During West Africa’s Ebola outbreak, an epidemic that has killed 135 people in Guinea and neighbouring Liberia, Canadian doctor Tim Jagatic worked with Doctors Without Borders to assess potential cases in high-risk communities and to treat patients inside a make-shift tented facility. The Globe and Mail’s Allan Maki connected with Dr. Jagatic to take us inside the tent.
Are you making any progress in the fight against Ebola?
“It’s a serious virus and it’s very difficult to find. With malaria, when the rainy season comes, the mosquitos come, too. We can prepare for it …We’re 95 percent certain there’s a certain reservoir involved (as a host for the virus) and that allows us to have a better strategy. Find the source then cut it off.
“I think if we’ve been able to do preventive treatment early on with people, we have better outcomes. It’s not definitive but it definitely is encouraging. It’s about getting people into the (health care) system and treating them.”
How do you treat Ebola?
We do a triage and ask them if they have been in contact with someone who has been to a funeral recently – the mode of transmission is through a dead body, and it just so happens in this community that there is a lot of contact. When someone dies, they wash the body; people can touch the body (at the funeral). That allows the virus to spread more. … We provide patients with oral rehydration. If they have diarrhea and vomiting, we give them drinks, like Gatorade. If they have a fever, we give them Tylenol. We start them off with antibiotics. Whatever symptom comes up, we treat that symptom.
Are you ever worried about contracting the virus?
The possibility is definitely in the back of everyone’s mind but there is no overt fear of it happening because we have very effective protocols for avoiding transmission and everybody follows the protocols very strictly.
What precautions do you take ?
When we enter the ward, we put on our PPE – personal protection equipment – a yellow protection suit, boots, goggles, mask and gloves. When we first make contact with the patient, we let them know we’re going to do everything we can to help them.
The temperature in Conakry is regularly around 30 degrees celcius. Is it uncomfortably hot inside your PPE inside the tents?
It’s a factor we take into consideration because we lose a lot of water, but don't cool down because the sweat doesn't evaporate. So we organize the medical activities before going into isolation to reduce the amount of time we stay inside. Normally we don’t stay for more than an hour and there is plenty of rehydration afterwards. I’d estimate I lose about 1.5 to 2 litres of water each time I go in. So we experience significant physiological stress and don’t go in more than three times per day. The rest of the time we do triage or outreach in the community to try to look for suspicious cases.
Have you experienced any animosity in Conakry? The other day, in the town Macenta, villagers threw stones at aid workers believing they were the ones who had brought the Ebola virus into their area.
It was a mob (in Macenta) and there was fear and a lot of confusion. That has been resolved. Here in Conakry, MSF always reaches out to community and religious leaders and we haven’t had any issues.
How hard is it for you to work with patients knowing the Ebola comes with a 90 per cent chance of death?
You do have to accept the reality of the situation. We’re putting a dent in the mortality rate. We’re going to lose some people but we treat it that we did everything we could. … It might sound cliché but for me I feel a sense of privilege to treat these people. It’s very humbling. The other day this patient was having difficulties (emotionally). I talked to him for 45 minutes and today he’s doing better. It’s impossible to express what that means to me.
Have you had any moments in Guinea that stand-out for you?
“One of my favourite stories was this woman who came to us – and she’s a character - she came over and was knocking on our (tent’s) door and complaining – not about having Ebola, but because the sandwich we gave her was too salty. We all laughed a little.