Those two emotions wave over us hourly. The church had previously called for a multi-denominational day of prayer and fasting so we started the morning with people there. I’m going back in a few minutes, to be with people who are also grieving and praying. I don’t know of any other death that could so severely affect this district. Everyone is crying.
Jonah first went to investigate this epidemic weeks ago, it was probably still October then. Rumors had reached him of a mystery illness. I remember well the day he came into the Paediatric Ward and told us about it. I gave him gloves and my bottle of alcohol hand gel, pitifully inadequate measures now. We had not heard of any bleeding, just vomiting and diarrhea and unusual deaths. We wondered if it was a cholera outbreak. I remember him slinging his backpack on, and getting on his motorcycle, saying “If I die, I die.” When he came back he guessed typhoid fever, due to the prominent abdominal pain and even what seemed to be two cases with intestinal perforation. He noted the family grouping of the cases and held some community meetings to sensitize on hygiene, the basics of handwashing and latrines. He dispelled rumors of witchcraft and poisons. He wrote up a report. Then over the next week or two there was a task force set up, some Ministry of Health epidemiologists came and took blood samples. We got the good news that it was not Marburg or any Viral Hemorrhagic Fever based on samples sent . . . Not sure where. Then there was the message that more samples had been sent to South Africa. Days went on. Uganda’s attention was on CHOGM. Jonah continued to attend to patients as they came into Bundibugyo Hospital, as did Scott. Jonah was the primary doctor for Muhindo Jeremiah, an older gentleman who had been active in visiting the sick in Kikyo then fell ill in Bundibugyo. A week and a half ago Muhindo died. A few days later Jonah went to Kampala on personal business; he has a house there still from medical school days with rooms he rents out, and three of his daughters are in school in Kampala, and his mother and brother stay with them there. We went to Kikyo the day Jonah went to Kampala, all of us still wondering what this disease could be, still being told the samples had been sent from South Africa now on to the CDC in Atlanta. Then last Thursday the bombshell announcement came, that it was Ebola, a new strain. That day we talked to Jonah on the phone, he had a headache he said, maybe early malaria, he’d watch. By Friday morning he found it prudent to admit himself to Mulago hospital. That was his last act of bravery and wisdom. We talked on the phone that day, he sounded so normal, so himself. I went to find his wife Melen who was still here. We prayed and wept and embraced and called him again. Saturday morning I drove her early to town to get on transport to go to Kampala, even though she knew she would not be allowed to see him. She’s six months pregnant with their sixth child. From Friday until 4 pm yesterday every report we got from the doctors was hopeful. He was walking and talking, drinking. His doctor even said he was wanting to call and talk to us but they were looking for a way to charge his phone which he had with him in the isolation. He did have a couple of days of reduced urine output indicating an effect on his kidneys, and he did continue to have fever. With each new symptom and passing day the hope that it was all just malaria became less and less. Still Jonah is a strong man, healthy, smart. He was in the country’s main hospital, not out here in Bundibugyo. He was getting lab tests. He had a team of doctors, including MSF Spain. We had hope. Then suddenly last night they called back. He had died. Maybe there was bleeding, involving his kidneys and lungs, I don’t have the real story yet.
Jonah was a man of integrity. He refused to charge patients extra fees for his services, even though that is widely practiced in government hospitals. He was completely trustworthy with his responsibilities and resources. He was a leader who knew how to motivate, listen, draw consensus. He was not afraid. He worked hard, entering medical school in his mid-30’s after an initial career as a medical assistant. We sponsored him all the way because we saw in him both the clinical prowess to save lives and the character to change the system. He was the first person from Bundibugyo to graduate from Makerere University School of Medicine in 29 years. He knew that God was the one who provided his opportunities, and he had a strong sense of his duty to serve. His father was killed by ADF rebels in about 1997. When the initial attacks came Jonah and Melen fled to our house. We supported each other through war, school, families, children. I was present for the birth of one of their girls (Biira) in their home. Biira and Caleb were baptized together. We’ve spent holidays together, traveled together, been present for each other’s significant events. Since graduating from medical school Jonah has not found it easy to be back in Bundibugyo. A person who stands against corruption meets obstacles here. He has struggled. But we always thought he would eventually prevail.
I think I know now how Jesus’ disciples felt Friday night after the crucifixion. What is God doing? Will evil win? Our hearts cry out. Before all of this happened we sent out a December prayer letter, and now I can see that the Spirit was preparing our hearts. I’ll try to post it some time. But the message was: the Kingdom coming is a dangerous business, real people get hurt and die. I never dreamed it would be Jonah.
Of course our grief is mixed with fear, with wondering what that means for our own exposures, though less than Jonah’s. Scott and the WHM leadership made a decision last night that I will no longer be allowed to see patients, even non-Ebola ones, so I can wait out my incubation period and hopefully be cleared to reunite with our kids. Scott Will is taking over my NHC duties. I just got a message from him that there are only 12 patients admitted and no staff yet visible, but he said “God is still here”. Scott Myhre is taking responsibility for Bundibugyo Hospital. He said he’d like to mourn today, but it is like a battle, when your comrade falls that is not the time to quit. We have moments of clarity and peace, and lots more moments of shivering dread. The outpouring of prayer and posts has strengthened us. I think we are too weak and numb to pray well, but in the body that’s OK, all over the world people are doing that work for us.
Tuesday, December 04, 2007
Dr. Jonah Kule...killed by Ebola
Dr. Jonah Kule died this evening, Tuesday 4 December, at Mulago Hospital.
We have lost one of our best friends.
To say nothing of the devastating impact on his family, on the district, on the country.
Ebola is horrific. There are no words to express our grief. And this makes the whole epidemic even more frightening, if that were possible.
Pray fiercely for an end to this, soon.
Ebola in Bundibugyo: Tues night Report
The District Task Force responding to the Ebola crisis meets every evening for several hours, and today I went with Scott. Mostly because I felt so wiped out by the day in general and wanted to stick with him, as well as experience the politics and planning side of the epidemic. About two dozen people, mostly men, mostly Ugandans except us, MSF, and two Kenyan epidemiologists, gathered in a circle of chairs outside the RDC’s office. Bottom line: there are a slew of competent and motivated people at work. The RDC himself serves as chair, and he’s an impressively large and voluminous presence, practical and authoritative, the kind of person you want in charge.
THE FACTS:
We chatted prior to the meeting with some of the doctors and others involved. Dr. Yoti was (as he put it) a young fresh-from-school doctor in the 2000 Gulu Ebola epidemic, and when he survived that he decided to study Infectious Disease as a specialty in South Africa, and now works tirelessly all over Uganda under the auspices of the WHO tracing epidemics and disasters and trying to save lives. I found him clinically solid, thoughtful, and humane, and the kind of guy I’d hope to have in charge of any patient I cared about. Rosa, the MSF Medical Coordinator, a nurse with the experience of the 2007 Congo epidemic and the down-to-tacks hard work and confidence to pull off the isolation and care of patients. She’s spent several days now setting up the isolation wards, arranging for food, water, triage, training teams to man an ambulance to pull in suspected cases safely and another team to safely bury those that die, teaching attendants to protect themselves, as well as managing the patients. Dr. Ann (MSF) and Dr. Thomas (WHO) are carefully tracking the numbers. There are umpteen other people pitching in in every way they can.
THE FACTS:
- cumulative cases as of 5 pm on Tuesday: 90
- cumulative deaths: 19
- New admissions: 7; that includes 3 in Kikyo and 4 in Bundibugyo
- Current admissions: 23 in Bundi, and I think 14 or 15 in Kikyo
- Positive lab samples: 9, but that will change tomorrow, since there are about 15 samples waiting to be sent on the flight, and the CDC has landed and will be operational with their biohazard level 4 virology lab in Entebbe tomorrow.
- Identified contacts being followed: 327 (which does not include Scott or me, though the epidemiologist told us to follow ourselves because we should be considered contacts)
- Subcounties from which suspected cases have originated: 5 (Kasitu 50, Bubukwanga 18, Bundibugyo Town Council 10, Busaru 4, Harugale 3, others unknown). Note that the case may be counted as arising from a subcounty because the patient’s home is there even if the contact was made elsewhere . . .
We chatted prior to the meeting with some of the doctors and others involved. Dr. Yoti was (as he put it) a young fresh-from-school doctor in the 2000 Gulu Ebola epidemic, and when he survived that he decided to study Infectious Disease as a specialty in South Africa, and now works tirelessly all over Uganda under the auspices of the WHO tracing epidemics and disasters and trying to save lives. I found him clinically solid, thoughtful, and humane, and the kind of guy I’d hope to have in charge of any patient I cared about. Rosa, the MSF Medical Coordinator, a nurse with the experience of the 2007 Congo epidemic and the down-to-tacks hard work and confidence to pull off the isolation and care of patients. She’s spent several days now setting up the isolation wards, arranging for food, water, triage, training teams to man an ambulance to pull in suspected cases safely and another team to safely bury those that die, teaching attendants to protect themselves, as well as managing the patients. Dr. Ann (MSF) and Dr. Thomas (WHO) are carefully tracking the numbers. There are umpteen other people pitching in in every way they can.
Ebola in Bundibugyo-Tues-Day 6
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.
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.
Monday, December 03, 2007
Ebola in Bundibugyo: Monday night, still escalating
The official case count has gone up from 51 to 79 since the initial numbers were released four days ago. We now have 21 admitted in Bundibugyo (up from 16 yesterday) while only one more patient came to Kikyo (10 total). Dr. Sessanga continues to struggle on with his case; Dr. Jonah needed IV fluids today but was reported to be stable. It was another dawn to post-dusk day for Scott, which included two three-hour-long meetings as well as final assembly and initial use of a brand new lawnmower we just imported in the nick of time to keep the airstrip open for the sudden increase in flights. Three MSF personnel hitched a ride in on the plane that took our team out; more CDC and WHO folks are expected on Wednesday, so keeping the airstrip open is an important part of the logistics of this operation. Pray for Scott to have wisdom to know his role, to respond with leadership and compassion and wisdom and courage. We are used to being a bit more on the sidelines politically, focusing on patient care. This crisis throws him into the middle of everything, and the lines of authority are not always clear. Added to that is the fact that this is a new strain, so if one person makes a statement about transmission and another challenges it, we really can’t be sure who is right, because this epidemic may not progress in the same way that others have done. The MSF team is impressive and fascinating, they are tracking numbers and plotting maps and have already concluded from interviews that besides patient care in the hospital, the greatest risk factor is the handling of dead bodies at burial.
We do sense the incredible outpouring of concern and prayer from our friends. It is a bit edgy to go hour to hour with the background thought of . . .do I feel a twinge of nausea, could that be a fever coming on . . . But mostly we remain confident that our measures to protect ourselves even before we knew the gravity of the situation were adequate. The kids made it to Kampala safe and sound, and compared to the agony of deciding to send them away, the reality of missing them is not nearly as painful. Scott was remembering the days of war, when the team dwindled down to two or three adults only, it feels like that again now, with all the separation and uncertainty.
We do sense the incredible outpouring of concern and prayer from our friends. It is a bit edgy to go hour to hour with the background thought of . . .do I feel a twinge of nausea, could that be a fever coming on . . . But mostly we remain confident that our measures to protect ourselves even before we knew the gravity of the situation were adequate. The kids made it to Kampala safe and sound, and compared to the agony of deciding to send them away, the reality of missing them is not nearly as painful. Scott was remembering the days of war, when the team dwindled down to two or three adults only, it feels like that again now, with all the separation and uncertainty.
Explaining Ebola
This afternoon seven of the eight boys who are my kids’ close friends hung out playing cards. I tried to explain ebola, most of these boys are CSB students whom we sponsor. They asked good questions, but one got me thinking: Is this disease only in Africa, or is it in other parts of the world? I felt disloyal, or sad, to admit that all the major outbreaks had occurred relatively close (on a global scale) to where we now sit, in eastern Congo, southern Sudan, northern Uganda. Almost the only time the filovirus has been found elsewhere was when it was inadvertently transported out in monkeys from Uganda. I could see the world-wide image of Africa, the continent of disease, being reinforced once again. And it is not just a matter of how uninformed or prejudiced westerners view Africa, the assumptions are so powerful they trickle down into the minds of these boys. It seems unfair that Bundibugyo only gets the five minutes of world attention because of yet another disease.
They're Off
The Caravan lifted off a few minutes ago with its precious cargo . . . I have never been in Bundibugyo without our kids before, it is very very quiet all of the sudden. There are still people laughing and chatting on the road, still kids coming into our yard, still bright red tomatoes piled on the counter to be cooked, which lend an air of unreality to the fact that we are in the midst of a major public health crisis, temporarily scattered as a family and team. Julia and Caleb were efficient and helpful all day, they have matured even faster in the last three days. Jack spent most of the day with his friends, especially his closest one Ivan. Ironically now all my kids are gone, but my students who were released from school today are all sitting on my porch waiting for the “plan” since they normally spend most of their days here when on break. If I sent my team and kids away to protect them from risking contact with us, how can I allow these boys to be here? What about my houseworkers? Other friends? Always these evacuations bring painfully to the surface the options we have that others do not. Someone wrote that it reminded her of kids being shipped out of London in WW2, which gave me a new empathy for those parents.
Scott is gone from sunrise to sunset and past every day it seems. As soon as the plane took off he was back up to yet another meeting. I think this is probably the hardest point of the whole crisis, the fourth day, when things should be falling together but there is still considerable confusion and jostling for who is responsible for what, how do MSF and WHO and CDC and Red Cross and Ministry of Health all cooperate, and what is our role in all that? All intensified by the absence due to disease of the two men who would be most able to hold it all together.
Feeling a bit numb. More later.
Scott is gone from sunrise to sunset and past every day it seems. As soon as the plane took off he was back up to yet another meeting. I think this is probably the hardest point of the whole crisis, the fourth day, when things should be falling together but there is still considerable confusion and jostling for who is responsible for what, how do MSF and WHO and CDC and Red Cross and Ministry of Health all cooperate, and what is our role in all that? All intensified by the absence due to disease of the two men who would be most able to hold it all together.
Feeling a bit numb. More later.
Sunday, December 02, 2007
Ebola Bundibugyo Monday Morning
The good news: Jonah is improving. Dr. Sessanga is still critically ill (down 10kg, 8 days of fever, barely talking) but the MSF doctor said the fact that he can still sit and even walk a little on day 8 is a good sign. The cavalry is still a bit slow in arriving, only two came yesterday but more expected today. Scott spent the entire day with them again. 16 admissions at BGO hospital, still 8 in Kikyo. We now have the “Ebola Bible” manual for the epidemic and need to work today to shut down non-essential medical services that could spread the disease (like immunizations) and clarify which services are essential (the guidelines take a pretty hard core view of that, such as C section to save the mother only not the baby, due to the volumes of blood involved). Had a good mini-advent time with team focusing on HOPE, on Mary’s song of God’s power in the weak and poor, of God turning impossible situations around. We feel that. This will be short, Scott is already at the airstrip at dawn with the new lawn mower which finally arrived, because in the midst of everything else we realize the airstrip is an essential part of logistics for help. MAF comes at 3 pm to evacuate our non-medical team, and our kids, primarily to prevent the danger of them being infected by us should we fall ill. I am dreading the moment and have great sympathy for mothers who give their babies up for adoption because they think it is best for their child. But before that happens I need to pack for them, assuming at least three to four weeks away from home, possibly longer. Thanks to all who are leaving encouraging messages, we see them and are grateful.
Ebola Bundibugyo, the Emotions
I am making this two separate posts, to separate the facts from the emotions. And since my mother and my son both read this from America I probably won’t be fully honest. But I will say that the emotional toll of the last 72 hours has been tremendous. There is first of all the wrenching anxiety about the patients that we know. Since about a third right now are hospital staff, they are not mere numbers in a list. Jonah of course top of the list of people we love who are in danger. A virus that selectively attacks the people who care for the sick seems positively diabolical. Then second there is the small but real possibility that one of us, mostly Scott, would fall ill. Since the only other two doctors who have seen these patients are down, we can not ignore that risk. We have been careful and pray that we’ve been careful enough. The full protective MSF biohazard garb is arriving today, before that we’ve worn masks and gloves only. And related to that sobering hypothetical scenario is the responsibility we feel to protect and care for and make good decisions about our children and our team, a third area of gut-twisting thoughts. It is unbelievably painful to consider that we (Scott, Scott Will, and me) might be dangerous to them. So over the last day we’ve been growing in our conviction that we need to get the non-medical team members out of here, away from us. It is an impossible dilemma, to look at my beautiful three children who are here with me, and think that for their own good I need to send them away from me. To look at our bewildered team scrambling to make plans and feel that we can’t go with them. So far we are all well, but if our medical exposure stopped this minute it would still be at least two weeks, maybe three, until we were sure we were safe. Over the last three days since we knew it was Ebola, I have only been with one patient who may have been a case (she died), while Scott has continued to care for the ill until MSF arrives (hopefully soon). Clearly it would be good to keep one parent healthy, but where does that leave the support we need to give each other? And if those three areas of stress are not enough, there is the parallel crisis of the collapsing medical system. Scott has been gone all day again, third day in a row of juggling the medical and surgical emergencies that would have fallen to Dr. Sessanga and Jonah. How do we weigh ethically protecting ourselves and our children and our responsibility to the community here where we’ve spent a large portion of our lives, in their time of greatest need?
So those are the thoughts that wake me up in the middle of the night and make it hard to sleep, that catch me unawares in the middle of hot afternoon sunshine and make me cry. The hymn that keeps surfacing in my head is the one about protecting soldiers and sailors . . .Eternal Father, strong to save . . . Oh Trinity of Love and Power . .. We are clinging to that love, and that power, as our only surety. Please pray.
So those are the thoughts that wake me up in the middle of the night and make it hard to sleep, that catch me unawares in the middle of hot afternoon sunshine and make me cry. The hymn that keeps surfacing in my head is the one about protecting soldiers and sailors . . .Eternal Father, strong to save . . . Oh Trinity of Love and Power . .. We are clinging to that love, and that power, as our only surety. Please pray.
Ebola Bundibugyo Sunday Facts
Admitted at Bundibugyo: 15, including Dr. Sessanga whose sister just came to our house looking for Scott because he’s no longer responsive; the matron (head nurse); the nurse who was working in the isolation unit Fred; a clinical officer named Joshua Kule; and an ophthalmic assistant. Among the other patients are six direct contacts (mother, brother, wife, daughter and two friends) of Muhindo Jeremiah who died just over a week ago.
Admitted at Kikyo: 8 as of yesterday, haven’t heard today.
Died: official number is 18. Likely higher, hard to say.
Calvary: Still en route, but expected any minute. They slept in Fort Portal last night. There is a 17 person team from combined MSF branches (Belgium, France, Spain, etc.) including the doctor who was in charge of the recent outbreak in Congo. They have two doctors, four nurses, and a wide variety of other staff who won’t see patients but do logistics, education, investigation. Even an anthropologist. The CDC lab team arrives in the country Tuesday night. They say they’ll be up and running for labs in Entebbe (Uganda Viral Research Institute) by Thursday, possibly even Wednesday evening.
Jonah: I just talked to his sister, she says there is definite improvement since yesterday. We heard he had a positive malaria smear, so it is possibly not Ebola. But then he developed more symptoms, so we are waiting for a confirmation. His blood sample is with the CDC in Uganda, not yet reached America.
Team: OK. We had a prayer and discussion time this morning. As team leaders we are leaning towards sending out non-medical staff and children, to be cautious. Scott and Scott zipped up to Bundibugyo again mid-meeting to do an emergency C section, but by the time they got the mother into the OR the baby had died, and she then delivered the still-born vaginally. So you could, in a public health sense, count that as another Ebola casualty. As soon as they got out of that they were called to see a motorcycle accident victim, a lady with severe facial trauma and fractures they need to refer to Fort Portal, but probably can’t because she’s a family member contact of an Ebola survivor (one of the cases Scott has been following the last two weeks). He was actually driving the motorcycle when it crashed. It is incredibly complicated.
Community: the churches have called for an all day prayer meeting in our Community Center on Wednesday, which is a really encouraging sign, I hope many people come and pray. There were educational videos shown outdoors in the market last evening. Anxiety is mainly high among the health center staff, with good reason. One of our staff just came and brought me a chicken and said goodbye—she’s from Arua, and she wants to escape with her children while she can . . . Schools are closing a week early, and CSB is sending kids home tomorrow. Ndyezika’s wedding has been postponed, and likely others will too, a real blow to marriage since after years and years there are more wedding planned for December (six that I’ve been invited to) than the last several years combined.
Admitted at Kikyo: 8 as of yesterday, haven’t heard today.
Died: official number is 18. Likely higher, hard to say.
Calvary: Still en route, but expected any minute. They slept in Fort Portal last night. There is a 17 person team from combined MSF branches (Belgium, France, Spain, etc.) including the doctor who was in charge of the recent outbreak in Congo. They have two doctors, four nurses, and a wide variety of other staff who won’t see patients but do logistics, education, investigation. Even an anthropologist. The CDC lab team arrives in the country Tuesday night. They say they’ll be up and running for labs in Entebbe (Uganda Viral Research Institute) by Thursday, possibly even Wednesday evening.
Jonah: I just talked to his sister, she says there is definite improvement since yesterday. We heard he had a positive malaria smear, so it is possibly not Ebola. But then he developed more symptoms, so we are waiting for a confirmation. His blood sample is with the CDC in Uganda, not yet reached America.
Team: OK. We had a prayer and discussion time this morning. As team leaders we are leaning towards sending out non-medical staff and children, to be cautious. Scott and Scott zipped up to Bundibugyo again mid-meeting to do an emergency C section, but by the time they got the mother into the OR the baby had died, and she then delivered the still-born vaginally. So you could, in a public health sense, count that as another Ebola casualty. As soon as they got out of that they were called to see a motorcycle accident victim, a lady with severe facial trauma and fractures they need to refer to Fort Portal, but probably can’t because she’s a family member contact of an Ebola survivor (one of the cases Scott has been following the last two weeks). He was actually driving the motorcycle when it crashed. It is incredibly complicated.
Community: the churches have called for an all day prayer meeting in our Community Center on Wednesday, which is a really encouraging sign, I hope many people come and pray. There were educational videos shown outdoors in the market last evening. Anxiety is mainly high among the health center staff, with good reason. One of our staff just came and brought me a chicken and said goodbye—she’s from Arua, and she wants to escape with her children while she can . . . Schools are closing a week early, and CSB is sending kids home tomorrow. Ndyezika’s wedding has been postponed, and likely others will too, a real blow to marriage since after years and years there are more wedding planned for December (six that I’ve been invited to) than the last several years combined.
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