Written by Mike Robinson
Published by Wellington Advertiser on Friday, January 9, 2015
Local nurse Dorothy McEachern is back in the west African nation of Liberia, assisting victims of the Ebola virus.
McEachern, who was in Liberia for a month in 2014, spoke with the Advertiser in late December, just prior to her departure for her second trip to Liberia.
The Fergus resident works at both Groves Memorial Community Hospital and Grand River Family Physicians. She says it is difficult for Canadians to grasp what is happening in Liberia.
“Ebola has wiped out complete villages-they’re gone,” she said.
In the summer of 2014, through the Samaritan’s Purse organization , McEachern spent a month in Liberia.
“It was rainy season … so it rained every day,” she said.
Workers in the Ebola care unit worked 12-hour shifts dressed in PPE (personal protective equipment). McEachern explained it takes between 10 to 15 minutes to get into the PPE and another 10 minutes to decontaminate. Every part of the person’s body is covered, she adds.
“It is a whole protocol you cannot deviate from,” she said.
Part of the covering includes two pair of gloves that are duct-taped over the Tyvek protective suit, used in industry to protect the wearer from any fluids.
McEachern noted clinic workers eventually donned a different type of protective gear, which she compared to wearing Saran Wrap.
“You are totally soaked when you come out (being sealed in, in a hot environment),” she said.
And while an hour is the accepted norm for being in such gear, “we were (often) in for two or three hours at a time. There was just too much to do.”
Even so, the group she was working with ended up being evacuated.
She explained Samaritan’s Purse had to pull out from the clinic because staff could not keep up with the workload and the number of cases.
“It was definitely a country-wide emergency and we could not keep up.”
McEachern explained Samaritan’s Purse had been in Liberia for about a decade doing work such as water treatment, building schools and orphanages-so it was established in the country when Ebola hit.
Because of that, the organization offered to help because it already had medical teams in place that could assist.
She noted the group Doctors Without Borders, which had pulled out of Liberia at the time because the organization could not keep up with its efforts in Sierra Leone and Guinea, asked Samaritan’s Purse to take over the Ebola treatment centres in Liberia.
Additional staff were brought in, as well a Liberians who were trained on site … such as nurses and those trained in decontamination procedures.
“We were working with the Liberians … but it just got out of hand, we could not keep up,” McEachern said.
“You can’t turn people away—there is nowhere for them to go.”
McEachern noted the hospital beside the clinic she was at closed down because it was being contaminated by people who were ill.
Describing her work in the treatment wards, McEachern explained, “We would go in inside the protective gear in groups of two or four—never alone. But we did not have enough people to provide the care needed by the Ebola victims.
“You have to feed them, clean them. When they get bad there is vomiting, diarrhea—they need to drink but are too weak—you have to help them.”
Staff were trying to operate IV units, but were also unable to leave patients unmonitored with the IV.
“We were looking after a 15-bed unit and there were 20 people there … and another six came in.”
Finally the government called a state of emergency and brought the World Health Organization in.
At that time, Doctors Without Borders returned, McEachern said, and the Liberians basically took over.
That was a good thing for the clinic, after Canadian Dr. Kent Brantly and the two of the Americans on staff became infected.
At that point, the Liberians who had been with the team didn’t show up for work, McEachern said.
“They were scared, we were all scared. We all thought we had Ebola-because the symptoms in the beginning are so nondescript.
“It could be anything from the stomach flu, malaria-the symptoms are the same at the beginning.”
She said when the Doctors Without Borders organization returned, more Liberians were convinced to return and Samaritan’s Purse pulled out.
At the time, the organization was trying to create a 60-bed treatment centre and the people rioted.
“People thought we were bringing Ebola to them, but we were trying to help them,” she said.
Several months later, McEachern has returned to Liberia for three months to continue that aid. While still with Samaritan’s Purse, McEachern is in a different role.
She explained kits are being distributed to all the remote villages containing chlorine, a raincoat, boots, masks goggles, gloves … all the materials needed to care for someone.
Additionally, the kits contain ORS (oral rehydration solution) and “we’re training them in the villages to look after their own people.”
The plan is to create 15 community care centres close to remote areas and train the Liberians to look after those infected. This approach has no invasive treatment, she said.
“It is only looking after them and keeping them isolated. The isolation is needed to prevent the spread of the disease,” she said. “Hopefully this approach will help eliminate the Ebola.”
In her new role of community care centre coordinator, McEachern will travel to the hot spots—like northern Liberia.
She says religious and local beliefs are part of the challenge in educating residents about Ebola.
“Voodoo is prevalent and there is so much distrust of the government,” she explains. “They need to know the virus is real … but we didn’t bring it.”
McEachern added at one point some people thought volunteers were stealing bodies to harvest the organs.
“When they come in with Ebola we have to isolate them. Sometimes if they are well enough, we can bring them to a slat window to talk to their families.”
However many families never see the victim again because once the person dies, the government takes the body.
McEachern was uncertain what the government did with the bodies, but believed they were burned.
Since Liberian burial customs include washing, touching and kissing the body, she said this can be difficult to accept.
“The viral load of the disease is heaviest on the dead body,” she said. “To [have a] family member who has died and never see the body, it is devastating.”
Because of this she said “in the villages, when someone died, they would hide the body and didn’t want to report it.”
While there are reports of 7,000 to 10,000 having died from the disease, McEachern contends “that is nowhere near a factual number. Those are only reported deaths.”
In addition, there is a large Muslim community, which McEachern described as the most resistant-since religious doctrine says bodies must be buried within 48 hours.
“They don’t want us to have the bodies at all.”
McEachern said there was retaliation as workers went to villages to retrieve dead bodies.
In her role, McEachern expects her job description to change daily depending on what is needed.
“I may have to go up into remote areas, sleep in the jungle, in tents,” she said.
While there is a Samaritan’s home base just outside the capital city of Monrovia, there is only access to two small planes and a helicopter, she explained.
“The place I am going I believe is only accessed by helicopter and is an eight-hour walk just to get into it.”
She hopes the word is getting out regarding Ebola and the victims, adding that eventually everyone is going to have contact with someone who can explain the truth about it.
“Right now we’re training Liberians to help Liberians,” she said.
McEachern’s secondary role as a nurse, “is that if our staff get ill, we take care of them-with modern procedures.”
To be effective, treatment requires an IV which is key for rehydration. But she explained, “we cannot casually train people to do IVs. All they can do is encourage drinking fluids.”
“It’s what I do”
McEachern admits she has never gone on an overseas mission for this long. Plus there will be a three-week quarantine after that, she added.
But, she said, “When I am doing this-whether it is in Liberia, or in Haiti following the earthquake or doing surgeries in China-it is what I do and who I am.”
About helping others, McEachern said, “This is what I do, my passion.”
While she loves her job in Centre Wellington, she said she’s been doing it a long time.
“My family is fairly supportive; they know it is who I am. And Skype is a good thing when there is an internet connection. That helps.”
McEachern is also a member of the Fergus-Elora Rotary Club and has done presentations for them following missions.
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