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Fear, Caution As Doctors Fight Ebola On The Ground


Monia Sayah is a nurse working with the aid organization Doctors Without Borders. She's just returned from Guinea, where this outbreak first started. I asked her what she's seen there.

MONIA SAYAH: What we saw at the beginning - there was disbelief, a lot of fear from the population especially the healthcare workers. They understood that something was very wrong and that they were the first in line. They were taking the most risks and they didn't know if they had been infected already because the incubation period can be up to 21 days. So a lot of fear and a lot of concern.

WESTERVELT: And Ebola is highly contagious. The head of the World Health Organization this week said, there's a high risk it will continue to spread.

Tell us what you know about the disease and how it's spread.

SAYAH: The Ebola virus, the sub-type of the strain we're dealing with at the moment in West Africa, is the Zaire strain. And it's the most deadly I would say, of the different types of Ebola viruses that we know about. And how Ebola is spread is through direct contact. It must be a direct contract. It is not airborne. It is not like the flu. So a person, to be infected, the person has to be in direct contact with bodily fluids of the sick person.

WESTERVELT: So what is the biggest challenge you saw in trying to contain the outbreak?

SAYAH: There are many layers to an intervention and to containing an outbreak, whether small or large. There are many components such as having a treatment facility of course, to treat the affected people, but also to isolate the virus so that we can break chains of transmissions. The education - educating the communities about what is Ebola, and how it is spread and how they can protect themselves. And what should they do if someone shows symptoms, that they need to come to the facilities as early as possible. We need to make sure that to when a case tested positive that we trace anyone who's been in contact with that person during the sickness needs to be followed for 21 days to make sure that they do not develop symptoms. And if they do develop symptoms, that they are brought to a facility in order to be tested.

WESTERVELT: A large number of cases involve people exposed in medical facilities. This includes Sierra Leone's top doctor who died of Ebola this week. Tell us about the precautions you and other medical workers have to take when treating the sick.

SAYAH: We use PPE - personal protective equipments - and what that is is gowns and two pairs of gloves, rubber boots, goggles, hoods, masks. And when we are about to go inside the high risk area, everything is very organized and very square. We know what we're going to do and why we're going to do it. We go in with a - as a buddy system - much like when we're diving so in case the other person is about to make a mistake, or trip or faint because conditions are quite difficult. It's very hot; we get dehydrated because we sweat a lot inside those suits. And we limit the amount of time that we are inside the high risk zone. We can't just stay two hours. At least for me, I can't.

WESTERVELT: There's no cure or vaccine and there's a high mortality rate but there are survivors in this outbreak. I mean, have you seen this in your experience, people recovering?

SAYAH: Yes, we see people surviving. I won't say cured because they were not cured, they just survived. What we do is supportive care inside a of treatment facility. So if a patient is dehydrated, we rehydrate. If there's any sign of infection - bacterial infection - then we'll give antibiotics. And we try everything we can to boost their immune system so that their body can fight against the virus.

WESTERVELT: What would you like to see on the ground? What can be improved on?

SAYAH: We need more people. We need more actors to be involved in educating the population, the communities, sensitizing them about the fact that the key to resolving this is that people come and get treated and not hide their sick and not have secret burials. We have a lot of work ahead. It's now in three countries in multiple sites. We've never seen it before. Doctors Without Borders has stretched its capacity to respond. We're doing the best we can but I think many more actors need to be mobilized.

WESTERVELT: Monia Sayah is a nurse with Doctors Without Borders. She's on a break from her work in Guinea and plans to head back soon.

Monia, thanks for taking the time with us, and stay safe.

SAYAH: Thank you. Transcript provided by NPR, Copyright NPR.