COVID-19 is not Ebola - The safety of female nurses is at risk at treatment centers in Sierra Leone

There are 150 patients at the Covid-19 Treatment Facility at Fourah Bay College - they are all positive and asymptomatic. 

Yesterday, while making a delivery of emergency supplies to FBC as part of the C19 Dignity Project, we learned first-hand the risks that healthcare workers face at facilities like FBC.

The underlying issues at Covid-19 Treatment Facilities for Asymptomatic patients - FBC Example

Asymptomatic patients at treatment facilities are shocked, angry, and in denial of their status. 

“Look way ah fresh den say ah get Covid, Na lie ya” - a healthy-looking patient yelled out at us. 

The mood quickly turned from chatty to tense when two patients from afar saw us and our cameraman. They picked up sticks and stones and rushed us.

“You feel say we gladi way wi day ya? Ah noh wan see nobody na ya. We go beat you, stone you! You wan make people know say we day. You feel say wi gladi, if ah see anybody na ya we go wound you,” said one patient, an accountant who had paid to take his exams and now couldn’t because he was being held at FBC. 

Nurses and healthcare workers are at risk for assault

He walked up to the nurse with his two hands full of stones and threatened her:

“Ah go kiss you”, he said angrily. The only thing separating them was her mask. He threatened to touch her and infect her.

We all pulled back as some patients yelled and cursed. It was two of them initially but they were able to get others cursing and revved up.

The nurses there said that this wasn’t the first time there had been physical confrontations and verbal assaults. 

Several said they had been physically groped and sexually assaulted by male patients there. They said they don’t feel safe.

Major Patricia Briama, FBC COVID-19 Treatment Center

The only person who calms the patients is Major Patricia Briama. She is the lead at FBC CTC. When they see her military uniform and grace, tensions ease but she can’t be there all the time.

She needs support.

Most of the staff at FBC - nurses and cleaners - are women. They need to be protected.

One reason why patients are disgruntled is because of hygiene. Until we made our delivery of supplies, the toilets, which are shared, had not been cleaned because tools and detergents were either finished or broken. 

You cannot begin to imagine the stress and strife that patients and healthcare workers are enduring. 

Ebola lessons have their limit 

One of the mistakes we are making with COVID facilities is that we are using the Ebola playbook. While Ebola lessons will give us an edge on surveillance and contact tracing, we need to develop a different approach to patient management at asymptomatic treatment facilities.

During Ebola, all patients were sick. But the majority of COVID patients will have no symptoms. To ensure they stay in facilities we need to think of their well being, specifically focusing on food and nutrition, hygiene, psychosocial counseling, and entertainment. We need to make sure facilities for asymptomatic patients are given priority. Otherwise, our healthcare workers are at risk, as well as the rest of the community, should they escape.

Recommendations  to improve safety and patient well-being

To improve safety at FBC and other centers for asymptomatic patients, Sierra Leone’s Emergency Operation Center must increase military security personnel and counselors. 

In addition, the Government should prioritize and increase support for food and hygiene, especially for lactating mothers and their babies. 

Children at treatment centers need toys, games, and educational materials.

To uplift the spirits of patients and healthcare workers, religious leaders should visit to conduct prayer sessions in the green zones over loudspeakers. 

If we do not make the well-being of patients and healthcare workers a priority, facilities for asymptomatic patients like FBC will be a disaster zone. 

The cleaners, the nurses, and Major Patricia Briama at FBC represent the best in this nation for their undeniable courage and resilience during this soul-shattering crisis. 

We need to ensure they are protected. And we need to ensure ALL patients, whether asymptomatic or not, are treated with the dignity they deserve. 

We are in this together!

#C19DignityProject

To support our frontline health workers please consider making a donation to our adopt a bed campaign: https://vickieremoe.com/donate-1