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22/12/2014

BBC Radio 4 - Six Weeks to Save the World

Dr John Wright records his work in setting up an Ebola centre to serve Moyamba junction.

Dr John Wright records his work at an Ebola centre set up to serve Moyamba junction, a key stop-off point as people criss-cross Sierra Leone, where containment of Ebola is crucial.

Dr Wright took the decision to volunteer in the fight against Ebola after the United Nations warned that the world has just 60 days to get the virus under control or face an "unprecedented situation for which we don't have a plan" The report, issued by the organisation's health arm, said the virus was "running faster than us and it is winning the race."

The UN identified the opening of Ebola Treatment Centres and more effective community containment as key to success and in Bradford where Dr Wright is director of the Institute for Health Research, it was a rallying call that saw him immediately volunteer. He worked in southern Africa in the early 1990's, when HIV was endemic and has continued to visit. He has been asked to lead the new treatment centre being set up in Moyamba, Sierra Leone, by Doctors of the Word.

His audio diary starts where he did: at the York army barracks where he and other NHS volunteers spent nine days last month (November) preparing for the task ahead. Much of the training was in a military hangar converted to an Ebola treatment centre and heated to African temperatures so they could get used to wearing the protective suits. It is once they reach Freetown that the reality really hits home:

"It is our first full day here - the size of the task ahead of us is rapidly becoming clear and it all feels quite daunting. We've got three weeks to set up a fully functioning Ebola treatment centre, which is like a mini hospital," he says. Many decisions need to be made in a very short space of time:

The Royal Engineers need input on building the facilities. A lab is needed because without being able to properly test people there is no way to separate Ebola cases from Malaria and TB patients. Six sea containers of medical equipment have to be ordered, including drugs and protective suits and additional staff must also be recruited to provide round the clock care. 

"One of the most unsettling aspects of Freetown is the lack of physical contact. No one touches each other. Instead we go through this virtual mime with our arms. We're pretending to hug each other and you realise how human contact is such a fundamental part of how we demonstrate our friendship: when its suddenly removed it creates a great sense of loss."

At present the Moyamba treatment centre is little more than a patch of cleared ground, with a planned opening date in mid-December. It will start with just ten patients and gradually build up to full capacity at a 100. Key to Dr Wright's role will be introducing interventions necessary to get correct diagnosis in the community and safe transport to the centre, to limit the spread of the virus. All trade at the junction has been put on hold until the spread of Ebola can be brought under control.

His recordings will include his dealings with local chiefs and managers from the radio station in Moyamba: health messages and greater awareness will be key areas he hopes to target. The official Ebola death toll has risen to 5,420 out of 15,145 cases according to the Word Health Organisation, although the true figures are thought to be higher. In Moyamba the present lack of a treatment centre has led local Chiefs to set up makeshift isolation facilities in schools. 

"This is a double edged sword," says Dr Wright: "potentially they're doing the right thing by isolating them, but they have to make sure they're looked after and I'm anxious about the care they're getting A lot of people are also getting misdiagnosed and we need to sort this out - lots of them will be presenting with malaria so we don't want them misdiagnosed when they could be saved with simple medicines. 

"One of the concerns with all of this is that we have this European army of clinicians going out all dressed up in scary protective equipment and it could be very alienating. So we have to do this in partnership and radio will be key out there. As will working with the chiefs on things like road checkpoints and house to house visits. There are a lot of unknowns."

Professor Wright will be working alongside Chris Bulstrode, Emeritus Professor at Oxford University, who has also been recording his experiences. His decision to go was one that caused concern for his wife Dr Vickie Hunt: 

"I think its a very worthwhile thing to do, but I didn't expect you to be offered a nine month contract. I do worry about the quarantine when you come back. You are supposed to be solitary and my main concern is that, just say, you got Ebola and I was quarantined as well, I'd be horrified to think we'd passed anything to our grandchildren.".

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