I saw pain and despair in Ebola ravaged nation

Courage doesn’t always roar. For Daniel Were, bravery was still the little voice that encouraged him to volunteer in Ebola-ravaged Liberia.

But not even gory stories and heart-rending images from the West African countries prepared him for this life-changing experience. His departure from Kenya on November 14 last year was not without apprehension. Family and friends discouraged him. His wife pleaded that he stays behind fearing he would get infected with the disease moving like a whirlwind, killing hundreds and not sparing healthcare workers.

Yet his mind was made-up and he painstakingly convinced his wife, parents, siblings and friends that he was responding to a call of duty with a promise to take extra caution.

And he is now a satisfied man after the four-month mission. “I saw pain and despair among the patients who looked up to us to hold their hands to deal with a disease killing their children, wives, husbands, leaders and health workers indiscriminately,” Mr Were told The Standard on Saturday in his first interview since his return from Liberia this week.

The 39-year-old, who trained in nursing at the Kenya Medical Training College, is an Infection Prevention and Control Coordinator at Kenyatta National Hospital in Nairobi and was chosen among hundreds of applicants to serve on a humanitarian mission in West Africa when Ebola was decimating populations.

Serving as the Infection Prevention and Control Coordinator of Sinje Ebola Treatment Unit, Were described his assignment as a mix of medical skills and a sacrifice supported by limitless love and concern by colleagues, friends and family back in Kenya.

Standard precautions

He was tasked to ensure safety of health workers by observing standard precautions like hand washing with 0.05 chlorine solution, wearing protective gear before contact with body fluids and adorning goggles and special mask.

The sojourn to Liberia with 21 other health workers under the International Organisation of Migration (IOM) marked several connecting flights from Jomo Kenyatta International Airport in Nairobi at 11pm through Dubai, Turkey, Morocco before they arrived in Monrovia, Liberia on November 16th, last year, 18 hours later.

“The airport looked deserted and we were picked by Quicksilver agents contracted by IOM for transfer to our apartments where we would spend three weeks undergoing intensive training,” Were added.

“We went through hot and cold training where we were presented with Ebola situations and expected to perform as per the training procedures,” he recounted.

He was tasked to ensure health workers observe hand hygiene, use disposable medical examination gloves before contact with body fluids, and contaminated items and adorn gown and eye protection gear before procedures and patient-care activities like treatment or feeding.

“Hand washing is a critical component in disease control thus we ensured that hands were washed with soap and running water or an alcohol-based hand-rub solution for at least 40 to 50 seconds using the World Health Organisation (WHO) recommended technique,” Were pointed out.

“There are detailed steps how to wear the protective gown known as donning, handling patients as we provide double barrier nursing and treatment and how to subsequently remove the gowns, a process we call doffing to avoid infection,” he said.

In January, 170 health workers comprising doctors, clinical officers, public health officers and laboratory technicians left for Liberia and Sierra Leone for a six-month mission under an agreement between the AU and the Kenya government.

Greatest challenge

Were explained that the greatest challenge in Liberia is unpredictable pockets of outbreaks that differ from each other hence keeping health workers on their toes daily.

“Ebola is a disease that requires extra caution but otherwise the management is the same medically where you treat the symptoms,” said Were who is a Registered nurse and currently studying Bachelor of Science in Nursing at Kenyatta University.

Despite the humanitarian tag that comes with the task, Were warns that it takes courage to be part of the mission in Liberia, where the disease has killed nearly 10,000 people since March 2013.

“We lost five patients which dampened our spirits but my task involved ensuring the bodies are disinfected and appropriately placed in body bags before they are handed over to the burial team.”

What is a typical day as the Infection Prevention and Control coordinator of an ETU?

“I worked 12 hours per day together with the County Health Team or with other implementing partners in the county but we remained on call in case there was an emergency,” he says. One of his most memorable times on the assignment was the full recovery of a family of four, a 17-month old girl, her five year brother and their parents.

Events that brought a smile to his face was when vulnerable groups like infants, children and pregnant women turned negative and were discharged to go home.

“Her recovery was one of the happiest moments at our unit because it was symbolic of a young soldier conquering a battle,” Were remembers.

Asked whether Kenya was prepared in case of an Ebola outbreak, he said with the right people and health systems in place, combating an outbreak will be strengthened by the uniting Kenyan spirit.

“We need to be alert and improve our health systems so that we respond to outbreaks promptly thus avoid mass deaths,” he says, noting that Kenyans have huge, kind hearts to adequately respond when all else is available.

However, he faulted the location of the KNH Ebola treatment unit saying its in proximity to high a population of people and the permanence in structure makes it more inappropriate.

“In Liberia, the treatment units were set up away from where people live and entry is regulated,” says Were adding that the KNH structure would not meet the WHO stipulated guidelines for setting up a treatment unit. His only means of communication to Kenya was through mobile social networking site, WhatsApp, especially to his wife who daily checked and prayed for him.

This weekend, Were is visiting friends in Kisumu County for the mini-Christmas celebrations he missed and will take this opportunity to indulge them in West African fables as he catches up with Kenyan banter.

Meanwhile, after Were and his colleagues returned, a female British healthcare worker was diagnosed with Ebola and is undergoing treatment in a specialist Ebola centre in Kerry Town in Western Sierra Leone.