It’s official, COVID 19 is here. The air, land, and sea borders were all closed 3 weeks ago. But this week, on the 31st of March was the first confirmed case. A Sierra Leonean who had been in France, but then returned to Salone. He had been in quarantine and at the end of his time, still tested positive. Somehow he had 130 contacts during that time. There’s also rumor that he was actually discharged before testing positive. But rumors truly are vicious in this place.
The second positive case came a day later, completely unrelated. A Dr. Bell who is a pillar in the very small medical community of Sierra Leone. She’s a pediatrician who sees inpatients and clinics across both government and private hospitals. She lectures at university and medical school and also sits on all the most important health committees at the highest levels of government. She had no travel history, no exposure to the other case, and in the two weeks prior had interacted with literally thousands of people. In just 24 hours, it’s quite apparent how far the cat is out of the bag.
So in our hospital, our basic preparations were further escalated. We have a small amount of supplies left over from Ebola: Tyvek suits (picture big plastic onesie pajamas) and goggles. All the elastic on all the masks and gloves have been destroyed by the African heat. Regardless, we have pushed on ahead with re-training the staff on donning and doffing PPE. (Putting on and taking off personal protective equipment). I say ‘re-training’ because many of our staff continued to work at this hospital through Ebola. Taking off a suit incorrectly could literally end your life.
It’s amazing how physically mimicking something brings up so many stories from the past. Mr. Abu told me many stories about how terrible the fear was of the red zone. But after going in and out countless times, how life threatening became normal. Apparently when reaching for the zipper at the neck of the Tyvek suits, it was common to hear people shouting “Jesus! Jesus! Jesus!” If you reach too far and you touch your chin, it could all be over.
On the eve of another virus, far more contagious than the past, it’s hard to know how to move forward. What is faith? What is arrogance?
There’s one more flight home: a charter flight from the US Embassy. The emails tell us that if we don’t take this flight, we are here for the duration. Your home country shouldn’t have to come rescue you if you decided against repatriation and were warned. It’s a surprisingly difficult decision.
Pros – Run home to a country where there are actually ICUs. The government has the ability to intervene for its citizens. Your family won’t worry about you as much. Your life isn’t as much at stake. The entire administrative committee agrees we should go. Everyone we ever talk to says we should go. There’s only one shot left.
Cons – ‘Well Africans, we came to help you. But now that you need us we’re running away.’ There’s the guilt of abandonment. There’s the shame of not running towards trouble like so many missionaries before us. There’s only 4 ventilators in this entire country and the government officials are keeping the best hospital to themselves. If we contract the virus, Rachel and I will be admitted to different wards, unable to see each other for 2 weeks. All while being subjected to 3rd world medicine. We’ve been here for 7 months and homesickness and culture shock are a real thing. If we get trapped without flights home for another (potentially) 6-12 months, are we going to get so burned out we don’t want to return to Sierra Leone?
This is different from Ebola. During Ebola our hospital was overrun with support. Cuban doctors, British generators and infrastructure, Sierra Leonean government supplies and buildings erected. But now, every country is concerned about themselves. Foreign aid is unlikely. Even with confirmed cases, the government is yet to dispense any aid to hospitals.
There are just so many questions we can’t answer:
- Did we come to Sierra Leone for such a time as this?
- If there isn’t international support and the country runs out of medicines, do they even need doctors?
- Is God asking us to risk our lives or did He give us unified counsel from everyone we ask and one last flight home?
- Maybe we stay to help, then burnout and never return. Can that be a successful mission, even though we didn’t stay our 5 years? Is burnout a part of God’s plan?
- If we become truly ill, is it even possible to medevac in the middle of global infectious pandemic?
- How desperate will the people become when Sierra Leone is hit by the global economic downturn complicated by an already inadequate health system?
- Once we leave, how long will the borders be closed? Will we even be able to return in the next year?
- Are we any safer at home? Especially if the truth is that we’re just afraid and don’t have even a mustard seed of faith. Are we running away from God’s will?
Rachel and I want to do the right thing, but we don’t see any right answer. The chorus of advice is unified, but we’re not at peace. We have less than 24 hours to make our decision, all with the knowledge God will bless us regardless of which path we take.
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