Ebola Bundibugyo--Wednesday Night Numbers

We flew home at dusk on Scott’s motorcycle, the sky pinking westward and mist shrouded mountains silhouetted eastward. I saw a young girl dancing with abandon as we passed, and many people greeting, talking, walking, carrying their burdens and cooking their food, smoke rising from fires, just like any other day. Yes, Ebola is here, but for the vast majority of people it is only a shadowy fear, and their real life continues. I lose sight of that sometimes. A week ago we were stumbling through our tears and anticipating illness, wondering if we would leave this place alive, and if we did could we ever come back? Now a week later hope surfaces again. Even Melen is smiling more readily, her shorn head a final sign of her mourning coming to completion. This place breaks my heart and demands my all. But in God’s economy, that draws out love. I have thought often this week that the pain which was introduced into childbirth by the Fall had a redemptive consequence: that for which we labor with such cost becomes dear to our hearts. In the paradox of the Kingdom, a difficult child becomes the one that we love. And a place so steeped in death becomes a place that we deeply care for. Today’s numbers also carry seeds of hope:

• Cumulative cases remain at 115. There was a story of a contact with fever who had not been reeled in quite yet, so it will likely increase tomorrow, but for tonight we’re stable.
• Cumulative deaths: 32. One more in the last 24 hours. (CFR 27.8%)
• Inpatients: Bundibugyo 11with 5 discharges, 0 deaths, no admissions. Kikyo 10 with 1 discharge, 1 death, no admissions.
• LABS: still in process, but there have been 31 confirmed positive samples, all from Bundibugyo district. All samples from suspected cases in other districts have proven negative to date.
• Spread: As above, all Bundibugyo so far, but Bundibugyo contacts have been dispersing themselves. They want to get away from Kikyo, away from the disease, and have been turning up in neighboring districts. So it is very possible that true cases will arise elsewhere.
• Contacts: 265 of 368 followed up today. Jonah’s family has six more days to make it to 21 and all are well. I have five more.
• Issues: there was a call for projections in order to plan the budget. Will this go on for a month? Two? More? The epidemiologists are supposed to bring us their best guess tomorrow. I did talk to the CDC and MSF about the impact on resuming Christ School. The official policy from the outsiders is that contacts should be able to continue their normal activities until they have a fever. They are not supposed to be very infectious the first day of illness, which gives time for isolation. I do wonder if the teachers or students will be willing to return even if we give the medical all clear. Anyway this should be more clear by early January when we’ll know the trend of cases better. Half the time I feel like life will go back to normal; half the time I feel like the stress of evaluating every fever or whiff of illness in everyone we know as a potentially fatal disease will be unbelievably stressful.
• Medical Care in General: Scott and Scott worked at NHC today. Scott W saw all the HIV positive people and even saved a child’s life by putting in a more complicated IV line for a blood transfusion. Every day that we don’t have Ebola cases at Nyahuka makes us more comfortable with expanding services there once again. We wish we had better mortality data for the district in general. I spoke with a family today whose baby had died the day after the Ebola announcement. I’m sure there are many dying at home, of malaria and anemia and sepsis and everything else, afraid to come for care.

Luke should have landed by now, we’re waiting for his call. Pat plans to drive back in tomorrow. See the posts below for a Christmas meditation, and the reminder of links for donating to help Jonah’s family and other needs. Scott will take food tomorrow to two widows (Joshua Kule’s , the clinical officer, and Anansio Maate’s, the eye assistant, as well as two children whose mother is in the isolation unit, and visiting to check on Melen, one of the ways we as a smaller organization can fill some gaps).