First day in the red zone. The unit is divided into 3 areas: green, orange, red. Green is the office; a huge white board takes up one wall, outlining details of the patients in our 15 beds. The office is busy with staff and personnel; it takes a team of about 8 providers and cleaners to run each shift of this complex operation. Orange zone is where we change into personal protective equipment (PPE); red zone is the patients’ quarters, the morgue, and the decontamination area.
I am in the orange zone with a colleague, suiting up. I tuck my scrubs into rubber boots and step into the white, hooded Tyvek suit, then cover the front with a white plastic apron. Next, mask with face shield, sprayed with essential anti-fogging solution. Double layer of long gloves that reach the elbows. Check in a mirror, then check my colleague.
|Me in full personal protective equipment (PPE), ready to enter the red zone.|
My scrubs are already drenched with sweat; a trickle starts down my spine. We step in a shallow basin of chlorine, then into the red zone, moving very deliberately despite the heat. One can tolerate the heat and claustrophobia of PPE for only so long; we try to spend a maximum of 2.5 hours at a time in the unit to avoid heat exhaustion.
We make our rounds on the patients, administering medications, encouraging hydration. One new admission, a young man, relatively well and unlikely to test positive for Ebola based on his symptoms, beckons me over to tell me I look like the devil. I’m sure our white suits have many negative connotations for the patients; I try to explain in broken Krio that I wear the suit to protect him, not just me.
Just a few weeks ago, over half the patients in the unit would test positive for Ebola. Now, thankfully, the number of positive cases has dropped, likely due to a culmination of efforts to improve country-wide coordination. Several new Ebola Treatment Units (ETU) opened up in the Freetown area recently too, making it possible to truly isolate positive cases, breaking the chain of transmission.
Only recently has this unit been able to be the ‘holding unit’ it intended to be. The new ETUs make it possible to quickly transfer out patients who test positive for Ebola, reducing the risk of transmission to Ebola-negative patients in the unit.
We finish our rounds and head to the decontamination room. Methodically, meticulously, we pull off the layers of protection. Between each step, we wash our hands under running chlorinated water, watching the second-hand on the clock to make sure we don’t cut corners. The process of PPE removal, better known as ‘doffing’, takes about 20 minutes. The hint of a breeze on my face after removing my face shield is utter bliss.