Dr. George Risi had to pass a dozen armed checkpoints to leave Sierra Leone – four of which ordered him out of the car so a guard could take his temperature.
The Missoula infectious disease specialist is still checking his thermometer twice daily since his return from 20 days of volunteer work in an Ebola virus ward. He and fellow Missoulian intensive care nursing director Kate Hurley cared for up to 95 patients, from babies to grandparents, suffering from the often-fatal disease.
“We both feel fine,” Risi said Thursday at his office in the St. Patrick Hospital Providence Center. “We had no breaks in technique.”
The same can’t be said for large parts of Sierra Leone, which started a three-day national lockdown Friday in an effort to stop the spread of the disease. More than 5,300 people have been infected in Sierra Leone, Liberia, Nigeria and Senegal, and an estimated 2,600 of those have died, according to the World Health Organization.
Ebola infections start like many other common diseases in the region, with fever and discomfort, but quickly progress to a catastrophic collapse of bodily functions. Once victims start showing symptoms, they can infect others who come in contact with their sweat, blood or bodily fluids. Even corpses can be infectious.
But those who reach medical help in time often survive. While untreated Ebola tends to be 70 percent fatal, Risi said about half of the patients in the Kenema clinic where he worked made it through alive. Those who do usually have antibody resistance for up to 10 years.
And communities that develop strong medical responses can also beat back the disease. Uganda had an Ebola outbreak in 2000 that killed more than 200 people in a few months – considered the worst incident on record at the time. It has had three more flare-ups since 2011, but only 18 people contracted the disease and all but eight survived.
“The health care system in Sierra Leone is just overwhelmed,” Risi said. “It’s great that international agencies are stepping up in a big way. Cuba is sending 165 health care workers next week. But there’s so much more you wish you could do.”
As it was, Risi and Hurley ferried over $1,500 worth of protective garments and other clinic supplies donated by Providence Health International. Their personal luggage got lost, however, forcing them to wash their two sets of personal hospital scrubs every night for 10 days.
Kenema General Hospital had the busiest Ebola center in Sierra Leone. Because of the shortage of trained personnel and the infectious nature of the disease, many of the patients end up caring for one another. Risi told of a woman named Margaret McCauley, who was interred with her husband Eddie.
“They had six children at home, who they had to leave when they got ill,” Risi said. “Eddie was much more ill than his wife, and Margaret was in the bed next to him, nursing him as well as she could until he unfortunately died. After a day of grieving, and with much encouragement by Kate and the others on the team, Margaret took on the care of several of the orphans (in the ward). She carried them around in her arms, fed them, sang to them, put them to bed. Margaret went on to survive, and many of the kids she helped would not have survived without her.”
McCauley returned to her own children, but all her possessions had to be burned.
Risi said fear of Ebola is almost harder on a community than the disease itself. Rumors about its cause or the motives of foreign aid workers have prompted many people to resist treatment or even attack and loot aid centers.
“Any competent hospital can handle Ebola,” Risi said. “We know how to protect ourselves – you just need to be diligent in the use of the guidelines.”
And even places like the United States have regular experience with scary diseases, including a case of Ebola-related Marburg virus in Colorado and numerous hantavirus cases in Montana and elsewhere in the Rocky Mountains. Antibiotic-resistant MRSA bacteria are a regular threat in school locker rooms, while SARS influenza has occasionally shown up in airline passengers coming from Asian countries.
“We’ve had some near-misses,” Risi said. “But we’ve also handled these things with no problems.”
The Missoula volunteers have no current plans to return to Africa, although they may assist in some training programs for other medical personnel heading that way. The international aid groups Doctors Without Borders and Save the Children have both asked governments to forgo sending money, but instead help volunteers get to the stricken regions.