Via NPR's Goats and Soda blog, a powerful essay of Karin Huster of Partners in Health: A Nurse's Desperate Plea: Show Me The Ebola Money. After describing how she and her colleagues had to help a delirious 10-year-old, Huster goes on:
We're done. Out of there. It's been about an hour and a half, well past the time we can spend in the Hot Zone without overheating in our PPEs. But we can't leave. The other patient in the room is barely alive, but hanging on. The woman needs more IV fluids, too. Luckily, she already has an IV, so all we have to do is find IV fluids and get things going. Done. My partner and I look at each other approvingly — job well done. As well done as we ever could. Out. Now.
Our final job on our way out is to transfer a patient from the suspect to the confirmed ward. We traverse the courtyard and explain to the man that he has tested positive for Ebola and we need to take him to a different building. Frail but strong in spirit, he picks up the bucket he uses for bodily fluids and walks over with us to the confirmed ward. I have hopes for him. After all, he has been there for several days already and is stable. I remind him to drink a lot. "Pee the Ebola out," I tell him. I am not sure he's convinced.
Such is our daily fight against Ebola in a country that so far has seen 8,356 confirmed cases of Ebola – and 2,085 deaths.
It is also a daily battle to do our work in a place with a nonexistent health infrastructure and where the international response system has been woefully inadequate and inefficient.
Millions and millions of dollars of aid are reportedly waiting to be spent – yet little of it seems to make its way to where people need it most. Droves of WHO and CDC consultants have made their way to Ebola treatment units and community care centers, observing, dispensing wise recommendations, taking plenty of notes, writing reports.
And that is all well and good, but the bottom line for us and our patients is that the basics are still not met. We're fighting to get supplies. We're told they're coming. They never arrive.
Patients who come through the triage area after a two-hour ambulance ride still wait, critically ill, under the blasting sun without a shaded area to rest under. Our enclosed compound has gaping holes in the fence through which confused Ebola patients sometimes escape to the streets. Our patients lack bed sheets and soap. We sometimes run out of chlorine, an essential cleaning agent that kills the Ebola virus and allows us to work safely. There are no functioning toilets for our patients. We are still missing the tools to place an IV safely. We don't have IV poles to hang our fluids. Our gloves are too short. Staff sometimes (and understandably) strike for lack of pay. The list goes on.
The decision by Partners In Health (PIH) to become involved in the fight against Ebola by partnering with the Sierra Leonean Ministry of Health's health care facilities is a noble one – and it is the right choice. It confirms a long-term commitment to improving and strengthening the country's health infrastructure and not to just "fix the Ebola problem and get out."
But it means PIH has to collaborate within an existing structure where changes are often painfully slow to come. And slow is not an answer when faced with Ebola.
Sierra Leone won't win this fight until the essentials are in place.
Yes to vaccines, ICU care, and tablets to electronically record patient care - as some ETUs have. But this is luxury, and it must come only after the basics are well in place. Where is all that money the world has given? It could have made a difference for so many patients in our Ebola treatment unit. The ten-year-old girl died that night, alone. As did her entire family.