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  • on 07.11.2014
  • at 12:00 PM
  • by Kevin Hind

MSF doctor writes about her experience working in Ebola zone in Sierra Leone 0

‘Before arriving in an Ebola project, most MSF expatriates have to go through two days of intensive training. An important part of this is putting on the full personal protective equipment (PPE)‘, writes Indira Govender from an Ebola zone in Sierra Leone.

Before arriving in an Ebola project, most MSF expatriates have to go through two days of intensive training. An important part of this is putting on the full personal protective equipment (PPE). Dressing up for the first time is incredibly uncomfortable, essentially covering your entire body in plastic, tying a waterproof hood around your head, with an N95 respirator mask that protects your mouth protruding through a slit in the mask of the hood. Only your eyes are exposed and then you wear goggles. On top of the yellow suit is a thick waterproof apron and your feet are covered in heavy rubber boots that protect against penetration inside the high risk area. All of these items have to be of a certain standard to ensure a high degree of protection and minimize the risk of infection. Depending on the environmental temperature at the training centre, you start perspiring inside the PPE and begin to feel your green cotton scrubs become damp underneath the suit. This is all part of the initiation and no one enjoys their first experience. You’re told that you will get used to it, and after ten days be quite comfortable in PPE but I think that has more to do with a mental shift that takes place in order to continue working and fulfill responsibilities inside the high risk area than a physical adaptation.

Field conditions are often much more challenging. For one, the environment is extremely humid and you are already perspiring before putting on the PPE. The first item is a pair of latex gloves and you must get used to the feeling of latex clinging to your damp hands so that you can continue dressing. The last item is the goggles, you want to spare as much time, even if only a few minutes, before putting it on because it mists up inside, obstructing your vision so that high risk procedures such as drawing blood for routine tests or administering intravenous fluids become almost impossible. The longer you stay inside the PPE, the more you sweat and on some days it feels as if you’ve lost up to 2 liters of fluid as your scrubs are drenched when you undress. To prevent people collapsing with exhaustion, no one is permitted to be inside for longer than an hour, but the discomfort starts long before this. You start feeling sweat running down your body, the respirator gradually becomes soaked and is sucked into your mouth as you inhale.

Since the face protection in not breathable or absorbent, sweat runs down your face and bending forward can cause droplets to drip off your eyelashes onto the goggles. If water collects in the respirator it also feels as if you’re exhaling underwater. At some point, the top tie of the hood becomes a tourniquet around your head and it hurts. It takes a few rounds of PPE before you silence the voice in your head telling to you rip off the goggles. In fact, you have to consciously remind yourself not to touch your face while in PPE inside the high risk area to avoid contamination. But all of this is bearable if you know why you’re in it, so going in with a purpose helps. Another big motivation to put on PPE and make sure it’s on properly are the stories of how vulnerable health care workers got infected with Ebola and died. Many didn’t know what they were dealing with until it was too late and others were simply not adequately protected.

continue reading on Africa Is A Country

By Indira GovenderAfrica Is A Country

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