Saturday, April 18, 2015


I wrote a post in December in which I talked about Mariatu, a 9 year old girl with profound neurological symptoms that we saw in the confirmed ward. Those of us who took care of her had serious doubts that she would survive, but we put a lot of work into taking care of her.

Our hard work paid off and she got better. During my last trip through the Ebola treatment unit (ETU), Mariatu smiled at me, which was the best going-away gift I could have received.

A few of months ago, Christian Bain sent me photographs of Mariatu as she was being discharged from the ETU. She was gaunt, but she was smiling and she was an Ebola survivor.

I wondered what happened to her after she was discharged from the ETU. Was she able to go home? Did she have family to go home to? Did she have residual neurological deficits? I asked some of my colleagues who were in Sierra Leone about her. Martha Phillips wrote, "She was discharged to Government Hospital and nearly died there, but Guy and Christian and Dani [Kloepper] intervened, and she did survive."

This week Christian and Dani sent me some recent photographs of her. She's home with her family and she looks great! Those photographs make me very happy and I wish I could share them with you, but Mariatu is a former patient of mine and I am ethically, if not legally obliged to respect her confidentiality.

Mariatu's survival was due to the hard work of a lot of people. Working with her was usually a two- and sometimes a three-person job. Although she was able to sit up and feed herself when I left, she was still very sick. I doubt that Mariatu would have survived without the care that she received and the guidance that I received from Tracy Kelly, a pediatric nurse practitioner.

For me, Mariatu's survival is the pinnacle of all of the successes we achieved in Maforki. Caring for her was challenging; it required investments of time, effort, and compassion from a group of outstanding health care providers. Those of us who cared for Mariatu ran the risk of suffering disappointment and heartbreak if she died. I don't think any of us felt that it was a risk not worth taking.

Thank you Christian and Dani for the joy the photographs of Mariatu give me. Thank you for your part in her survival.

Thank you to all of my colleagues at Maforki.

Monday, April 13, 2015

Demolishing the Maforki Ebola Treatment Unit

Christian Bain is one of the extraordinary nurses I worked with in Port Loko. He arrived in Sierra Leone shortly after I did and stayed after I left. He was recently evacuated with 15 other people who had been exposed to another health worker who developed Ebola virus disease (EVD). He's back in Sierra Leone and has been sending me photographs of the Maforki Ebola Treatment Unit (ETU) as it is being demolished:


 Of the four of us who arrived in Maforki in early November, Chris, Jennifer, Larry, and me, I am the only person who has not returned to Sierra Leone. Larry was one of the people evacuated last month. Chris and Jennifer are still there.

Chris and Larry

Jennifer with Paul Farmer

One of the doctors who arrived in Port Loko shortly before I left noted that I was "outside of the demographic"; I was the only person with a young child at home. The rest either had no children or had adult children.

I don't know what happened at the government hospital in Port Loko. I don't even know the name of the health worker who developed EVD and was evacuated to National Institutes of Health Clinical Center. I never saw the inside of the government hospital while I was in Port Loko.

I can tell you that, after taking the CDC's Ebola safety course, I felt adequately prepared to work in an ETU. One of the things we were told repeatedly is that our own safety was our first priority and not to walk into a situation in which there was any doubt about our personal safety. I took that message very seriously.

I will also tell you that I worked with some of the most admirable, compassionate people I have ever met, many of whom quit jobs to work in the Ebola response. Everyone I worked with, both expatriate and local staff, was highly professional and brought a wealth of knowledge, skills, and experiences to the table. Working with them was one of the most rewarding experiences of my life.


The Ebola epidemic is not over and there is still a lot of work that needs to be done. Because immunization programs were interrupted by the epidemic, there could be more measles deaths than Ebola deaths in West Africa. Other health care services were unavailable during the epidemic and many children are only now returning to school.

Partners In Health and other non-governmental organizations will remain in West Africa after the Ebola epidemic ends to help rebuild the health care infrastructure. I would be proud to work with PIH again.

A couple of my colleagues in Port Loko have blogs that I highly recommend:

A Canticle for Lazarus Martha Phillips arrived in Port Loko shortly before I left. Her writing is heartfelt, poetic, and inspiring. Time spent reading her blog is time well-spent!

Nurse Nick Nick Sarchet is quoted in the New York Times article published yesterday about Partners In Health and their work in Port Loko. Nick had an exposure while I was in Port Loko and was evacuated in December (Breach). He returned to Sierra Leone in February and was evacuated again last month.

Nick and Paul Farmer

Christian and me