Orsola Sironi never thought of being part of an Ebola treatment team. “I was telling my friends that I would never accept a position in an Ebola project,” she admits. Despite her initial doubts, she is now part of the staff dealing with the outbreak of the feared virus in Equateur province, in northern Democratic Republic of Congo (DRC).
Orsola took part in the initial exploration in this remote part of DRC three months ago, and currently she is the medical coordinator of the Ebola treatment centre in Lokolia, one of the two facilities Médecins Sans Frontières /Doctors without Borders (MSF) has set up in the area.
Unrelated to the one in West Africa, the current outbreak in DRC’s Equateur province started last August. Since then, MSF has deployed almost 70 staff members to help the local authorities cope with the epidemic.
As of 19th October, 62 people have been admitted to the facilities in Lokolia and Boende, and infection has been confirmed in 25 cases -13 people have recovered, while 12 have died.
How did this intervention start?
I started working in this Ebola intervention when it still was seen as a fever of undetermined nature. I was part of the investigation team trying to understand what kind of disease we were dealing with. It turned out to be Ebola.
The funny thing is that before the exploratory mission, in the light of what was going on in West Africa, I was telling my friends that I would never accept a position in an Ebola project.
My initial fears were regarding the information communicated by the media about the low level of acceptance by the population and the dehumanisation of staff who have to work dressed like astronauts.
What are the most challenging aspects of this outbreak?
For me, one of the most difficult aspects of this intervention is that for every patient we admit into our treatment centre there are many contacts within the community. The admission and symptomatic treatment of cases is only one part of a broader response strategy. Surveillance and sensitisation are the other fundamental components to contain the outbreak.
The logistics are also very challenging. We are working in a very isolated area and I am actually amazed by the means put in place by our logistics teams: we were able to set up a full treatment centre in the middle of the equatorial forest in a very short time.
Sometimes we forget how the equatorial environment implies a lack of roads, and of means of communication, with the consequent difficulty in bringing in material and accessing the population.
However, we should not forget the other diseases and crises affecting this huge country. We have to maintain our capacity to react to other urgent needs of the population.
Despite the very high mortality and high degree of transmission, Ebola kills fewer people than measles, malnutrition or malaria and we need to be able to treat these other diseases as well.
How do you deal with it on a personal level?
Ebola can be a quite emotional context. You are in contact with patients that have lost their entire family. It happens that you see a mother who dies and a few days later you witness her little baby succumbing as well.
At the same time, it is really gratifying to see patients defeat the virus and recover. The majority of them express their gratitude by sensitising their communities and working as caretakers for the patients of the treatment centre.
Our first recovered patient, for example, is currently taking care of the babies of a recently admitted case. This helps us not to get discouraged by all the difficulties we find every day in our work.
Data for Ebola cases at MSF clinics in DRC are correct for 19th October 2014
