I hit the wall, perhaps because now my kids are out of the danger zone (I hope), perhaps because we’re finding it hard to sleep, perhaps because we now have lots more information on Jonah who is holding his own but definitely continuing to have symptoms, perhaps because the adrenaline has limits. I’m very weary, and back to borderline weepy.
Jonah: still with fever, not terribly high, still with diarrhea, no bleeding, up and talking and walking and drinking in Mulago Isolation unit. Day 5 of illness.
Sessanga: Refused to unlock door for Scott to enter his house this morning, but answered the phone. Diarrha and vomiting better, but complaining of headache.
BGO Isolation ward: one death this morning 5 am, another contact of Jeremiah Muhindo, who seems to have been very infectious. 2 new admissions, so total caseload 22. Scott says they are finally getting up the mesh fence and controlling the access a bit better.
Kikyo: no news yet today.
The rest of Uganda: Panic mode. Lots of people are coming to have their symptoms evaluated at other hospitals, worried. We have word from the CDC that their lab in Entebbe should be functional on Wednesday, so that will help SO MUCH with the sense of impending spin-out-of-control spread, if the suspect cases from Fort Portal and Mbarara are not confirmed (though I don’t even want to think what it will be like if they are).
The REST of the patients in BGO: Scott got called for another obstetric emergency at 7:30, was up to BGO by 8 but the mother had died, perhaps a ruptured uterus. She had delivered one twin in a distant health center, but by the time they got her to Bundibugyo and called it was too late. He and Scott Will saw all the maternity ward inpatients this morning, trying to discharge those not critical for their own protection. He ultrasounded about 15 women. Staff are present and functioning. There is a police surgeon who came in, and we anticipate any moment the arrival of another doctor sent by Ministry of Health, to be medical superintendent.
The REST of the patients in Nyahuka: Meanwhile I went down to Nyahuka where we still do not have any confirmed cases, nor is there anyone admitted for isolation. The staff is somber but present, willing to work, even a couple of nurses who are not usually there showed up to volunteer during their school break! That surprised me. Since I don’t have any kids I made “hot ice cream”, milk from our cow cooked with eggs and sugar, and took the whole lot down to the ward to feed warm to the inpatients. I was able to discharge 8 kids, one I hesitated on since he had hepatosplenomegaly and diarrhea and a prolonged fever, though he was improving, I considered whether he qualified as an alert case . . . . Then I was called to see a new admission, who is almost certainly going to die. A two-year-old, malnourished-looking, with a week and a half history of fever at home, mucus stools. Not classic Ebola symptoms by any means, but when I saw him gasping and hot and dehydrated . . . I put on gloves at least. Then the knot of panic began to build—is this kid infected? What should I do? Called Scott who called MSF who said that they never saw a child as the first case in any community, so since this kid was from a village with no cases and the only one sick, not considered a suspect. OK. We are giving IV fluids, antimalarials, and antibiotics, but I think they came a day or so too late. When all the inpatients were seen and I had moved around the hospital checking in with all the staff, I came back up to the community center where we had shifted our normal first-Tuesday-of-the-month distribution of food to families with motherless infants (we provide a month of milk when a mother dies, then a ration of beans to increase the caloric intake of a surrogate breast feeder). I should have counted, we must have had 40 families or more. We used the opportunity to do some community education about Ebola, they asked good questions, like WHERE DOES THIS DISEASE COME FROM??? And another lady wanted to know what she should do if her husband gets sick, should she care for him or keep away with the baby??
In a single day we can go back and forth twenty times from “we are OK, we are protected, people are praying for us, we will get through this” to “what if one of us or even worse both gets sick?” Is it wrong to feel anxious when you’re living in the middle of an Ebola epidemic? I don’t think God will judge us. I miss my kids, oddly when I read about myself in my team’s emails I cry.