment (PPE) usually worn when dealing with Ebola. We need to have clear visibility of patients and be there 24/7. But, with this PPE, you cannot do it.

On one hand, this virus is dangerous and you need to be careful, but the PPE reduces the humanity that we can show to a patient. It also limits our medical interventions. For example, if you have to find a vein in a patient’s arm, it’s not easy in the thick gloves.

Then there’s the sweat. The heat inside this PPE means there are limits on how long you can wear it. I’m also getting older and need to wear glasses, but you can’t inside the suit.

So, we have worked to get new and improved PPE that is lighter and allows you to be with patients for much longer.

However, the real game-changer is the new structure of the treatment centres themselves. They now have see-through sections, meaning patients can be monitored every second of the day from the outside. It’s a great concept. 

Medical staff will be able to see a person’s vital signs and keep up with the virus. We know how the disease progresses. So, when we see that we need to act, we can act fast.

If I see that a patient’s oxygen levels are going down, we can put on the new PPE and enter the room to give oxygen. If their heart rate is changing, if they need fluids. Whatever it is, we can intervene in a targeted and timely way.