Ebola
Redemption in Liberia, a
hospital's painful recovery from
epidemic
Pulse News Agency International By Reuters | 07:17 |
26.01.2016
Nurses shout to be heard as they rush through the dimly-
lit corridors, past peeling, faded posters proclaiming 'Ebola
is real!' and prompting people to 'Smile!' and 'Say Thanks!'
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The cries of young children ring around the hospital as
hundreds of patients, packed tightly together on wooden
benches and surrounded by boxes of syringes piled high,
wait to be seen.
Nurses shout to be heard as they rush through the dimly-lit
corridors, past peeling, faded posters proclaiming ' Ebola is
real!' and prompting people to 'Smile!' and 'Say Thanks!'
But the patients at Redemption Hospital in Liberia 's capital
Monrovia have had little to be happy about or thankful for in
the wake of the world's worst Ebola outbreak, which has
killed 11,300 people in Guinea , Liberia and Sierra Leone
since 2013.
The epidemic, which was declared over in Liberia for a third
time earlier this month, hit the West African nation the
hardest with 4,800 deaths, and ravaged its under-
resourced, fragile health system.
Redemption was at the centre of Liberia's outbreak, treating
the capital's first case of the deadly virus in June 2014,
which surged through the hospital, killing 12 doctors and
nurses and a string of patients, before forcing the facility to
shut down.
"When Ebola struck, we lacked protective equipment, running
water was sporadic and there was waste everywhere , said
Dominic Rennie, administrator of Monrovia's only free
general hospital.
"We had two or three patients in each bed as we wouldn't turn
people away... conditions were ripe for Ebola to spread."
The hospital reopened in January last year with a host of
reforms - from fewer beds and an Ebola isolation unit to
infection prevention measures for staff, such as
handwashing and always using and disposing properly of
protective gear.
While Redemption and other facilities were revamped as the
epidemic ebbed and came under control, the changes may
be difficult to sustain in the capital and across the country
as vigilance fades and emergency funds dry up, health
experts warn.
These improvements could even come at a cost to patients,
said Jude Senkungu, a doctor for the International Rescue
Committee (IRC).
"The time-consuming triage process (checking patients for
Ebola symptoms before admitting them to hospital) could prove
fatal for those arriving with critical injuries, " he said.
REFORMING REDEMPTION
The Ebola epidemic in Liberia overwhelmed the West
African nation's weakened health system, which was slowly
recovering after a 14-year civil war that ended in 2003.
Liberia had one of the world's lowest doctor-to-patient
ratios - 50 doctors for 4.3 million inhabitants, one for every
90,000 people - before Ebola hit, and spent just $44 per
citizen on health in 2013 - half of the average for sub-
Saharan Africa.
"Most health facilities were destroyed by the war - Liberia had
to start over from scratch ," said IRC country director Aitor
Sanchez-Lacomba , adding that reconstruction of
infrastructure and implementation of basic health services
only began in 2010.
In the emergency ward at Redemption, on the site of a
former market in a congested slum on Monrovia's
outskirts, doctors step over boxes, buckets and stools as
they rush between patients.
While the clutter acts as a reminder that the hospital is in
transition, it is a far cry from the chaos before and during
Ebola, Senkungu said.
"You could barely even move at times as the ward was full of
people slumped in chairs, or on the floor, attached to drips. "
Redemption stopped receiving inpatients in August 2014 as
Ebola swept through the hospital, and became a holding
centre for suspected cases while a treatment unit was set
up nearby.
Most of Redemption closed in October - it continued to
admit outpatients with other illnesses, but fear meant few
came - to be decontaminated and reformed before
reopening in January 2015.
Now, amid the bustle of traders and traffic inching past the
hospital entrance, patients are greeted with disinfectant,
hand-washing stations, temperature checks and triage -
where arrivals are assessed and suspected cases sent to a
new isolation unit.
Inside Redemption, the hospital now has 175 beds
compared to 215 before Ebola, stocks of gloves, masks and
gowns, constant running water, and a new incinerator to
dispose of waste.
"Long gone are the days of having more than one patient in a
bed or one baby in each crib ," said Rennie, with a faint smile.
TURNING PATIENTS AWAY
While Liberia struggled to contain the Ebola epidemic as the
number of infected hit 10,000, its response to fresh
outbreaks in July and November was vastly improved,
health experts say.
"The flare-ups were a huge test for the health system - but they
were contained to just a handful of cases each time", said
Anouk Boschma, International Medical Corps country
director.
Yet alarm was raised in November over the failure to send a
suspected Ebola patient directly to a treatment unit, and
fears linger over the vigilance of health workers.
"With new measures and protocols, changing old habits and
behaviour takes time... it is not helped by a lack of mentoring
or supervision in health facilities ," Boschma added.
A lack of trust from the public presents another challenge,
said Pierre Mendiharat from Médecins Sans Frontières
(MSF).
The number of Liberians visiting health facilities dipped
after the flare-ups, followed by a spike in the number of
child patients suffering toxic symptoms due to medication
provided by families and traditional healers, the MSF
program manager said.
"Fear and mistrust are a huge problem... you need suspected
Ebola patients to visit health facilities not only for their own
health - but to isolate them so they don't transmit to others ."
While many facilities are now stocked with protective
equipment and drugs, and staff trained in infection
prevention, a transition from emergency to long-term
funding means progress may be difficult to sustain, experts
say.
At Redemption, a world away from politics and aid issues,
Senkungu and his colleagues face a daily struggle to get by.
"We now have to turn patients away, it is upsetting for all of us,"
he said, walking past a bright blue mural featuring 12 doves
- one for each of the hospital's staff who died of Ebola.
"We care for the poorest people in Monrovia, who cannot afford
to go elsewhere. What will happen to them? "
