Ebola Bundibugyo: Mid Wednesday

Since every day seems like a week, multiple posts seem appropriate.  Joshua Kule, the senior clinical officer, and the head nurse of the hospital (?Peluce) also died this morning, so with Jonah that brings 3 of 6 health care workers admitted dying within 12 hours of each other.  So it is not surprising that both Scotts found the hospitals rather empty of patients and short on staff.  Many are afraid, but a few brave and hard working souls persist.  Scott said it was very disturbing and poignant to be given the key to Dr. Sessanga’s office and told to use it . . . And to find the top paper on his administrative stack was a request by Joshua Kule for his month of annual leave to begin today.  I know that Dr. Jonah was also planning an annual leave beginning this week.  . . . A Uganda Police Surgeon assisted Scott in seeing all the non-Ebola hospital inpatients, and then he worked with the administrator to designate a cemetery area. It seems the district feels it would be a fitting honor to health care workers who die to offer burial on site, and to create some sort of memorial for them.  We’re OK with that as long as they aren’t coerced out of fear of transporting the bodies home.  Meanwhile our airstrip might need an air traffic controller.  I met a mid-morning flight bringing in the director general of the Ministry of Health as well as an assortment of WHO officials and someone with MSF too I think, it gets confusing.  We don’t shake hands here anymore, so that puts an odd crimp in introductions.  I hear another flight landing now, and I know there’s a third one this afternoon, with CDC officials and I hope an MSF doctor.  There are actually a significant number of doctors here now . . . But only three (as far as I can tell) are actually seeing patients (Scott, Dr. Yoti, and the Police Surgeon).  The others are one step removed, tracing contacts and managing data and handling logistics and reports.  By the end of the day we hope that will have changed as a new medical superintendent is promised, and the MSF team expands.  

Our mission sent a prayer guide based on Psalm 91 that was very appropriate and encouraging, pleading with God to save people from this disease, asking Him to use it for good in some way that we can not yet see, confessing our bewilderment over the death of Jonah.  In the church meeting here this morning people took turns standing up and giving testimonies, comments, etc., it is very African for everyone to get a chance to speak.  I noticed that some chose John 9 as a text, the story where the Jesus rebuts the idea that sickness is a punishment for someone’s specific sin.  I’m glad to see people wrestling with the “why”, looking for meaning in a bleak and frightening situation.  Even in the task force the idea of blame sort of swirls below the surface, if that patient died then maybe it was someone’s fault . . . But the truth is that Ebola is a powerful virulent organism, and there is not much one can do to stop a patient from dying once infected.  

Concern is mounting all around us too.  Two districts within Uganda announced that they would close off access to anyone from Bundibugyo, and the DRC announced closure of the Congo border (though I doubt their ability to enforce that).  If the CDC lab can become operational today and the samples from scattered patients (Fort Portal, Mbarara) be confirmed negative that might help the general sense of this thing spiraling out of control.

More from the front lines when Scott gets back, he’s been gone all day again.  Since so many are reading and praying, please pray for SLEEP.  We are in a situation where the difference between life and death might be the overall resilience of our bodies to resist or pull through this infection; yet we’re also in a situation where the work is tremendous and the stress keeps us on edge, making it hard to get healthy rest.  So when one of us feels particularly tired, we have that sickening knot of wondering deep in the gut, is this because we laid awake for hours last night, or is this the beginning of a fever?  Thankfully so far it is the former.  Pray that for the MSF nurse Rosa too, who is the primary Ebola care-giver.  And Dr. Yoti.  Thanks.