Diary Of An Ebola Doctor

RACHEL MARTIN, HOST:

Now to a very personal story from the front lines of the ongoing fight against Ebola in one of the countries hardest hit - Sierra Leone. The World Health Organization reports that the Ebola epidemic in that country may be leveling off, although, nearly 250 new cases were reported there last week. And two promising Ebola vaccines will soon be tested on healthy volunteers in West Africa.

Since early December, American doctor, Joel Selanikio has been treating Ebola patients in Lunsar, Sierra Leone, about 60 miles from the capitol of Freetown. As he wrapped up his tour with the International Medical Corps, he sent along this audio diary of his time in the epidemic's hot zone.

In his first entry, Selanikio is getting ready to enter the Ebola ward, and he's suiting up in his PPE. This is personal protective equipment. A word of caution here, some listeners may find portions of this story disturbing.

(SOUNDBITE OF AUDIO DIARY)

DR. JOEL SELANIKIO: I rounded on a 16-year-old girl a few days ago. Her name was Hawanatu (ph), or Hawa (ph) for short. When I first saw her under her blanket, I thought that she must be an amputee. Then I realized that she was just a very, very small, thin girl. I didn't get to Hawa the next day and today, I rounded on her again. For the first time in two days wanting to examine her fully, I pulled away her blanket and found that rather than just having a rash, her entire body surface was peeling off in thick pieces, revealing very, very red painful-looking skin underneath.

Honestly, every person around that bed literally gasped when they saw what she looked like. It was like a burn victim. I've honestly never seen anything like it except in a burn victim.

It's really hard to describe all the emotions that I felt when I realized what this 16-year-old girl had been going through while supposedly under my care. But I can say that mostly I felt ashamed because I had agreed to care for her, and I hadn't. It's a hard, hard thing to realize that your actions or your inactions have harmed a child.

Martha (ph) was a baby girl about 13 months old whose mother had died at our facility. When Martha came in, she seemed like a normal, healthy baby. She was drinking well, eating well, smiling and active. But over the next few days, she became more irritable and less active, drinking and eating less. And we could see her becoming dehydrated despite our efforts to provide IV fluids. Because unlike in a normal hospital setting, we didn't have the staff or the IV pumps to provide continuous fluids or continuous observation of Martha.

On the third day, she lost her IV access and still wasn't drinking. For about 45 minutes, I cradled her in one of my arms and used my other hand to squirt oral rehydration solution into her mouth with a syringe. She drank like she was starving to death, which she was. And the next morning, she was dead.

One of the things that has surprised me here, although it probably shouldn't, is how fast death has become part of my routine. Of course, I knew from the news that many Ebola patients die. And I knew that many of my Ebola patients would die. And I knew from years of working in hospitals and health care that care providers, doctors, nurses, everyone else, can't function if they breakdown every time a patient dies. So I knew that I would handle it. I'd compartmentalize it. Still a few weeks into this, I've certified the deaths of more patients than in my last two decades. And I'm shocked to the degree to which it has just become part of my daily routine.

So Martin (ph), a 19-year-old boy, was double negative today. That is he got the second of two negative Ebola tests separated by 48 hours proving that he was now cured and can go home. I remembered when he'd come in very sick and also he was tired of living, he said, because his father had died. And he said, I'm going to die like my father. And I said, no, you're not going to die Martin, you're going to fight it. And you're going to drink, and you're going to eat, and you're going to rest, and you're going to live for your father. And I thought about that while I was laughing and clapping for Martin. And then I thought about little Martha who had died and Hawa with the skin condition and Aminata (ph) and Ibrahim (ph) and Sori (ph) and Ahmed (ph) who had died. And I was crying inside my PPE behind my fogged up goggles just crying to myself.

(SOUNDBITE OF CELEBRATION)

SELANIKIO: When a confirmed Ebola patient manages to defy the odds and fight the disease, they can be discharged. At that point, the patient is brought out of the confirmed award inside the hot zone, led into a little shower building that straddles the hot and the cold zones and which is referred to by the staff as the "showers of glory," quote-unquote. And they emerge reborn, as it were, from the hot zone into the world. And the patient is welcomed out of the shower with all kinds of clapping and shouting, music and lots and lots of dancing. Really excited that we managed to save one more person.

(SOUNDBITE OF CELEBRATION)

MARTIN: That was an audio diary from Dr. Joel Selanikio. He finished his tour of duty in Sierra Leone this weekend. He is headed home to Washington, D.C.

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