PITTSFIELD >> When she arrived in Foya, Liberia, on Sept. 1, Debbie Wilson found a rudimentary clinic that was overwhelmed by Ebola.
Stricken patients filled all 30 beds. Others were lying on the floor. The nurses and workers had no masks or gloves, and feces and vomit covered the floors and sheets.
Local workers were doing their best to treat friends and neighbors, many of whom would be lost. The head nurse lost his girlfriend to Ebola a week before the team arrived.
Entire families were wiped out. For some families, only a single child might be left. It was not uncommon, Wilson said, for a young pregnant woman suffering from Ebola to deliver her baby stillborn and pass away a few hours later.
Wilson, a resident of Lenox and nurse with the Berkshire Visiting Nurses Association & Hospice, had experience setting up treatment centers in to fight cholera in Haiti, malnutrition in Chad and unhealthy cooking fuels in Zambia. Now, Doctors Without Borders wanted her to travel to Liberia with three or four other international health care workers to set up a multi-tent, 120-bed Ebola clinic, to train and equip 78 local nurses, 12 nursing assistants and a crew of hygienists, and to educate the community about Ebola treatment and prevention.
"Sometimes you can't say no," she said. "So you just say yes."
Having traveled by plane and jeep into Liberia, the final leg of the trip was by canoe, floating all their personnel, supplies and equipment into Foya, Wilson said.
Upon arrival, she recalled, the people were welcoming to the newcomers, but a bit suspicious and fearful at the same time. The visitors had to navigate carefully to learn the culture while educating folks about sanitation, prevention and how to change customs to better protect against spreading Ebola.
For example, the burial custom in the area includes embracing and kissing the deceased. If the deceased was a victim of Ebola, many of the funeral-goers would contract the disease, Wilson said. They were taught to sanitize and wrap the bodies of the deceased, and shown proper burial techniques.
Training health care workers on donning and using the protective gear, how to use IVs on patients, how to sanitize gear, and training all the support staff was a tough job and had to be done quickly, she noted. Once the clinic was up and running, one of the big challenges was actually working in the protective suits in oppressive heat. The shifts were short, and the workers came out of the gear soaked in sweat.
After difficult work over long hours and days there were signs of progress, Wilson said. Educating the community about prevention paid off. Getting treatment to the victims more quickly improved the survival rate. And setting up their own blood analysis lab was a real boon — it cut the time needed to find out if someone had Ebola from three days to five hours. That reduced the time they had to quarantine folks who didn't have it, thus preventing many of them from contracting Ebola while in quarantine.
By the time Wilson left on Oct 5, there had been no fresh Ebola cases at the clinic for two weeks. There were only 12 patients left in the clinic.
Now that she's home, one of Wilson's main concerns is for the friends she trained and worked with for more than a month in very stressful conditions. For them, she said, the dangers are still there, and the outbreak has left the Liberian health system, economy and government in extremely difficult circumstances that will take years to overcome.
"They are not getting paid; they've lost friends and family, and they have an awful lot of work ahead of them," Wilson said. "To me, my Liberian nurses and co-workers at Berkshire Visiting Nurses are the real heroes."
Since the outbreak started in December, there have been more than 13,000 cases and more than 4,800 people lost to Ebola in the West African nations of Liberia, Sierre Leone and Guinea. The World Health Organization also reports that 546 health workers have been infected with Ebola, of whom 310 have died.
According to Wendy McWeenie, a resident of Williamstown and advisor to the United Nations on health care financing in under-developed areas, Ebola has not only left the Liberian health system and economy in shambles, it has also left many of its citizens distrustful of health care workers and clinics.
"It's had an intense impact on all the health indicators," she said.
In Liberia, McWeenie said, many more children are expected to die from malaria because parents of sick children fear going to the clinic — they think they could catch Ebola or that the clinic workers would think their child has Ebola and put them in quarantine.
"So they're not getting treated and more will die of malaria as a result," McWeenie said.
For the same fears, women giving birth don't seek help at clinics anymore, so the infant mortality rate also is expected to increase.
And with the Ebola crisis having decimated the ranks of health workers — before Ebola, Liberia had 50 doctors to treat a population of 4.5 million — immunization has dropped from 90 percent to 25 percent.
At the same time, food availability has plummeted and prices have skyrocketed.
"People are afraid to go to work; there is no tourism or business travel," McWeenie said. "The economic impact of this is going to be felt for a very long time."
Liberian President Ellen Johnson Sirleaf on Thursday lifted a state of emergency imposed to control the outbreak. She said the outbreak is not over, that there are still surges in new patients in some areas, but that enough progress has been made to lift emergency measures.
Contact Scott Stafford at 413-663-3741, ext. 227.