As Zoe's diary closes, another chapter opens in Africa
Scott McPherson
in influenza and infectious diseases
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Doctors Without Borders healthcare worker Zoe Young is back home, freed from the ordeal of helping contain an outbreak of Ebola in the Democratic Republic of Congo. As you know, we were reading her diary intently in the first days of the containment process, alternately recoiling in horror, gasping at vivid descriptions and the primitive surroundings the MSF/DWB workers had to function in, and then sometimes even laugh at some of the goings-on at the camp.
Zoe has finished her diary and is required reading for anyone who wants to understand what it is like to be the Boots On The Ground in situations like this. The photo is of MSF worker boots drying in the sun, not of lost colleagues.
Here is one snippet from her diary that I found particularly interesting and ironic (note the film they are watching).
22/10: Diary Day 20 - Tuesday
Today I went off to see the new baby Zoe. Her whole family was at home and everyone wanted to pose for photos. When I got back to the isolation unit the staff there were rather hurt that I hadn’t taken photos of them (I had, but not enough), so we had a photo session. When they posed they were all very serious, so I prodded them and bared my teeth in a manic smile to get them to smile back at me. I got some really good photos with their faces split wide open in big grins.
Isabel, Barbara, Henry, Jan and I went off to see some other springs to be improved. We had a fabulous walk past ponds where they are rearing Tilapia fish.
The first spring was very well organised. They had made a dam of sticks lined with big leaves and then filled with sand. The water came through in hollow bamboo pipes. The sand was wonderfully white and clean and the water was completely clear. If they dig they might be able to find some clay, which would make the dam a bit more resilient and need less maintenance.
The next spring is not going to be so easy to improve. There is nowhere to put a dam with pipes so that jerry cans can be filled up. At the moment it is a kind of sandy pond.
We watched another movie night tonight: “28 Days Later”. It’s all about a virus that is unleashed in the UK and results in everyone killing each other.
Well, firstly we knew that it should have been called “21 Days Later” if it was Ebola (the incubation time) but we let that go and settled down to watch. There were about 10 of us around one laptop. It was a very silly film and of course we shouted instructions at the screen about how to deal with projectile vomiting and blood everywhere and why weren’t they wearing goggles? Perhaps this could be a new job for me: advising on horror movies. http://www.msf.ca/blogs/ZoeY.php
Here's hoping Zoe gets plenty of rest, because she may be needed again soon.
Angola is experiencing a mystery illness, and it is felling people by the score. From the World Health Organization:
Unknown Illness in Angola
16 November 2007
An outbreak of a disease of unknown etiology is currently ongoing in Cacuaco municipality, Angola. The first cases were reported on 2 October. As of 15 November 2007, a total of 370 cases had presented for treatment at the Municipal Hospital in Cacuaco.
It is anticipated that additional unreported cases may be occurring within communities among patients preferring to remain at home or to receive treatment from traditional healers. The clinical symptoms of the disease are extreme drowsiness, waking only to painful stimuli. Patients recover slowly, over a number of days, but remain ataxic with many unable to walk unaided. The symptoms are most extreme in children.
The neurological indication is of a cerebellar abnormality with no sign of peripheral neuropathy. Reflexes are normal. The case presentation suggests a toxicological cause, however, the etiological agent has not yet been identified. Samples taken from patients have been tested for 300 organic solvents and a general drug screen covering 800 compounds has also been carried out.
These tests have so far proved negative. Tests for cadmium, lead, mercury and manganese have shown levels within the normal range. Environmental samples, as well as food and drinking water, have also been taken and results of tests are awaited.
Epidemiological investigations so far have not revealed a common source or route of exposure, and these investigations are now being extended in scope.
Angolan bug mystifies the experts
UN health experts say they remain mystified by an unidentified disease in Angola that has killed four people.
About 200 other victims are in hospital suffering from symptoms which include fever and extreme drowsiness.
A team of specialists has spent two weeks studying the outbreak at a clinic in a northern suburb of the capital.
The World Health Organization said it was important "people do not panic" and report to hospital if they have such symptoms, AFP news agency reports.
A WHO spokeswoman said experts were still carrying out tests.
"More and more people have fallen ill but we have not been able to identify the cause of their sickness," Reuters news agency quotes Fadela Chaib as saying at a news briefing.
"It might be exposure to a toxic substance, something in the environment. But the possibility of an infectious disease is not yet excluded."
The outbreak in Luanda's northern Cacuaco suburb was first reported in October.
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