By Pierre Trbovic – anthropologist from Belgium working with Doctors Without Borders –
Soon after arriving in Monrovia, I realized that my colleagues were overwhelmed by the scale of the Ebola outbreak. Our treatment center, the biggest MSF has ever run, was full, and Stefan, our field coordinator, was standing at the gate turning people away. On an MSF mission, you have to be flexible. This wasn’t a job that we had planned for anyone to do, but somebody had to do it, and so I put myself forward.
For the first three days that I stood at the gate, it rained hard. People were drenched, but they carried on waiting because they had nowhere else to go.
The first person I had to turn away was a father who had brought his sick daughter in the trunk of his car. He was an educated man, and he pleaded with me to take his teenage daughter, saying that while he knew we couldn’t save her life, at least we could save the rest of his family from her. At that point I had to go behind one of the tents to cry. I wasn’t ashamed of my tears, but I knew I had to stay strong for my colleagues; if we all started crying, we’d really be in trouble.
Other families just pulled up in cars, let the sick person out and then drove off, abandoning them. One mother tried to leave her baby on a chair, hoping that if she did, we would have no choice but to care for the child.
I had to turn away one couple who arrived with their young daughter. Two hours later the girl died in front of our gate, where she remained until the body removal team took her away. We regularly had ambulances turning up with suspected Ebola patients from other health facilities, but there was nothing we could do. We couldn’t send them anywhere else. Everywhere was, and still is, full.
Once I entered the high-risk zone, I understood why we couldn’t admit any more patients. Everyone was completely overwhelmed. There are processes and procedures in an Ebola treatment center to keep everyone safe, and if people don’t have time to follow them, they can start making mistakes.
It can take 15 minutes to dress fully in the personal protective equipment and, once inside, you can only stay for an hour before you are exhausted and covered in sweat. You can’t overstay or it starts getting dangerous. The patients are also really unwell, and it is a lot of work to keep the tents clean of human excrement, blood, and vomit, and to remove the dead bodies.