| Dec 03, 2014
This is a special blog post from Dr. Paul Bunge, a recent MTI volunteer sharing his experiences from his time in Liberia to help stem the Ebola outbreak.
It was a disappointing sight: the paddle lock on the clinic door. This community's only clinic now closed, meaning people would have to wait longer and travel farther for care, limiting their choices and perhaps making the difference as to whether or not they or their children would be treated at all.
Our team had been to this clinic before. Part of the Medical Teams International (MTI) project to support the healthcare facilities in the Monrovia area, four teams regularly visit the 240 clinics along with personnel from the Liberia Ministry of Health. These integrated teams provide training, supervision, and supplemental supplies to these clinics focusing on infection prevention and control specifically in the time of the Ebola epidemic. A well-designed program covering many areas including protective gear, effective triage, waste management, and needle safety has helped these clinics immensely. Most of the facilities had closed completely or in part over the course of the outbreak, but were now returning to function with the help of our teams.
Today was sad. The nurses on our team wondered why this clinic was closed. They remembered the staff there was delivering babies (many “clinics” in Monrovia also have small maternity wards). They had very limited space and limited supplies. They counseled the midwives that they would need to be much more careful, and to wear more protective gear when delivering babies in this time of crisis.
I was a volunteer doctor on the teams. Supplementing the education they were doing with background knowledge, I was able to answer questions and give reasons for some of the strategies we were taking, as well as give input as to priorities and focus for the teams and the clinics. The project is run by a Liberian staff which is top notch—the nurses on the teams with years of experience generally, and all with harrowing stories of friends and coworkers with Ebola. The perfect group to teach and supervise in this critical time.
Just next door to the clinic, three men were lounging under a couple of palm trees. I asked them if they knew why the doors were locked. A man in a hammock explained the story. His wife had been the primary midwife at the clinic. He remembered the team coming one month ago with their advice and warnings. Sure enough, a pregnant woman in distress had come to the clinic one night. They delivered a dead baby, a common presentation of Ebola. Four of the clinic staff got sick and had to go the Ebola Treatment Unit (ETU), including his wife. As he told the story you could see the tears gathering. One of the staff had died, but “thank God we hear that the rest are improving some,” he said. The three men sitting under the tree were waiting out the 21-day quarantine expected of exposed workers and family members. They were feeling physically fine, only very bored. With neighbors bringing them food, they were spending their days chatting and playing Parcheesi. We encouraged them and exchanged phone numbers for the future when the clinic might be able to come back on line.
The MTI teams have since been able to bring more protective gear to the clinics, as resources have become more available. The Ministry of Health and the W.H.O. continue to give updates regularly which are implemented in the teams and the information and materials passed to the clinics. It is work that must be done carefully, diligently, and with much flexibility and creativity. Part of the much larger effort in the fight against Ebola. It was an honor to see these hard-working people in action. Despite this sad day, several clinics that had been closed were able to safely reopen their doors due to the work of MTI. Still going out to clinics every day, and now expanding the program into other counties, their work is saving lives on the ground in Liberia, and helping stop the spread of Ebola to the rest of the world.
For more information about Dr. Bunge's volunteer experiences or for media inquiries, please contact firstname.lastname@example.org.
Learn more about MTI's Ebola response in Liberia.