Christchurch nurse working with Ebola patients
Sahra and her colleague Edwin outside the Treatment Centre
Nurse Sahra Ahmed said she didn’t do a lot of research about Ebola before she put up her hand and headed to Sierra Leone with the Red Cross.
“What I saw in the media was very scary and I just knew I wanted to help out. I also didn’t want to intellectualise it or tell too many people, so that I could be put off.”
On 25 January 2015, Somalian-born Sahra flew to Madrid for two days training with the Spanish Red Cross, before flying to Sierra Leone and starting work in a Red Cross treatment centre, four hours away in Kenema.
She left with the blessing of her husband, her 12-year old daughter Raha, and her colleagues at Pika Te Ora Health Centre. Her mother was not quite as supportive. “She told me that I was mad and that death came to those who went looking for it. I knew she was just worried and we’re OK now,” Sahra says.
In Kenema, Sahra’s role was initially to care for 12 nurses and a driver, who had been in contact with a young male nurse who had died of Ebola. The isolation period was 21 days but as two more nurses became sick with Ebola their time in quarantine extended to 36 days. “They were completely cut off from their families and going up the wall,” she says. “They were also very close as colleagues and really affected by the nurse’s death.”
For the rest of her time in Kenema and Kono, Sahra’s role was Community Health Mobilisation team leader – a broad public health position that involved looking after the psycho-social wellbeing of Ebola sufferers; ensuring that the bodies of those who died were treated with dignity and handled safely; and delivering survivors back to their villages, with the message that it was safe to welcome them back into their communities.
She says as people came into the Treatment Centre she would check that they understood how Ebola progressed, why people were wearing Personal Protection Equipment (PPE) and the treatment they would receive. Blood tests were taken to confirm whether the person had Ebola and after 24 hours they would either go home or stay at the centre.
Sahra says everyone leaving the Treatment Centre, whether they had recovered from Ebola or not had it, would have to shower in a chlorine solution and be given a new set of clothing. People who had survived Ebola would also receive a package of food, clothing, condoms and a little money to tide them over for the next few months, while they were recovering. “It was the best feeling in the world telling people they could have the Happy Shower and then taking them home to their village,” Sahra says. “We all felt so happy that they had survived.”
Temperature checks being administered at the Treatment Centre
Daytime temperatures of more than 30°C and heavy PPE made working conditions difficult at the Treatment Centre. “The full PPE was so hot that it was another 20 degrees warmer inside the suit. We were only allowed to wear it for 35 minutes and at the very longest an hour. And we could only wear it twice a day,” she says. “As a team we were very safety conscious – no touching or hugging people - which is very hard in our profession. But the number one thing was to not spread Ebola.” Sahra said the establishment of a second treatment centre at Kono had saved many lives. Previously people who had become ill with Ebola, or any other disease, had travelled four hours from Kono to Kenema in an ambulance. The ambulance would take five to ten people at a time over rough terrain. “Some would die on the way and people who didn’t have Ebola when they left would certainly have it by the time they arrived in Kenema.”
Sahra was also involved in preparing bodies for burial and liaising with the victims’ families and village chiefs when they died. “People were switched on. They knew how Ebola infection happened but the way things had to be done, especially the burials, really upset the families,” she says. “One of the worst things for them was that every death, even if it was from diabetes or a heart attack, had to be treated as an Ebola death as there was no way to be sure it wasn’t.”
Sahra says that aside from fearing for her life when she became ill with a stomach bug in Kono, she has coped well with her experience. “You really have to wear mental PPE when you are working there. I went to help and make the community feel that there were people who cared about what was happening. You just want to help make life a little easier for them."