Small Victories in West Africa

With each passing week, these updates seem more difficult to write. Only so much can fill a single letter and so many faces, so many stories, so much hope, and so much sadness fills each day here in Liberia. Providing comfort, compassion and care despite full PPE (personal protective equipment), limited patient contact and limited resources, can be a daunting task.

Every day challenges us to find different and innovative ways of meeting our patient’s needs and showing them that we care. For kids that are having trouble eating solid foods and who dislike oral rehydration salts, we have found that they like milk (baby formula). Now formula is made and brought in with morning rounds every day. Most Liberians are accustomed to a cup of tea at night. We now fill empty water bottles with tea and toss them over the fence to the healthier patients to hand out. If it brings them even the smallest amount of comfort, it is worth the effort. Sometimes, though, all of those efforts are futile and the only comfort we can bring to a patient is our presence and a heart that is willing to accompany them in their suffering. On my last night shift, I found myself in such a situation, where my presence was the only comfort I had to offer.

In the middle of the night a patient came out to the fence to tell us that another patient was confused and trying to walk out of the unit. A Liberian nurse and I suited up and went into the confirmed unit. Sure enough, a man named Joe was confused and trying to cross the fence to the suspect unit. We put him back in bed and gave him some medication to help him sleep. Before leaving, I quickly checked on the rest of the patients to be sure they didn’t need anything. I found two kids actively dying. Dorcas was a very small 14-year-old girl with a very sweet disposition. Alfred was much younger and had come in already in the late stages of the illness. Both of them were without family in the unit. I ended up at the beside of the one who was closest to death — Dorcas. She was gasping for breath and unresponsive. I did as much as I could to help her, which is not much at that point. I held her hand and spoke to her so that she knew she wasn’t alone.

As I sat at Dorcas’ bedside, I could hear Alfred moaning in the next room. I went over to his bed. He was delirious and rolling back and forth. I took his hand and knelt down beside his bed. He turned to me and begged me not to send him home. I held his hand for awhile, assuring him that he didn’t have to go anywhere. The Liberian nurse and I went back and forth a few more times between the two of them. I could tell that my physical limit was being reached in PPE, but I couldn’t bear the thought of them both dying alone. Eventually, we had to leave them in God’s hands and exit the unit. They both died shortly afterwards.

The next day, it was a patient that would encourage me and remind me that what we are doing is making a difference in the lives of so many. Ester is a woman in her mid-forties. In the bed next to her is her son Saah. Saah is ten years old, but has the demeanor of someone much older. Despite having Ebola himself, he is consistently at his mother’s bedside, encouraging her to eat, drink and get better. When I went into their room the morning after Dorcas and Alfred died, both Saah and Ester were sitting at the end of their beds. When I asked Saah how he was doing, he calmly put down his cup of tea and told me that he was disappointed the hotdog he had for breakfast had been boiled and not fried. I then went over to Ester and congratulated her on how well she looked sitting up in her pretty, flowered dress. Ester threw her arms around me and, through tears, told me that when she arrived to our ETC, she was sure she was going to die. Still clutching my waist, she thanked me for helping her get better because now she has a chance of going home to take care of her children. Compassion can be very painful at times, but the more it requires of my own heart, the more I am convinced of its necessity and its value.

Many times, the greatest displays of courage and compassion come from the patients themselves. A few weeks ago, a 17-year-old girl named Bendu was admitted to the ETC. As she grew stronger — and without prompting — she began taking care of the many children that are without family on the unit. Everyone refers to her as mama Bendu. Shortly after Bendu was discharged from the unit, a three-year-old girl named Satta had to be admitted to the unit without family. We contacted Bendu and offered her a job, which she eagerly accepted. Not only does Bendu look after the little ones with great care, I am learning that she spends day and night caring for any person in need on that unit. She told me yesterday that she wants to become a nurse. I am humbled and amazed by the amount of courage, selflessness and compassion that exists within that one little woman.

Ebola is harsh and cruel, but little victories rob it of its power and keep us all hopeful. It’s hard not to smile as Joe and Solomon spend an entire night laughing at their own antics – too excited to sleep knowing they are going home in the morning. It’s encouraging to hear Bendu comfort Christine, who is now well enough to be upset and angry that Solomon is going home before her. It’s so gratifying to be able to tell Ester that her baby came into the unit, but tested negative and is waiting for her at home. These seemingly small victories are why we are here and why we are all willing to risk so much.

I hope everyone had a fun and safe Halloween! Take care!