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Quarantined home in Sierra Leone
A sign warns people away from a quarantined home in an effort to combat the spread of the Ebola virus in Port Loko, Sierra Leone. Photograph: Michael Duff/AP
A sign warns people away from a quarantined home in an effort to combat the spread of the Ebola virus in Port Loko, Sierra Leone. Photograph: Michael Duff/AP

‘Confronting Ebola for the first time generates strong emotions’

This article is more than 9 years old

Martin Deahl, a British doctor working in Sierra Leone, describes the profound emotional impact of his first shift at an Ebola treatment centre in Port Loko

Part two: We relieve pain and distress, but in all honesty we rarely save

Part three: Katiada showed extraordinary courage in battling Ebola

Dr Martin Deahl is a consultant psychiatrist from Newport in Shropshire. He recently completed his first shift in a 100-bed Ebola treatment centre built by the UK government and run by the aid agency Goal in Port Loko, Sierra Leone.

After all the training, waiting and anticipation, I have just returned from my first shift in the “red zone” at the Goal Ebola treatment centre. It was an anticlimax, in the sense that everything ran smoothly, there were no dramas and, importantly, no nerves or additional anxiety. So prepared and well-drilled were we that personal protection equipment, our safety, and all the supplementary precautions necessary were carried out automatically, with the patients the total focus of attention.

I hadn’t been in the centre at night before. There was a surreal atmosphere, with tents glowing in the dark, and the noise of insect life coming from every nook and cranny.

Four patients were admitted that day. A 68-year-old man, already ill for a couple of weeks, had red eyes and bleeding gums; he was aware of what was going on, but barely able to support himself. A 50-year-old woman was in a similar state, and there were also two children, aged eight and nine.

Dr Martin Deahl ready for work at the Ebola treatment centre.
British physician Martin Deahl ready for work at the Ebola treatment centre in Port Loko, Sierra Leone. Photograph: Goal

The children were weak, frail and vulnerable. Unable to lift a bottle of water to their lips or sit up without help, they were clearly very dehydrated. They had sunken eyes, their breathing was rapid and shallow, and their pulses were weak; they were very sick. One had just lost her mother. It meant that both parents and every member of her close family had been taken by Ebola.

I had thought non-verbal communication would be impossible in personal protection equipment, but was surprised and heartened to find that a hug was a hug and even two layers of gloves didn’t diminish the emotional impact of squeezing a hand.

There is little place for modern medicine here. Life or death is a matter of rehydration, rehydration, rehydration. Encouraging patients to drink oral rehydration solution can be hard – it tastes vile, like sugary salt water – so water, or anything the patient fancies, is a good second best. The adults want tea and coffee; bringing this into the red zone is a logistical nightmare, but with a bit of imagination and ingenuity we managed it. The children liked fizzy drinks and sodas, which was an easier wish to grant.

Drinking has to be encouraged and supervised: sips, not glugs. Glug and you vomit, rendering the whole exercise counter-productive. Prompting and supervising drinking becomes problematic when you only have 45 minutes in the zone, although concentrating on the patient takes the mind off the heat, sweat and physical discomfort. Ninety minutes (my personal record) flew by, and I was only aware of my own physical state after I’d doffed my personal protection equipment. As one team leaves, another enters; it’s reminiscent of a relay or tag team.

Confronting Ebola for the first time generates strong emotions. Sadness at seeing such suffering and fear. Anger – what have these people done to deserve this? A sense of guilt that the international community didn’t respond more quickly. Love, especially for the children, innocent young lives so undeserving of anything like this; why them, not me? And, of course, fear of the ever-present invisible enemy. I have seen a lot of suffering in a career of more than 30 years, but rarely have I felt so emotional about my patients.

Dr Martin Deahl wrestled with powerful emotions during the course of his first shift at an Ebola treatment centre in Port Loko, Sierra Leone. Photograph: Goal

Home at 1.30am and off to bed, on call for the rest of the night. Found myself awake at 4am, in tears. Took a mental step back to try to work out what was upsetting, realising I had been bargaining with God in my half-sleep and in a maelstrom of conflicting emotion. If you stop the little girl vomiting, I’ll be good, do better, try harder, X, Y or Z … anything for the price of a life.

Extraordinary. I’m not religious and have certainly never had such thoughts before. But, such is the intensity and surreal nature of this situation, we are all experiencing an emotional journey of self-discovery that will change us – hopefully for the better – for ever.

More on this story

More on this story

  • Ebola’s reign of terror: since outbreak a year ago virus has killed over 7,500

  • Sierra Leone hospital staff strike over Ebola payments

  • Untested Ebola drug given to patients in Sierra Leone causes UK walkout

  • NHS Ebola staff ‘insulted’ by UK travel ban

  • Ebola death toll close to 7,400, says World Health Organisation

  • Ebola kills Sierra Leone's most senior doctor

  • Life on the Ebola frontline: 'I thought of nothing else except my death'

  • World Health Organisation and DfID slow to react on Ebola, say UK MPs

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