Tuesday, February 24, 2015
Lynn takes on the Ebola fight in Sierra Leone. An Update
In August of 2014 Greatest Goal Ministries was forced to close our outpatient center in Sierra Leone due to the Ebola crisis. We joined the Ebola fight by shipping 4 containers of gloves, hand sanitizer, bleach and medical supplies through the Office of the First Lady of Sierra Leone. Our GGM staff was placed on paid leave with a core group continuing minimal operations. We began an outreach program to disabled communities across the country. In all we reached about 25 communities with food, medical supplies and Ebola teaching.
As the Executive Director and co-founder of GGM for the past 7 years I felt I needed to do more. On December 3, 2014 I left for Sierra Leone to work with Partners In Health (PIH) on the front lines of the Ebola crisis in Sierra Leone. My 6 week deployment ended January 11 but I was asked to continue as PIH Nursing director at a Government Hospital. I am scheduled to return to the USA around the first of April.
I know most of you have not heard from me for quite some
time. I understand the media in the USA has all but stopped with updates about the situation in West Africa. Ebola is definitely on the decrease but it still remains present which presents a risk to all of us involved in health care.
Travel restrictions with road blocks has been lifted but all businesses and restaurants must still close by 6:00 pm every day and no businesses open on Sundays. Sports and public gatherings are still banned as the state of emergency is still in effect.
Last week I became ill with a fever meeting case definition for Ebola.
I was transferred late at night last week by Ebola ambulance to the British run Ebola unit outside of Freetown. Having worked now for almost 12 weeks in Sierra Leone it was quite the experience to now be considered a possible Ebola patient. It was determined quite quickly that I was sick with a stomach infection and dehydration. I was discharged about 40 hours after my admission.
I am sharing this email to remind everyone that the fight is not yet over in this part of the world. Please continue to support and pray for all of us who are still on the front lines and the organizations that are supporting the Ebola efforts and the health care of these fragile nations. I am so grateful to the tent hospital that was built and run by the British Military to serve health care workers who become ill. It was an experience I will never forget and will be forever grateful that my diagnosis was something else.
The work and conditions are not easy here but I feel fortunate to have had the support of my family and friends to serve in Sierra Leone during this devastating health care crisis. I have made so many friends and will never forget the time that we worked together.
See you all in another month and then 3 weeks later after my quarantine. Until then lift up a prayer or thought for the people of West Africa and all of us still working to eradicate Ebola. The fight continues.
--
Lynn Pelton
Executive Director
Greatest Goal Ministries USA
Web: www.ggmusa.org
Tuesday, December 23, 2014
December 22: An update from Lynn in Sierre Leone
December 22
It is hard for me to believe that Christmas is only a few days away. The hours and days are flying by in a whirl and every day seems the same: Wake up at 6:30. In our vehicle at 8:00. Arrive at the ETU at 8:30. Morning report and we are off and running. Our day ends about 6:30 or later, then there’s a half hour drive home through three check points each way. We have something to eat, check our email and then go to sleep. The next day we start again. We have had one day off since we arrived.
I think about Christmas in the states; the lights, the decorations, the hustle and bustle that is all part of the holiday scene. There is a stark contrast in Sierra Leone this year. The celebration of Christmas in this country has essentially been cancelled. Christmas is usually celebrated by Muslims in some way and by all the Christians. It is normally very festive with big gatherings in private homes and villages. Most people take time off work from December 22 - January 5. People travel the long distances from the capital of Freetown to the provinces and their home village… but not this year. This year Ebola has changed everything. I understand that the media in the United States has all but quit writing about the toll Ebola is still taking, but here on the ground the fight is far from over. Some have told me we have not yet seen the peak in Sierra Leone.
The government has issued another lockdown through at least Christmas, perhaps longer. No one will be allowed to travel through check points unless for authorized Ebola business. You must also have a valid sticker in your vehicle and a name badge. Even sending our patients home is impacted now.
The new curfew went into effect Saturday at noon. All shops and businesses were shut down from Saturday at noon to Monday morning. All businesses, restaurants, etc. must close this week at 6:00. No public gatherings are allowed and all beaches are banned. Normally the beaches would be packed with people enjoying the holiday. House to house searches for the sick begins on Monday.
We have been extremely busy with 32 patients admitted in one day last Tuesday and on average 10-15 admissions each day. About one fourth of our patients survive at this time but we are working hard to change that and increase the survival rate. We reunited three Ebola-positive survival mothers with their infants last week. One was a set of 10 month twins, and two other babies just a few months old. No one knows yet why the nursing children did not get sick, but we thank God for their survival. We had placed the children in an interim care center where they were watched. And the system worked when it was time for discharge. It was a day of giving thanks and spreading hope as we watched the mothers receive their children.
As we celebrate the birth of Christ and gather with friends and loved ones, please take a moment to remember those living in West Africa suffering through this Ebola crisis and those helping to fight it. I have only been here about 3 weeks and I am tired. The Nationals, Doctors without Borders and others have been fighting it for as long as 6 months.
Progress is being made but no end is yet in sight. Prayer and more people on the ground joining the fight is the only way this will end.
A very Merry Christmas to all!
Lynn
It is hard for me to believe that Christmas is only a few days away. The hours and days are flying by in a whirl and every day seems the same: Wake up at 6:30. In our vehicle at 8:00. Arrive at the ETU at 8:30. Morning report and we are off and running. Our day ends about 6:30 or later, then there’s a half hour drive home through three check points each way. We have something to eat, check our email and then go to sleep. The next day we start again. We have had one day off since we arrived.
I think about Christmas in the states; the lights, the decorations, the hustle and bustle that is all part of the holiday scene. There is a stark contrast in Sierra Leone this year. The celebration of Christmas in this country has essentially been cancelled. Christmas is usually celebrated by Muslims in some way and by all the Christians. It is normally very festive with big gatherings in private homes and villages. Most people take time off work from December 22 - January 5. People travel the long distances from the capital of Freetown to the provinces and their home village… but not this year. This year Ebola has changed everything. I understand that the media in the United States has all but quit writing about the toll Ebola is still taking, but here on the ground the fight is far from over. Some have told me we have not yet seen the peak in Sierra Leone.
The government has issued another lockdown through at least Christmas, perhaps longer. No one will be allowed to travel through check points unless for authorized Ebola business. You must also have a valid sticker in your vehicle and a name badge. Even sending our patients home is impacted now.
The new curfew went into effect Saturday at noon. All shops and businesses were shut down from Saturday at noon to Monday morning. All businesses, restaurants, etc. must close this week at 6:00. No public gatherings are allowed and all beaches are banned. Normally the beaches would be packed with people enjoying the holiday. House to house searches for the sick begins on Monday.
We have been extremely busy with 32 patients admitted in one day last Tuesday and on average 10-15 admissions each day. About one fourth of our patients survive at this time but we are working hard to change that and increase the survival rate. We reunited three Ebola-positive survival mothers with their infants last week. One was a set of 10 month twins, and two other babies just a few months old. No one knows yet why the nursing children did not get sick, but we thank God for their survival. We had placed the children in an interim care center where they were watched. And the system worked when it was time for discharge. It was a day of giving thanks and spreading hope as we watched the mothers receive their children.
As we celebrate the birth of Christ and gather with friends and loved ones, please take a moment to remember those living in West Africa suffering through this Ebola crisis and those helping to fight it. I have only been here about 3 weeks and I am tired. The Nationals, Doctors without Borders and others have been fighting it for as long as 6 months.
Progress is being made but no end is yet in sight. Prayer and more people on the ground joining the fight is the only way this will end.
A very Merry Christmas to all!
Lynn
Monday, December 15, 2014
Photos from Lynn time with Partners in Health
Lynn Pelton has sent us the following pictures of her stay during the Ebola Crisis
The picture of the bags is food for the survivors from the World Food Program. Each surviving patient receives a 50kg bag of rice, a bag of lentils, a bag of fortified cereal, a bag of salt and oil. They also get a blanket, a water container and water purification tablets.
This mother and baby are happy survivors. The woman's face is darkened to protect her privacy.
The picture of Lynn bending over the little girl in the wheelchair: Admitting a 5 year-old orphan girl. The rest of her family died. She had to be assisted from the ambulance and was quite ill.
The man in green is holding a certificate showing that he is an Ebola survivor.
The picture of the woman tying the ribbon on the tree is a survivor. They tie these ribbons to “The Tree of Hope.”
The photos showing the blue tarps are of the triage area. The ambulance pulls into the area near the awning
Thursday, December 11, 2014
Third Installment with PIH
December 6
When an ambulance arrives at the ETU they back into our triage holding area, the doors are opened and if possible the patient gets out on their own. If they cannot, a makeshift stretcher made of a body bag attached to large tree branches with thick plastic ties is used to carry them out. Everything must be sprayed with a 0.5% chlorine solution. We wash all day in a 0.05% chlorine solution. Bleach at the 0.5% or higher can burn the skin and cause respiratory problems so it is vital to keep this watched. Unfortunately, though, there are problems every day with people being affected by this chlorine.
If the patient needs assistance, a team from the ETU ward must don their PPE and assist the patient. Every person wearing a PPE has a buddy in case one of them has any problems such as the mask riding up and covering the eyes or the face shield sliding down and covering the eyes …or becoming overwhelmed and almost passing out. Every one of these things has happened to one of our team members in just the past few days. It is much like scuba diving where you have a buddy watching your back and, if one of the two is having problems, then both must go to the surface. If one of the buddies has any difficulty in the ETU, both leave together with one trying to keep the other out of trouble. The buddy team also has a sprayer moving with them.
The most troubling to me is when a mother arrives with small children or when children arrive after their parents have died. Just in the past two days we had a mother and her 10 month-old twins admitted; the mother is quite sick. Another mother arrived with a 6 week-old baby and both are sick. Another mother arrived with her 8 year-old daughter – both sick, and a 7 year-old boy arrived whose parents have died. Also admitted were a 7 year-old girl with bleeding gums whose parents have died and a 4 year-old girl who had been staying with her grandfather while the mother was being treated at our ETU. The child was tested and observed in the suspect ward at the government hospital Ebola center. On November 26th the 4 year-old went home with two negative PCR tests. On December 5th the mother became a survivor only to return home and find her daughter very sick. She arrived this morning at our center. Either she was not far enough along to test positive or she was exposed in the ward. Because she was a survivor, we asked if the mother could remain in the ward to help her daughter. It was decided by the experts that there was not enough data to allow the mother total exposure again as she might fall victim to Ebola for a second time. I am afraid the 4 year-old may not make it through the night tonight. Another child that arrived today was a 3 month-old baby. Baby John Doe was brought in by a WHO surveillance ambulance. They had gone to a village to check on another baby and then discovered this sick baby where the parents had died. The baby was brought in with no name or other identifying information. The patients most likely to succumb to Ebola are the very young, anyone over the age of 60, a pregnant woman, those who are immune-compromised or have another co-morbidity. The surveillance team found a woman survivor to carry the baby and bring her to us. We now have four babies under 6 months old who will hardly be touched and must be monitored in a very difficult environment. Ebola is leaving an extremely high number of orphans.
If a patient comes to triage and does not have a fever or does not fit the other criteria, they are discharged. They receive a letter which advises them to return if their condition changes and that PIH will pay for their transportation home since the ambulance is now gone. When a patient arrives who is confirmed, the intake paperwork is completed. They will be treated with standard admission medication. Malarial medication, iron, vitamins, and paracetamol (same as acetaminophen). The remainder of the treatment course will occur on the ward. A confirmed case will go directly to a confirmed ward, either wet (if bleeding, vomiting or diarrhea), or a dry ward if none of those.
If the patient is a suspect case they will be treated as if they have Ebola until proven otherwise. Patients are separated into wet and dry wards and also separated from each other. A person must have fever for three days before the PCR (Ebola blood test) is drawn. If positive they will be moved to the confirmed ward. If negative the test will be repeated in another three days. If still negative they will be discharged and will continue to be observed for at home for the next 21 days. If positive they will be moved to the confirmed ward.
With four large whiteboards we nurses in triage coordinate the movement of patients according to the lab results. Everything rides on those tests. When a patient gets well we re-test the patient and if negative they will be discharged.
Discharge is a wonderful ceremony. The patient will take a shower and be given new clothes and shoes. All personal items are burned including clothes, shoes, cell phones or even any money. The patient passes through the exit gate and is taken to the front entrance to triage. The World Food Program provides a 50 pound bag of rice, 25 pounds of beans and cereals, salt, oil, a blanket, a plastic container and chlorine tablets to purify the water as well as a bucket and soap. They are also given money for transportation home. Before they leave we have them tie a ribbon on our “TREE of HOPE” and then I always say “Bye Bye Ebola!!” We assemble as many nurses and people as possible to celebrate this survivor and they are given a certificate. It is this ray of hope from our “Tree of Hope Survivors” that helps us keep working through all the tragedy during the rest of the day. Our PIH goal is to have only a 10% death rate, which is possible if we can treat patients early enough.
Next posting: What is being done about all the orphans and what are some of the other duties in the triage area?
Please continue to pray for all our health care workers that they may remain Ebola-free and pray for these West African people who are an absolute joy to work with and who do not deserve such a horrific humanitarian crisis.
God Bless,
Lynn
When an ambulance arrives at the ETU they back into our triage holding area, the doors are opened and if possible the patient gets out on their own. If they cannot, a makeshift stretcher made of a body bag attached to large tree branches with thick plastic ties is used to carry them out. Everything must be sprayed with a 0.5% chlorine solution. We wash all day in a 0.05% chlorine solution. Bleach at the 0.5% or higher can burn the skin and cause respiratory problems so it is vital to keep this watched. Unfortunately, though, there are problems every day with people being affected by this chlorine.
If the patient needs assistance, a team from the ETU ward must don their PPE and assist the patient. Every person wearing a PPE has a buddy in case one of them has any problems such as the mask riding up and covering the eyes or the face shield sliding down and covering the eyes …or becoming overwhelmed and almost passing out. Every one of these things has happened to one of our team members in just the past few days. It is much like scuba diving where you have a buddy watching your back and, if one of the two is having problems, then both must go to the surface. If one of the buddies has any difficulty in the ETU, both leave together with one trying to keep the other out of trouble. The buddy team also has a sprayer moving with them.
The most troubling to me is when a mother arrives with small children or when children arrive after their parents have died. Just in the past two days we had a mother and her 10 month-old twins admitted; the mother is quite sick. Another mother arrived with a 6 week-old baby and both are sick. Another mother arrived with her 8 year-old daughter – both sick, and a 7 year-old boy arrived whose parents have died. Also admitted were a 7 year-old girl with bleeding gums whose parents have died and a 4 year-old girl who had been staying with her grandfather while the mother was being treated at our ETU. The child was tested and observed in the suspect ward at the government hospital Ebola center. On November 26th the 4 year-old went home with two negative PCR tests. On December 5th the mother became a survivor only to return home and find her daughter very sick. She arrived this morning at our center. Either she was not far enough along to test positive or she was exposed in the ward. Because she was a survivor, we asked if the mother could remain in the ward to help her daughter. It was decided by the experts that there was not enough data to allow the mother total exposure again as she might fall victim to Ebola for a second time. I am afraid the 4 year-old may not make it through the night tonight. Another child that arrived today was a 3 month-old baby. Baby John Doe was brought in by a WHO surveillance ambulance. They had gone to a village to check on another baby and then discovered this sick baby where the parents had died. The baby was brought in with no name or other identifying information. The patients most likely to succumb to Ebola are the very young, anyone over the age of 60, a pregnant woman, those who are immune-compromised or have another co-morbidity. The surveillance team found a woman survivor to carry the baby and bring her to us. We now have four babies under 6 months old who will hardly be touched and must be monitored in a very difficult environment. Ebola is leaving an extremely high number of orphans.
If a patient comes to triage and does not have a fever or does not fit the other criteria, they are discharged. They receive a letter which advises them to return if their condition changes and that PIH will pay for their transportation home since the ambulance is now gone. When a patient arrives who is confirmed, the intake paperwork is completed. They will be treated with standard admission medication. Malarial medication, iron, vitamins, and paracetamol (same as acetaminophen). The remainder of the treatment course will occur on the ward. A confirmed case will go directly to a confirmed ward, either wet (if bleeding, vomiting or diarrhea), or a dry ward if none of those.
If the patient is a suspect case they will be treated as if they have Ebola until proven otherwise. Patients are separated into wet and dry wards and also separated from each other. A person must have fever for three days before the PCR (Ebola blood test) is drawn. If positive they will be moved to the confirmed ward. If negative the test will be repeated in another three days. If still negative they will be discharged and will continue to be observed for at home for the next 21 days. If positive they will be moved to the confirmed ward.
With four large whiteboards we nurses in triage coordinate the movement of patients according to the lab results. Everything rides on those tests. When a patient gets well we re-test the patient and if negative they will be discharged.
Discharge is a wonderful ceremony. The patient will take a shower and be given new clothes and shoes. All personal items are burned including clothes, shoes, cell phones or even any money. The patient passes through the exit gate and is taken to the front entrance to triage. The World Food Program provides a 50 pound bag of rice, 25 pounds of beans and cereals, salt, oil, a blanket, a plastic container and chlorine tablets to purify the water as well as a bucket and soap. They are also given money for transportation home. Before they leave we have them tie a ribbon on our “TREE of HOPE” and then I always say “Bye Bye Ebola!!” We assemble as many nurses and people as possible to celebrate this survivor and they are given a certificate. It is this ray of hope from our “Tree of Hope Survivors” that helps us keep working through all the tragedy during the rest of the day. Our PIH goal is to have only a 10% death rate, which is possible if we can treat patients early enough.
Next posting: What is being done about all the orphans and what are some of the other duties in the triage area?
Please continue to pray for all our health care workers that they may remain Ebola-free and pray for these West African people who are an absolute joy to work with and who do not deserve such a horrific humanitarian crisis.
God Bless,
Lynn
Second Installment with PIH
December 5
We just spent our second day at the PIH Ebola Treatment Unit (ETU) and the government hospital Ebola treatment center. My cohort is still in training. There are about eleven expats that were here when my cohort of nine arrived. PIH will be sending more teams every week. The PIH ETU is free standing and the organization has complete control. (A 'unit' is a structure exclusively seeing Ebola cases. A 'center' is a series of units that have been constructed at a healthcare center or hospital.) PIH has just started work at the government hospital's Ebola center and currently there is only one nurse and one infectious disease physician, both Americans, in addition to the national staff. PIH's presence will increase, but for now they are trying to learn what is being done and then integrate within. For that reason I am going to talk primarily about the Ebola unit.
Yesterday we observed the donning (put on) and doffing (taking off) of our PPE. Today we actually put it on and removed it. I received an accidental superficial cut on my inner forearm. Until it heals I cannot enter the "hot zone". After practicing, the rest of my cohort had a tour of the "hot zone" in their gear. I assisted in triage where I hope to be placed after training. The unit is set up with a triage area where an ambulance or vehicle can back in. This area is constructed of thin tree logs nailed together and covered with a tarp. It is about 3.5 - 4 feet high. The triage nurses then assess the situation in their PPE, taking a temperature and asking questions about exposure. Often it is a judgement call. If admitted they will go to the suspect ward and a lab test called a PCR will be drawn. It will take 2-4 days for the results to come in. During that time the patients are separated and will wait in one of seven wards. The attempt is made to keep them designated as 'wet' (known vomiting or diarrhea) or 'dry' (no vomiting or diarrhea). Sometimes children are brought in alone, sometimes it may be obvious what should be done other times it is a judgement call because the protocol is not an exact science.
Here is an example that happened today: A woman arrived by ambulance with a four month old baby. The baby was not sick but the nursing mother did fit the criteria for admission. What do you do? If the mother tests positive and the baby remains with her, the baby will probably become sick and may die. But where does the baby go? The triage area is not sheltered from the sun and until a decision was made the mother had to lie on the ground with her baby and wait. All patients are treated for fever with acetaminophen and preventative malaria medicine. We attempted to call UNICEF about the baby, but we could only leave a message. After three hours the decision was made to admit mother and baby. There was no other choice. But just as the name band was being placed on the baby, a representative from UNICEF arrived. With the mother's permission the child was taken by a caregiver.
The stories are tragic but people are surviving. Today we had five patients to discharge and tomorrow an additional five will be ready to go home. Stay tuned to read more about what happens after someone is admitted as a suspect and then found positive for Ebola. I'll describe what is it like to wear PPE and the celebration that happens for all survivors. I'll also share stories about patients and what it is like to be working at the ETU.
Please keep the workers and people of Sierra Leone in your thoughts and prayers. The motto at our center is "Pee Ebola out of Sierra Leone," meaning that with basic nursing care and hydration people are surviving. But there must be people willing to provide care and still be safe.
We just spent our second day at the PIH Ebola Treatment Unit (ETU) and the government hospital Ebola treatment center. My cohort is still in training. There are about eleven expats that were here when my cohort of nine arrived. PIH will be sending more teams every week. The PIH ETU is free standing and the organization has complete control. (A 'unit' is a structure exclusively seeing Ebola cases. A 'center' is a series of units that have been constructed at a healthcare center or hospital.) PIH has just started work at the government hospital's Ebola center and currently there is only one nurse and one infectious disease physician, both Americans, in addition to the national staff. PIH's presence will increase, but for now they are trying to learn what is being done and then integrate within. For that reason I am going to talk primarily about the Ebola unit.
Yesterday we observed the donning (put on) and doffing (taking off) of our PPE. Today we actually put it on and removed it. I received an accidental superficial cut on my inner forearm. Until it heals I cannot enter the "hot zone". After practicing, the rest of my cohort had a tour of the "hot zone" in their gear. I assisted in triage where I hope to be placed after training. The unit is set up with a triage area where an ambulance or vehicle can back in. This area is constructed of thin tree logs nailed together and covered with a tarp. It is about 3.5 - 4 feet high. The triage nurses then assess the situation in their PPE, taking a temperature and asking questions about exposure. Often it is a judgement call. If admitted they will go to the suspect ward and a lab test called a PCR will be drawn. It will take 2-4 days for the results to come in. During that time the patients are separated and will wait in one of seven wards. The attempt is made to keep them designated as 'wet' (known vomiting or diarrhea) or 'dry' (no vomiting or diarrhea). Sometimes children are brought in alone, sometimes it may be obvious what should be done other times it is a judgement call because the protocol is not an exact science.
Here is an example that happened today: A woman arrived by ambulance with a four month old baby. The baby was not sick but the nursing mother did fit the criteria for admission. What do you do? If the mother tests positive and the baby remains with her, the baby will probably become sick and may die. But where does the baby go? The triage area is not sheltered from the sun and until a decision was made the mother had to lie on the ground with her baby and wait. All patients are treated for fever with acetaminophen and preventative malaria medicine. We attempted to call UNICEF about the baby, but we could only leave a message. After three hours the decision was made to admit mother and baby. There was no other choice. But just as the name band was being placed on the baby, a representative from UNICEF arrived. With the mother's permission the child was taken by a caregiver.
The stories are tragic but people are surviving. Today we had five patients to discharge and tomorrow an additional five will be ready to go home. Stay tuned to read more about what happens after someone is admitted as a suspect and then found positive for Ebola. I'll describe what is it like to wear PPE and the celebration that happens for all survivors. I'll also share stories about patients and what it is like to be working at the ETU.
Please keep the workers and people of Sierra Leone in your thoughts and prayers. The motto at our center is "Pee Ebola out of Sierra Leone," meaning that with basic nursing care and hydration people are surviving. But there must be people willing to provide care and still be safe.
Lynn's first days with PIH (Partners in Health)
December 1
Today I boarded a plane for Boston — the first leg of my journey to Sierra Leone. This is a trip I have made several times a year for the past seven years. But this time it is different. Instead of traveling or leading a group as Executive Director and co-founder of Greatest Goal Ministries USA (GGM), I am traveling as part of a team of medical professionals with an organization called Partners in Health (PIH). The founder of PIH, Paul Farmer, is the subject of the book “Mountains Beyond Mountains” by Tracy Kidder about his work with tuberculosis patients in Haiti. He is also the chairman of the Department of Global Health and Social Medicine at Harvard Medical School.
As a new part-time employee of PIH I will have a one day orientation at their Boston headquarters before I head out. At this point in time I have limited information. I do know that I will depart for Sierra Leone on Tuesday afternoon traveling to Newark, NJ then to Brussels, Belgium. We will arrive on Wednesday December 3 about 7:00 pm in Sierra Leone. I know that PIH had hoped to send 50 of us to Sierra Leone over a three week period. I don't yet know where we will be working in Sierra Leone or how many will be on my team and traveling with me.
To prepare for this adventure I updated my vaccinations; yellow fever immunization is mandatory to enter the country and hepatitis, typhoid, Polio, MMR and DPT must be current. This was all verified and a thorough physical examination form was completed by my primary care doctor and faxed to PIH. Ten days later a physician from PIH reviewed my medications and health history. He informed me that, provided there is no breach in protocol, I will be considered low risk upon my return. This means I will have some movement restriction for 21 days. I will not be able to go to restaurants, grocery stores or the health club. I will also not be able to provide patient care at my nursing job until after my 21 day monitoring period is over. I will need to take my temperature twice per day and I will be called for those temperature readings each day by a physician from PIH and one from our local public health department.
December 2
Orientation began at 8:30 a.m. in Boston at the Partners in Health offices. Introductions started the program and we all soon discovered that we had traveled from all over the country. There were about 14 of us in the room; six of us are headed to Sierra Leone and the other eight are going to Liberia. My cohort consists of myself and another female nurse, two physicians and two male nurses. We come from a variety of backgrounds, but we all have the same general reason for going to Sierra Leone — we know that someone needs to do this work, so why not us? Aside from myself, no one in my group has ever been to West Africa.
The orientation consisted of an overview of the current situation in Liberia and Sierra Leone and a very general review of protocols. Our safety was stressed again and again. We were told that the maximum length of time in our protective suits is 45 minutes to 1 hour. During that time we will lose an average of one and a half liters of water. Therefore we must drink a liter of water before entering the suits and another liter after the work is completed.
December 3
Today we left Boston heading to Newark for our flight to Brussels. We were delayed by several hours which meant that we might not make out flight out of Brussels to Sierra Leone. However, the shuttle bus that was to take us from one terminal to another was in an accident and we were delayed again for another hour. There were hundreds of us affected by that time, so most flights were held on the ground to allow us to board. We are now in the air headed to Sierra Leone. Tomorrow (Thursday) we begin our Personal Protective Equipment (PPE) training at Connaught Hospital in Freetown. This is called “cold” training and then after a couple days we begin our “hot” training as observers in an actual unit. Once that is over we head out to our assigned Ebola center where we will be working for the next four weeks.
December 4
We arrived at the airport last night only to learn we would not be going to Freetown at all. All our training will take place at our Ebola site. We spent the night at the Lungi airport and this morning after breakfast will take our 45 minute drive to our new home. We have been told to expect very rustic conditions.
Peace, hope, and love,
Lynn Pelton
Executive Director
Greatest Goal Ministries USA
Web: www.ggmusa.org
Today I boarded a plane for Boston — the first leg of my journey to Sierra Leone. This is a trip I have made several times a year for the past seven years. But this time it is different. Instead of traveling or leading a group as Executive Director and co-founder of Greatest Goal Ministries USA (GGM), I am traveling as part of a team of medical professionals with an organization called Partners in Health (PIH). The founder of PIH, Paul Farmer, is the subject of the book “Mountains Beyond Mountains” by Tracy Kidder about his work with tuberculosis patients in Haiti. He is also the chairman of the Department of Global Health and Social Medicine at Harvard Medical School.
As a new part-time employee of PIH I will have a one day orientation at their Boston headquarters before I head out. At this point in time I have limited information. I do know that I will depart for Sierra Leone on Tuesday afternoon traveling to Newark, NJ then to Brussels, Belgium. We will arrive on Wednesday December 3 about 7:00 pm in Sierra Leone. I know that PIH had hoped to send 50 of us to Sierra Leone over a three week period. I don't yet know where we will be working in Sierra Leone or how many will be on my team and traveling with me.
To prepare for this adventure I updated my vaccinations; yellow fever immunization is mandatory to enter the country and hepatitis, typhoid, Polio, MMR and DPT must be current. This was all verified and a thorough physical examination form was completed by my primary care doctor and faxed to PIH. Ten days later a physician from PIH reviewed my medications and health history. He informed me that, provided there is no breach in protocol, I will be considered low risk upon my return. This means I will have some movement restriction for 21 days. I will not be able to go to restaurants, grocery stores or the health club. I will also not be able to provide patient care at my nursing job until after my 21 day monitoring period is over. I will need to take my temperature twice per day and I will be called for those temperature readings each day by a physician from PIH and one from our local public health department.
December 2
Orientation began at 8:30 a.m. in Boston at the Partners in Health offices. Introductions started the program and we all soon discovered that we had traveled from all over the country. There were about 14 of us in the room; six of us are headed to Sierra Leone and the other eight are going to Liberia. My cohort consists of myself and another female nurse, two physicians and two male nurses. We come from a variety of backgrounds, but we all have the same general reason for going to Sierra Leone — we know that someone needs to do this work, so why not us? Aside from myself, no one in my group has ever been to West Africa.
The orientation consisted of an overview of the current situation in Liberia and Sierra Leone and a very general review of protocols. Our safety was stressed again and again. We were told that the maximum length of time in our protective suits is 45 minutes to 1 hour. During that time we will lose an average of one and a half liters of water. Therefore we must drink a liter of water before entering the suits and another liter after the work is completed.
December 3
Today we left Boston heading to Newark for our flight to Brussels. We were delayed by several hours which meant that we might not make out flight out of Brussels to Sierra Leone. However, the shuttle bus that was to take us from one terminal to another was in an accident and we were delayed again for another hour. There were hundreds of us affected by that time, so most flights were held on the ground to allow us to board. We are now in the air headed to Sierra Leone. Tomorrow (Thursday) we begin our Personal Protective Equipment (PPE) training at Connaught Hospital in Freetown. This is called “cold” training and then after a couple days we begin our “hot” training as observers in an actual unit. Once that is over we head out to our assigned Ebola center where we will be working for the next four weeks.
December 4
We arrived at the airport last night only to learn we would not be going to Freetown at all. All our training will take place at our Ebola site. We spent the night at the Lungi airport and this morning after breakfast will take our 45 minute drive to our new home. We have been told to expect very rustic conditions.
Peace, hope, and love,
Lynn Pelton
Executive Director
Greatest Goal Ministries USA
Web: www.ggmusa.org
Friday, March 29, 2013
An update of Salone from the Journal of Syndey
From the journal of Sydney who has emailed us from Africa during her trip with Greatest Goal Ministries.
Thursday March 21, 2013 ……The survey……
We set out in teams of 4, 2 GGM folks, and 2
interpreters, to start our survey. Fortunately, Kevin, the map guy, was
in my group. Good thing, because I could not look at the satellite map
and have a clue where we were, much less where I was supposed to go. But
Kevin kept me on the right path, and literally, some of it was just a rocky
path. We got quite a bit done. It was really interesting talking to all
the people and very distressing to see how so many have to live. Using
bushes for toilets, getting drinking water from streams, small children having
to carry large, heavy bucket of water on their heads for long distances to
bring water to their family, whether it came from the stream or from the GUMA
pipe, (govt water supply). People talked about the cholera epidemic that
happened here last fall. They say they wash hands after toileting,
but if your toilet is a bush, where do you wash? Many of them, during the
rainy season, put out buckets and bowls and collect rainwater. No one we
talked to today said they ever treated their water before drinking. My
interpreter, Augusta, said to me, “We are suffering. We need help.”
To me, the big question is, how do we help? The problems seem so
overwhelming. But that is a question for another day, I guess.
Friday, March 22, 2013 ……….Time in the clinic………
The end of a very long and hard week. But
also, a very good week. We accomplished a lot, but it is such a drop in
the bucket. Because I have such a sunburn I did not want to be out all
day doing the survey in the hot sun, so I stayed at the clinic. My
purpose was to do some observing of how things are going, what needs
improvement, how to get better organized, etc. I started off in the
infusion room, because when I had been trying to save the dying lady, the
supplies I needed to start an IV, weren’t all there. Basic things, like
gloves. And because by that time it was a very urgent issue, people were
scrambling to get me what I needed. So, today, I searched around the
clinic to figure out where things are. We had been assured that everything
was well organized, that even tho stuff was in boxes, the boxes were all
labeled with the contents. So I started my search for gloves, and after I
had searched down keys to the different storerooms, I found 3 boxes labeled
“gloves”. The problem was, they did not contain gloves. However,
the four large boxes on a shelf I could not reach, and were not labeled, did
contain gloves. In fact, very little was labeled with what was actually
in them. TIA. So Dean, the military guy, took over and actually got
some stuff organized.
In the meantime, I was often taking care of
medical stuff. A 2 year old who had had 3-5 seizures on Wed. She
was the daughter of one of the men who has done some work around the hospital,
so I was instructed by Lynn to be the one to see her. Since she is not
actively seizing at the moment, I did not want to give her anything, and we are
not equipped to diagnose a seizure disorder. So I sent her to
Childrens. I saw a tiny, tiny 3 week old whose parents brought him in
because they said he was vomiting blood. He checked out ok so we sent him
home with instructions to go to the children’s hospital if it happened again.
We had a pt with confirmed cholera. I had to talk with her about where
they get their water, where they go to toilet (poop), hand washing, gave her
money to buy soap. They use the GUMA water, so that should be ok, but
they share a toilet with other neighbors. That unfortunately could be a
problem, and if they don’t use good hygiene there could be more cholera.
Not good.
The best part about being here always is the
kids! I love to see the precious babies in the clinic, even though my
white face sometimes scares them. I love how they come closer and closer
and some want to touch my white (now fairly red!) skin, I am fascinated by how
the moms can sling them onto their backs and with even the tiny ones that just
seem to hold on, tie the babies into the sling on their backs. When we
are out and about, they are so fun to play with, and the kids walking back and
forth to school like to slap your outstretched hands as they walk by.
Friday, March 22, 2013 ………..Dinner……..
Dinner on the beach was its usual
adventure. We had two neighboring restaurants, and as always, I use that
term lightly, competing for our business. They were literally begging us,
but we had to choose just one. After we had placed our order, barracuda
and chips for some, lobster and chips for the rest, a man approached and wanted
us to look at his arm which he said had been hurt in an accident. There
was a grimy bandage covering his arm, so Lynn said we would look at it.
She had to walk back up to the house to get the first aid kit, then she and I
took the dressing off, by flashlight, of course, and discovered a 4 inch wound
that had been sutured closed. It was a little swollen, and difficult to
evaluate in the dark. We debated taking the sutures out and draining the
wound, but decided not to at this point. I cleaned it up, covered it back
up, and Lynn stared him on antibiotics and he is supposed to see me on
Monday. Of course we had a crowd around us by this point, and everybody
now had something wrong that they wanted us to take care of. Finally we
just told them to see us at our hospital on Monday. After doing all this,
our dinners still hadn’t arrived, but it was very good when it did. All
in all, just another typical day in Africa!
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