A BRITISH doctor who has returned from Sierra Leone where he cared for Ebola patients, has said medical professionals wishing to help should bear in mind that “this is mainly a palliative mission” that makes “deaths less horrible”.
Dr Javid Abdelmoneim spent almost a month in the country as a volunteer for the medical charity Médecins Sans Frontières (MSF, Doctors Without Borders). He said doctors and nurses who want to help must not take the decision to go to west African countries affected by Ebola “lightly”.
“This is mainly a palliative mission,” Abdelmoneim told Eastern Eye.
“You’re not going to be saving lives. You need to aim your goals a little bit lower. If people survive, great; but if they are dying horribly, you’re trying to make that death less horrible.”
Ebola, a deadly virus mainly found in tropical Central and West Africa, has killed more than 7,800 people in the past year, out of 20,171 cases, according to the latest tally by the World Health Organization (WHO).
As of December 28, a total of 678 healthcare workers were known to have contracted the virus, and 382 of them had died, the WHO said. News of the disease spreading rapidly in West Africa has heightened fears about a potential outbreak in the rest of the world.
Dr Abdelmoneim told EE: “You’re going to go there (Sierra Leone) and see around 10 deaths a day, of two-year-olds, 60-year-olds and whole families. You can go in there with big dreams but it’s altogether on a different plane.
“A lot of doctors won’t be able to manage… because we are used to saving lives. I had one 13-year-old die in my career, and the whole department had to have a debrief to see if everyone was okay. Over 11 years, you still hear when a child dies in the other side of the department.”
The 35-year-old works as an A&E doctor at St Mary’s hospital in Paddington and Chelsea and Westminster hospitals. His first mission with MSF was in 2010, when he spent six months in Iraq and another six months in post-earthquake Haiti’s drugs-and-guns slum Cité Soleil.
Dr Abdelmoneim also spent time in Lebanon and went to South Sudan early last year. He said he usually does one mission a year and felt compelled to go to Seirra Leone last October, after MSF emailed him with a “desperate” appeal. “In all my time, I have never received an email from head office. It wasn’t a ‘Dear Javid’ letter, it was, ‘Dear volunteer, we are desperate. If you can spare any time we are absolutely being fleeced by this. We need your help’. I was fit, able, free, so I couldn’t really back out. Mentally I only do one mission a year and I had already been to South Sudan, but I couldn’t look at colleagues in the eyes if I didn’t go, so that’s why I went.”
Last week, news emerged that British nurse Pauline Cafferkey, who was diagnosed with Ebola in December after returning from Sierra Leone, was no longer seriously ill after she was in a “critical” condition upon her return. Around 100 people have been tested for Ebola in hospitals across England during the current outbreak, with all of them testing negative so far, apart from Cafferkey.
While Dr Abdelmoneim was treating victims of Ebola, he recorded his experiences on specially designed goggle cameras for BBC One’s Panorama programme. He described how, for months, he was “put off” the mission in Sierra Leone. “It’s inevitable that there was a fear, I knew about a Ebola outbreak from March. One nurse was pulled from our project from South Sudan when we were there, to go help tackle Ebola. I went there in September, so it took me that long to combat my fear.
“There is a distinct chance of dying, and a high chance of dying if you contract the disease. Our briefing in Brussels was as short and brutal as this – ‘Our medical evacuation insurance company has said they cannot guarantee your evacuation if you are diagnosed, so if you die in that country we will bury you in that country and we will not bring your body back. Are you still prepared to go?’”
revealed how his time in Haiti left him with a mild form of Post-Traumatic Stress Disorder (PTSD) which left him out of work for 15 months, but that experience helped him survive the grim work in tackling Ebola.
“Haiti made me disenchanted about being a medic and I tried to leave the medical industry altogether. It was a extended personal upheaval,” he said.
“PTSD can leave you with an abnormally heightened emotional response to similar triggers. “I went through a six-month mental rehab and only really got myself back into work after about 15 months.
“If that was your first time seeing that amount of death, really horrible deaths, you can’t prepare yourself. I think that’s why I was traumatised by Haiti. But that benchmark helped prepare me for Sierra Leone.”
He added that that MSF would never send new recruits to deal with Ebola, because the situation there was “on another level”.
“They recognise it’s tough, so we’re all a little battle hardened, but I think for all of us this was on a another level.
“There is also the added helplessness of having no treatment there. You’re giving them a bit of this and a bit of that and see how they do. For medics that’s pretty hard. Everyone is being overwhelmed by the numbers.
“In wars and epidemics, there are psychotherapists just for all our patients, but never have we had that as expats. With the Ebola mission, every expat had their own personal counsellor.”
Dr Abdelmoneim’s overall experience in the west African country wasn’t all depressing, though. He said the people who were in dire straits remained “fun-loving”.
“They love music and they love dancing and remain very upbeat despite the strain they are under as a nation and a people. It’s been a unifying force, Ebola. They had the civil war, they had come together nicely and got the economy on track and were doing very well, but this has just devastated their nation.”
The doctor, who used to work for MSF on a voluntary basis, now gets paid 10 per cent of his NHS salary. He said the impact he had on people during his missions abroad was far greater than his influence as an A&E doctor.
“On an individual level, your impact is significantly higher and occurs regularly, when you’re doing this sort of humanitarian work.
“At A&E, we’re not desensitised to untimely or horrible deaths, and we are not desensitised to the pressure we are under constantly. You feel like you’ve been beaten up after every shift, emotionally and mentally.
“With MSF missions, somehow I just don’t feel as beaten up. My personal feeling is that every case you see needs you. On the whole, you’re in places where there is no access to healthcare and quality healthcare. You make a much bigger difference to more people’s lives.”