[an error occurred while processing this directive]
BBC News
watch One-Minute World News
Languages
Last Updated: Monday, 25 April, 2005, 11:31 GMT 12:31 UK
Diary from Angola's virus frontline: Part II
MSF team  (photo: MSF)
Health teams are covered from head to toe to avoid contamination
Zoe Young of the medical NGO, Medecins Sans Frontieres (MSF), is keeping a web diary for the BBC News Website from Angola as she helps with the emergency response to an outbreak of the deadly Marburg virus.

Here she writes about her work in and around the town of Uige in the north-east of the country, which has so far been the area worst hit by the epidemic.

Thursday 14 April

Today we went to Songo, a small town 40 minutes' drive to the north of Uige. The hospital has about 100 beds and is freshly painted in blue and white.

In front of the maternity ward they have planted flowers and there are pictures of cartoon characters on the walls.

However, at the moment there are hardly any patients as they are scared of catching the disease, which they think is coming from the hospital.

As soon as we arrived we found out that someone had just died, probably from Marburg.

We asked that a family member come to see us so that we could ask questions about the symptoms.

She was the sister of the woman who had died and, although she had not touched the body, she had looked after the woman's child and so she was worried that she had caught the disease.

She understood perfectly well what that meant. She said she was going to isolate herself to prevent anyone else from catching it.

The MSF doctor, Sophie, and I were lucky enough to find a nurse that spoke French to show us around (we are not far from the border with DR Congo here).

We spent ages walking around the hospital deciding on a good place to make an isolation ward where patients from Songo can be held before being transferred to Uige.

One the way back to base, I stopped by Uige hospital to see what was going on. There was a team just going to collect a suspected case from the maternity ward.

They needed someone to come with them with a spray machine full of chlorine, so I volunteered to do it.

The patient was in the maternity ward that we had disinfected just two days ago. She was on a bed in the corner, and was very quiet. I wasn't surprised, since it must have been terrifying having five people in full protective gear coming to get her.

She stayed absolutely quiet the whole time. She was lying on a piece of plastic sheeting so the team was able to lift her carefully onto the stretcher and carry her into the isolation area.

Friday 15 April

I found out that the woman that we had taken from the maternity ward yesterday had died in the night. In fact they are now back down to zero patients in the isolation ward.

Saturday 16 April

First thing this morning at breakfast we all took our temperatures. The alert symptom for Marburg is a high temperature, so now we are all going to take our temperature morning and evening.

We are also taking malaria prophylaxis drugs because the symptoms of malaria are quite like those of Marburg so you can get a nasty fright if you suddenly get a fever. So every morning at home it is like a small dispensary as the doctor hands out our drugs.

Zoe Young
Zoe is a water and sanitation specialist
We wash our hands with a fairly strong chlorine solution on the way into the house and all the dishes are rinsed in the same strength chlorine solution after being washed.

The skin on my hands is all peeling off and they smell of chlorine all the time. I am sure I am going to get wafts of chlorine for days after getting home. Eau de Chlore.

When we arrived in Songo we found out that a woman had died in the hospital during the night. Her baby had been in the hospital about two weeks ago and had died last week.

Sophie wanted to take a saliva swab before the burial team arrived so that we could determine whether she had died of Marburg but I was worried about how we would decontaminate ourselves and where we would put all the contaminated material afterwards.

I certainly didn't want to put it in the car and travel back to Uige with it.

It was frustrating not to know if this was definitely another case. We have now agreed that the burial team will go tomorrow morning so Sophie can go with them and take the swab.

Hospital
Patients are reluctant to come to hospitals

This afternoon, I continued training our "spray men" in using chlorine to disinfect areas.

Natalie, our logistics expert, wanted the new office building to be disinfected so it seemed like the perfect opportunity to give them some practical experience.

They dressed up first in the protective gear and did quite well - they remembered all the steps and got them more or less in the right order. The room that we disinfected was absolutely soaked, with water running down the walls and forming puddles on the floor.

I was quite pleased with their progress and tomorrow morning I hope that they can do the rest of the building before moving on to the real stuff and spraying some of the hospital wards.

Monday 18 April

Today Sophie, the MSF doctor, and I went to take an oral swab from the woman who died two days ago. We waited in Songo for the army burial team, who came screeching into the hospital compound in their truck.

We had lost them on the road on the way from Uige - 11 very bumpy kilometres with the car plunging into deep crevices in the road.

The village seemed very empty when we arrived. All the houses seemed to be closed up with corrugated iron doors and shutters.

We found what seemed to be most of the population of the village waiting about 50 metres from the house of the woman who had died.

Body

We explained to a rather agitated soldier what we wanted to do and then took their spray man with us to disinfect our hands in the house.

Spray team
Zoe has been training the vital spraying teams
The spray man was very thorough and sprayed the whole entry before we went in. It was a one-room house decorated with posters, a big one of Jean Claude Van Damme on one wall.

The woman was just lying on the floor. I don't think anyone had been in there since she had died.

She looked like she was asleep and luckily there was a lot of chlorine in the air so I couldn't smell anything.

Sophie took the swab with a cotton bud, which she put into a little pot.

She dropped the pot into the plastic glove that I was holding open and I tied a knot in it.

There was copious spraying of the glove and my hand. Then into another glove which was not so easy to knot and more spraying.

Accident

Once outside the house, I sprayed Sophie and the guard with chlorine and then it was my turn.

Sophie said: "that went well - we didn't make any mistakes" and at exactly that moment the hose came off the spray machine and a jet of chlorine hit me in the face.

I was having problems breathing because my mask was completely soaked with chlorine and I was wondering what would happen if I suddenly keeled over.

We went back to the car to undress and disinfect ourselves. Everyone kept a very respectful distance away.

I finally got my mask off, which was a relief. Anyway, it was a good test of the protective equipment: I didn't get a drop of chlorine on my face or in my eyes.

Close shave

The driver had been very worried about coming and had been asking for protective equipment. We explained that he would stay in the front of the car for the whole time and that we would be disinfected before getting back in.

Anyhow, he was very quiet on the way. On the way back he perked up nicely, he was singing and laughing and smiling.

Obviously he thought that he had had a fairly close shave.

We have moved our base from Uige to Songo now, and have set ourselves up quite nicely in a house fairly near the hospital.

We had electricity for a few hours tonight which was exciting and we were able to charge all the computers and phones.

The house is quite scruffy really and has no window panes - only shutters - but rather incongruously there is a brown velvet three piece suite in the sitting room.

I am sitting on it now hoping that there are no fleas in it.




RELATED INTERNET LINKS:
The BBC is not responsible for the content of external internet sites


PRODUCTS AND SERVICES

News Front Page | Africa | Americas | Asia-Pacific | Europe | Middle East | South Asia
UK | Business | Entertainment | Science/Nature | Technology | Health
Have Your Say | In Pictures | Week at a Glance | Country Profiles | In Depth | Programmes
Americas Africa Europe Middle East South Asia Asia Pacific