AN EBOLA NURSE S DIARY

Transkript

1 AN EBOLA NURSE S DIARY A Radio documentary by Karen Albertsen Idea and Editor: Jesper Hyhne Presenter: Emil Eusebius Jakobsen Broadcast December P1 Dokumentar DR Danmark 2014 Length: Page 1 of 49

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3 Summary: About P1 Documentary: In September 2014 the Danish nurse Astrid Opstrup went to Sierra Leone with the international medical humanitarian organisation Doctors Without Borders to aid in fighting the ebola virus. In her bag she carried a small sound recorder. Astrid Opstrup had promised to record a radio diary for P1 Documentary while she was in Sierra Leone. When she returned to Denmark a few weeks later she handed over the audio files to the reporters from P1 Documentary. She had no idea what her diary sounded like. But the documentary reporters edited her diary recordings into a full length documentary of her time in Sierra Leone. And at the time of broadcast they invited her to the radio studio to play back the diary to her. This is Astrid Opstrups story - a unique perspective on the ebola outbreak seen from inside of the yellow protection suit. 1 is the talk radio channel of the Danish Broadcasting Corporation, equivalent to the BBC s Radio Four. The target audience is knowledgeable and curious. P1 Documentary is a regular programme broadcast every Thursday at 1 pm and available online as well. The purpose of the programme is to present unique in depth stories and investigative radio reporting to Danish listeners. Characters: Presenter: Emil Eusebius Jakobsen Narrator: Karen Albertsen The ebola nurse: Astrid Opstrup About the translation: The Danish transcription is printed in parallel with the English translation. Print it out, on both sides of the paper, and you will have the English and Danish text side by side. This will make it easier to follow the text while listening. Page 3 of 49

4 (Jingle) HOST HOST Currently a number of West African countries are affected by the largest outbreak of the infectious Ebola virus, and one of the most vulnerable groups are very young children that no one will look after because they are afraid of being infected: In September, Astrid Opstrup, a Danish paediatric nurse, went to Sierra Leone to, among other things, take care of the children. 3-month-old children need someone to be there. P1 Documentary gave her a radio recorder to take with her, and in this show you will hear her diary; a diary describing Ebola seen from inside the yellow protective suit - and what is involved in situations that can hurt, right into your soul: So I have now tried to take good care of the children, of the young, the very young. HOST Welcome to P1 Documentary, I m Emil Eusebius Jakobsen. (Music fades out) Time: 1.09 Page 4 of 49

5 (Kendingsmelodi) VÆRT VÆRT En række vestafrikanske lande er lige nu ramt af det hidtil største udbrud af den smitsomme ebola-virus. En af de mest sårbare grupper er de helt små børn, som ingen vil tage sig af, fordi de bange for at blive smittet: I september tog den dansk børne-sygeplejerske Astrid Opstrup til Sierra Leone for blandt andet at tage sig af børnene. Børn på 3 måneder har brug for at der er nogen der er der P1 Dokumentar gav hende en radio-optager med. Og i denne udsendelse skal du høre hendes dagbog; en dagbog der beskriver ebolaen set inde fra den gule beskyttelsesdragt - og hvad det indebærer af situationer, der kan gøre ondt, helt ind i sjælen: Så jeg har ligesom prøvet på nu at tage mig godt af børnene, af de små, helt små VÆRT Velkommen til P1 Dokumentar, jeg hedder Emil Eusebius Jakobsen (Musik klinger ud) Tid: 1.09 Page 5 of 49

6 HOST It s now very few people at home who haven t heard of Ebola, but there are very few Danes who have been close up and eyewitnesses of what Ebola is and can mean. Astrid Opstrup, welcome to P1 Documentary. Thank you. HOST You have spent 4 weeks at an Ebola centre in Sierra Leone and you had a recorder with you. Yes, I did. HOST And that s what we re going to hear about in a moment, but first I would just like to hear: What did you actually imagine you were going down to before you left? Well, I imagined, as I think most would imagine: That there are many dead and there is also a lot of blood, I think that s what I imagined. I had read some blogs before I left, with these descriptions that I actually ended up taking a little break from reading, because I thought that it sounded more violent than I might have believed, right at the start. So it was probably these considerations I had thought of most. Was that also the case when you arrived there? Page 6 of 49

7 VÆRT Det er efterhånden meget få herhjemme, der ikke har hørt om ebola. Men det er ganske få danskere, der har været tæt på og med egne øjne set, hvad ebola egentlig er og kan betyde. Astrid Opstrup, velkommen til P1 Dokumentar. Tak skal du have. VÆRT VÆRT Du har været 4 uger på et ebola-center i Sierra Leone, og du har haft en optager med. Ja det har jeg. Og det skal vi høre lige om lidt, men først vil jeg gerne lige høre dig: Hvad forestillede du dig egentlig, at det var, du kom ned til, før du tog af sted? Jamen altså jeg forestillede mig jo det, som jeg tror, de fleste forestillede sig: At der er rigtig mange døde, og der også er rigtig meget blod, tror jeg, at jeg forestillede mig. Jeg havde læst nogle blogs, inden jeg tog af sted, med de her beskrivelser, som jeg faktisk endte med at holde en lille pause fra at læse, fordi jeg synes alligevel, at det lød mere voldsomt, end jeg måske havde troet, lige i starten. Så det var egentlig nok de overvejelser, jeg havde gjort mig, tænkt på mest. Var det så også sådan, da du kom derned? Page 7 of 49

8 No, I don t think it was. Yes, there were many who had died, but it wasn t as violent as I had imagined. It was quieter, in a way. HOST Yes. HOST HOST And there was not so much blood. Quiet in what way? Well patients often die alone, and the way it happens is that mostly they stop breathing, but it s like they re sleeping and we rarely are when they die, so, yes, I think that s what I mean by quiet. You are a paediatric nurse and so it s certainly not wrong to say that the children came to play a special role for you down in Sierra Leone, and we are going to hear more about that now, because here is Astrid Opstrup s diary: Time: 2.53 (Ambience sounds from the airport) Page 8 of 49

9 Nej, det synes jeg ikke, det var. Jo, der er rigtig mange, der dør. Men det var ikke så voldsomt, som jeg havde forestillet mig. Det var mere stille. På en måde. VÆRT Ja VÆRT VÆRT Og alt det her blod, det var der ikke så meget af. Hvordan stille? Jamen, patienterne dør tit alene, og det, der sker, det er, at de sådan for det meste jo holder op med at trække vejret, men det er ligesom at de sover ind, og vi er der jo sjældent, når de dør, så det er, ja, jeg tror det er på den måde, at jeg mener stille. Du er jo børnesygeplejerske til dagligt, og det er vist ikke forkert at sige, at børnene kom til at spille en særlig rolle for dig nede i Sierra Leone. Og det skal vi høre mere om nu, for her kommer Astrid Opstrups dagbog: Tid: 2.53 (Atmosfærelyd fra lufthavn) Page 9 of 49

10 I m now sitting in Copenhagen Airport, where my little radio diary begins here. It s 8th September and the time is I m waiting to depart for Brussels, where I m to have some Ebola training before I travel to Sierra Leone in just under 4 days. The nervousness has calmly and quietly set in and all that with packing my suitcase and remembering everything, and phoning the last people and saying now I m leaving, and talk through the last things. But I also feel ready to leave, and I m really looking forward to it. So now I will quietly begin to board the plane, when boarding begins here shortly. Time: 3.47 (Music) NARRATOR It s a Monday in September in Copenhagen Airport, where others are waiting to go on a late summer holiday or to a business meeting somewhere in Europe, but Astrid is waiting to start the journey that will take her to West Africa. The training in Brussels will, among other things, prepare Astrid to wear the protective clothing. It s far too dangerous to work with those infected with Ebola without the yellow suit. It s Thursday 11th September and I ve been in Brussels for two days now and had Ebola training. It has been two days from 9 in the morning to around 7 in the evening, along with 40 others who are also about to leave about now. Er, it s been really, really good with this training. We ve learned a lot, and it has obviously gone incredibly fast, but we ve gained new knowledge and become calmer about having to leave. We have, among other things, trained to take this suit on and especially off again and been given some good small mnemonic rules and tips on how to do it nice and calmly. It s been really great to meet the others who also leaving. We are 7, I think, who are to travel to Sierra Leone together in the morning, and we have been able to talk a lot together about what is it that we are afraid of, what it is we are looking forward to, why we are doing this, all the thoughts that you might have now, and I think for most of us it s nonetheless a different mission than we re used to. Page 10 of 49

11 Jeg sidder nu i Københavns lufthavn, hvor min lille radiodagbog her begynder. Det er d. 8. september og klokken er 17.30, og jeg venter på at skulle af sted til Bruxelles, hvor jeg skal have noget ebola-træning, før jeg rejser til Sierra Leone om små 4 dage. Nervøsiteten er sådan lige så stille og roligt indtrådt, og alt det her med at få pakket kufferten og husket det hele, og få ringet til de sidste lige og få sagt nu tager jeg afsted, og få snakket det sidste igennem. Men jeg føler mig også parat til at skulle af sted, og jeg glæder mig rigtig meget. Så nu vil jeg lige så stille begynde at gå ombord på flyet, hvor boardingen begynder her om ikke så lang tid. Tid: 3.47 (Musik) FORTÆLLER Det er en mandag i september i Københavns Lufthavn. Hvor andre venter på at komme på en sen sommerferie eller til forretningsmøde et sted i Europa, så venter Astrid på at skulle starte den rejse, der skal føre hende til Vestafrika. Træningen i Bruxelles skal blandt andet gøre Astrid klar til at tage beskyttelsesdragt på. Uden den gule dragt er det alt for farligt at arbejde med ebola-smittede. Så blev det torsdag d. 11. september. Jeg har været i Bruxelles i to dage nu og haft ebola-træning. Det har været to dage fra 9 morgen til omkring kl. 7 om aftenen, sammen med 40 andre, der også skal ud og rejse, sådan mere eller mindre nu. Øh, det har været rigtig, rigtig godt med den her træning. Vi har lært rigtig meget. Det er selvfølgelig gået superhurtigt, men der er virkelig kommet ny viden og mere ro over det at skulle af sted. Vi har blandt andet øvet os i at tage den her dragt på og især af igen og fået nogle gode små huskeregler og tips til, hvordan man gør det i fred og ro. Det har været rigtig rart at møde de andre, der også skal af sted. Vi er 7, tror jeg, der skal rejse sammen til Sierra Leone i morgen, og vi har kunnet snakke rigtig meget sammen om, hvad er det, vi er bange for, hvad er det, vi glæder os til, hvorfor gør vi det, alle de tanker som man nu har, og jeg tror, for de fleste er det alligevel en anderledes mission, end man er vant til. Page 11 of 49

12 Time: 5.44 (Music) NARRATOR Time: 7.17 (Music) NARRATOR The journey to West Africa is long, and the closer the group comes their destination, the more obvious it becomes that Ebola is real and that precautions are necessary. Many passengers are wearing masks and gloves, and Astrid and her team must also avoid physical contact for many weeks ahead: Today is 13th September, and right now I m lying in my bed under a mosquito net in a small guesthouse in Freetown, Sierra Leone. Before we boarded the plane, we had a group hug, one might call it. You could sense it in each other, this having to work on an Ebola project, where Doctors Without Borders have very strict rules that you must not touch each other at all. That is, there are no handshakes, no hugs, not the slightest touch whatsoever. You mustn t drink from each other s glass, you mustn t eat with each other s forks, and there is no physical contact at all. I actually believe that this for me, not being such a physical contact person, meant I could still feel that I had to think hard about it, because it s the small things in everyday life that you do... just a pat on the back or just the little things that are totally prohibited. Page 12 of 49

13 Tid:5.44 (Musik) FORTÆLLER Tid: 7.17 (Musik) FORTÆLLER Rejsen mod Vestafrika er lang, og jo nærmere gruppen kommer deres destination, jo mere tydeligt bliver det, at ebolaen er virkelig, og at forholdsregler er nødvendige. Flere passagerer bærer masker og handsker, og også Astrid og hendes team må tage afsked med fysisk kontakt for de næste mange uger: I dag er det d. 13. september, og jeg ligger lige nu i min seng under mit myggenet på sådan et lille gæstehus her i Freetown i Sierra Leone. Inden vi gik ombord i flyet, der havde vi gruppekram, kan man vel kalde det. Man kan godt sådan mærke på hinanden, at det her med at skulle arbejde på et ebola-projekt, der har Læger Uden Grænser meget strenge regler om, at man ikke må røre hinanden overhovedet. Dvs. der er ingen håndtryk, ingen knus, ikke sådan den mindste berøring overhovedet. Man må ikke drikke af hinandens glas, man må ikke spise med hinandens gafler, der er ingen fysisk kontakt overhovedet. Jeg tror egentlig, at sådan for mig, som ikke sådan er det store fysiske kontaktmenneske, så kan jeg alligevel godt mærke, at man skal tænke meget over det, for det er småting i hverdagen, som man... lige et klap på skulderen, eller bare sådan, små ting, som er helt, helt forbudt. Page 13 of 49

14 Astrid is now in Sierra Leone. In Denmark she is a neonatal nurse on Copenhagen University Hospital s paediatric ward. It is here, among others that premature babies and children with birth defects and heart disease are cared for. Here they are treated and, for many, fortunately they also become healthy. This is not the case in Sierra Leone, where Ebola has a mortality rate of 50-90%. Today is Tuesday 16th September, and I find myself in Kailahun in Sierra Leone. There s a lot... it s all about infection control. Which means that when you arrive at the centre and you walk in, the first thing you do is wash your hands in chlorine, in some bleach, and then your shoes are sprayed with chlorine too, and then you are given rubber boots and you get handed your hospital clothes, in other words, these green suits that we wear when we are inside the centre, and then you go in and change into them, and you wear these clothes all day. Time: 8.47 (Music) NARRATOR When a new patient arrives with Ebola symptoms at the centre, a blood test is taken. Until the staff knows whether the sample is positive or negative, the patient is suspect, as the staff calls it in other words, the person is under suspicion and must not leave the centre again. And if it turns out that the patient has Ebola, then the arrow goes from suspect to confirmed as being infected. Patients in this category will be moved to an isolated area, where nobody else is allowed other than the infected and healthcare staff in the yellow protective suits, also called PPE, or Personal Protective Equipment. Time: 9.35 Page 14 of 49

15 Tid: 8.47 (Musik) FORTÆLLER Tid: 9.35 Astrid er nu i Sierra Leone. I Danmark er hun neonatal-sygeplejerske på Rigshospitalets børneafdeling i København. Det er her blandt andet for tidligt fødte babyer og børn med misdannelser og hjertesygdomme. ligger. Her bliver de behandlet og for manges vedkommende heldigvis også raske. Sådan er det ikke i Sierra Leone, hvor ebolaen har en dødelighed på %. Det er i dag tirsdag d. 16. september, og jeg befinder mig lige nu i Kailahun i Sierra Leone. Der er rigtig meget det hele handler jo om infection control, altså dvs. at få kontrolleret infektionen, kan man sige. Hvilket betyder, at når man kommer til selve centeret, så når man går ind, det første man gør, er, at man vasker hænder i klor, i noget klorvand, og så bliver ens sko sprayet med klor også, og så får man udleveret gummistøvler og så får man udleveret sit hospitalstøj, dvs. de her grønne dragter, vi går rundt i, når vi er inde i centeret, og så går man så ind og skifter til det, og det tøj har man så på hele dagen. Når der ankommer en ny patient med ebolasymptomer til centeret, så bliver der taget en blodprøve. Indtil personalet ved, om prøven er positiv eller negativ, så er patienten suspect, som personalet kalder det - dvs. vedkommende er under mistanke og må ikke forlade centeret igen. Og hvis det viser sig, at patienten har ebola, så svinger pilen fra suspect til Confirmed og er nu bekræftet smittet. Patienter i den kategori bliver rykket til et isoleret område. Her må ingen andre komme end de smittede og sundhedspersonale i de gule beskyttelsesdragter, der også hedder PPE, eller Personal Protective Equipment. Page 15 of 49

16 Time: NARRATOR It s this yellow suit that we know from the media and of course it was also, er, what you could say, relatively stressful to go in to the patients for the first time who are at the centre, because you know very well that it s contagious, and... it s very dangerous. So this about you getting dressed correctly and having a partner beside you all the time and we trust each other and we know that they go with us, and I was not... I was there with a team so that I shouldn t, as such, do anything except observe how things are done in there. The first time Astrid was in among those infected, she met one of the many children who came to mean a lot to her during her stay in Sierra Leone. For many children it s about them not only being infected with Ebola and therefore having to stay in the isolated area, but that they are often alone in there - either because their parents have died, or because they are not infected with Ebola. And I was there today to move a little girl (fiddling with the microphone) aged six months, who was positive. Her mother was... her mother died a few days ago from Ebola, and her father is also admitted at the centre too, but his blood tests show that so far he isn t infected. So he has to stay in the tent for suspects, while we took the six-month-old girl and moved her into the confirmed area, where she lives in a small kind of playpen, and so it was us who have to look after her, and of course it s strange. Page 16 of 49

17 Tid: FORTÆLLER Det er den her gule dragt, som man kender fra medierne. Og det var selvfølgelig sådan, øh, hvad kan man sige, relativt stressende at skulle ind for første gang til de patienter, der er inde på centeret, for man ved jo godt, at det smitter, og... det er meget farligt. Så det her med, at man får taget dragten rigtigt på, og man har en makker med sig hele tiden og man stoler på hinanden, og man ved at de tager os med, og jeg var heller ikke jeg var så derinde med et team, sådan at jeg ikke skulle som sådan udføre noget, men observere hvordan det foregår derinde. Da Astrid første gang er inde blandt de smittede, møder hun et af de mange børn, der kommer til at betyde meget for hende uder opholdet i Sierra Leone. For mange af børnene gælder det, at de ikke bare er smittede med ebola og derfor skal bo i det isolerede område. De er ofte alene derinde - enten fordi deres forældre er døde, eller fordi de ikke er smittede med ebola. Og der var jeg i dag med til at skulle flytte en lille pige (roder med mikrofonen) på seks måneder, som var positiv. Hendes mor var hendes mor døde for et par dage siden af ebola, og hendes far er indlagt på centeret også, men hans blodprøver viser indtil videre ikke at han er smittet. Så han var nødt til at blive i det telt for de suspekte, mens vi tog den seks måneder gamle pige og flyttede ind i det konfirmerede område, hvor hun så bor i en lille slags kravlegård, og det er så os der må tage os af hende. Og det er selvfølgelig mærkeligt. Page 17 of 49

18 (exhalation) Time: NARRATOR It s terrible, in fact, that you have to stand and tell a father that his child... is positive for Ebola and that we now have to move the child and basically take the child from him, as he doesn t have the possibility to go in there and we can t let her stay when she is so sick, because it is simply too risky for the others who are inside, who might have Ebola, but perhaps not yet. And he was obviously upset, and you... he took it really well in relation to what you can t possibly imagine. And so we carried this girl into this little playpen, and then it is us who looks after her and gives her food from a cup with a spoon when she has to be fed. The healthcare staff s primary job is to ensure that the sick and the poorly get food and water and are attended to. There isn t much more you can do when there s no treatment, and when it s too dangerous, for example, to put in a drip in order to give them fluids. There are many who can t feed or drink themselves, and that means we have rounds all day where we go in, of course when they get food, but also during the day we have rounds where we simply go in and ensure that they get something to drink, because that s one of the most important things in the treatment, it s what we can treat, it s that we make sure that they drink and eat. As it is so dangerous to treat with invasive methods, for instance, putting in a drip, it s very rarely done, simply because it s too dangerous. So it s about making sure that patients get something to eat and drink, which is what I was in there helping patients with. Page 18 of 49

19 Det er frygteligt i virkeligheden, at man står og fortæller en far at hans barn har er positiv for ebola, at vi nu flytter barnet og tager barnet fra ham sådan set. fordi han har ikke mulighed for at gå med derind, og vi kan ikke lade hende blive, når hun er så syg, fordi det er simpelthen for risikofyldt for de andre, der er der inde, som måske har ebola men måske heller ikke har. Og han blev selvfølgelig ked af det. Og man han tog det egentlig pænt i forhold til, hvad man overhovedet kan forstille sig. Og så bar vi den her pige ind i den her lille kravlegård, og så er det os der passer hende og giver hende mad af en kop med en ske, når hun skal have mad. (udånding) Tid: FORTÆLLER Sundhedspersonalets primære opgave er at sørge for, at de syge og dårlige får mad, vand og bliver tilset. Meget andet kan man ikke gøre, når der ikke findes nogen behandling, og når det er for farligt for f.eks. at lægge et drop for at give dem væske. Der er en del, der ikke kan spise selv, og ikke kan drikke selv. Og det betyder, at vi hele døgnet har runder, hvor vi går ind, altså selvfølgelig når de får mad, men også i løbet af dagen har runder, hvor vi simpelthen går ind og sørger for, at de får noget at drikke, for det er noget af det vigtigste i behandlingen, det er det, vi kan behandle, det er, at vi sørger for, at de drikker og spiser. Fordi det er så farligt at skulle behandle med invasive metoder, dvs. at lægge et drop, så gør man det meget sjældent, fordi det simpelthen er for farligt. Så det er at sørge for, at patienterne får noget at drikke og noget at spise. Så det var jeg inde og hjælpe patienterne med. Page 19 of 49

20 And there are many who are really, really sick, who just lay there and either have their eyes closed and don t really react, or they have almost staring eyes, er, and are confused. And not everyone would eat, nor everyone would drink, and unfortunately you can t actually force them to, and you also have to be careful that they don t vomit. So... so we do what we can to help them with the basics. However, it s a very different mission than I think I really ever imagined if I was to go out with Doctors Without Borders. Now it s only my second day I m here, and... even though I know that s how it is, then I think it will take me, I can feel, it will take a while before I really understand how or really take it in that it s actually the way it is. It s a bit like watching a film, in a way, you can t really understand that this is how it is. They re simply so sick. Time: NARRATOR The Field Hospital in Kailahun has room for 80 beds and is located in a bush area in the eastern part of the country. It takes nine hours on very bad roads to drive from the capital Freetown to the area in Kailahun. Many times each week ambulances arrive at the centre with the sick. Sometimes the ambulance is filled with a whole family: Today it is 25th September, and I m here in Kailahun. Er, right now I m sitting in our Staff Health Unit this morning. Er, I have now been here for almost two weeks, no, one and a half weeks and worked with Ebola. Er, and, well... it can be difficult to describe how it s all experienced, well... we have ambulances coming in, not every day, but mostly, or every other day at least, when it s possible. Page 20 of 49

21 Og der er rigtig mange, der er virkelig, virkelig syge, der bare ligger, og enten har lukkede øjne og ikke rigtig reagerer, eller også så har de det her stirrende blik nærmest, øhm, og er sådan konfuse. Og det var heller ikke alle, der ville spise, og heller ikke alle, der ville drikke. Og desværre kan man jo ikke som sådan tvinge dem til det, og man skal også passe på, de ikke kaster op. Så så vi gør, hvad vi kan for at hjælpe dem med det basale, vi kan. Men det er en meget anderledes mission, end jeg tror, jeg nogensinde egentlig havde forestillet mig, hvis jeg skulle ud med Læger Uden Grænser. Nu er det kun min anden dag jeg er her, og selvom jeg godt ved, det er sådan det er, så tror jeg, det tager for mig, kan jeg mærke, det tager lige noget tid, før jeg sådan rigtigt forstår eller rigtig kan tage det ind, at det rent faktisk, er sådan, det er. Det er lidt ligesom at se en film, på en måde, at man kan ikke rigtig forstå, at det er sådan. De er simpelthen så syge. Tid: FORTÆLLER Felthospitalet i Kailahun har plads til 80 senge og ligger i et bush-område i den østlige del af landet. Det tager 9 timer ad meget dårlige veje at køre fra hovedstaden Freetown til området i Kailahun. Flere gange om ugen kommer ambulancer med syge kørende til centeret. Nogle gange er ambulancen fyldt med en hele familie: Det er i dag d. 25. september, og jeg er her i Kailahun. Øhm, jeg sidder lige nu vores Staff Health Unit her til morgen. Øhm, jeg har nu været her i snart to uger, nej halvanden uge og arbejdet med ebola. Øhm, og, ja det kan være svært at beskrive hvordan det helt opleves, altså lige vi har ambulancer der kommer ind, ikke hver dag, men stort set, eller hver anden dag i hvert fald, når det kan lade sig gøre. Page 21 of 49

22 Time: NARRATOR The roads aren t very good and they are transported for a really, really long time. Some come from as far away as an 8 hour drive from here and they re simply stuffed into an ambulance, sometimes up to 10 people in one ambulance. Yesterday, two ambulances came with, what, 10 people in each ambulance where they were just packed in. And when they arrive here, they re often already so sick and they have travelled so far that they are really, really bad. They are really bad. Yesterday there were Four who were dead ONarrival, and the question in reality is how well the others are going to do, because half of them that were admitted with us were really bad. Er, what I think... the ones I most think about are those... recently we have seen whole families coming in here. I was in triage yesterday, that means it was me who had to ensure that patients received a number and a wristband and were admitted to where they belonged, whether we believed they very probably had Ebola or whether they really are here mostly for observation, then they were admitted into our various tents. And there were, among others, a family of 5 people, which were a father and his three children and an uncle. The mother was.. no, the mother had arrived with the ambulance a little before, but was really, really bad and had quickly been admitted so she could come in and lie down. It s... it s really hard to see whole families sitting there and being so sick. You look at them and know they probably aren t going to survive. Er... and it also turned out that all three children..... were infected with Ebola and the mother died two days after we had admitted her. It s the second time Astrid has been sent out with Doctors Without Borders. The first time she was in the Central African Republic, and here there were patients with diseases such as meningitis or malaria - diseases that could be cured or treated. This isn t so with Ebola. Page 22 of 49

23 Vejene er ikke særlig gode og de bliver transporteret i rigtig, rigtig lang tid. En del kommer fra sådan 8 timers kørsel herfra og de bliver simpelthen stoppet ind i en ambulance, nogen gange op til 10 mennesker i en ambulance. I går kom der to ambulancer med, hvad, 10 mennesker i hver ambulance, hvor de simpelthen bare bliver proppet ind. Og når de kommer her, så er de tit i forvejen så syge og de har kørt så langt, at de er rigtig, rigtig dårlige. De har det rigtig skidt. I går var der fire, der var døde ved ankomsten, ja, og spørgsmålet er i virkeligheden hvor godt de andre kommer til at klare sig, for der var rigtig, altså, halvdelen af dem der ellers blev indlagt hos os var rigtig dårlige. Øhm, det som jeg, tror jeg dem jeg mest tænker over det er at vi ser her på det sidste en del familier, der kommer ind. Dvs. jeg stod i triage i går, dvs. at det er mig, der sørger for, at patienterne får et nummer og et armbånd og bliver indlagt til hvor de nu skal høre til, om vi tror de meget sikkert har ebola, eller om de egentlig er her mest til observation, så bliver de indlagt i forskellige af vores telte. Og der var bl.a. en familie på 5 personer, hvor det var en far og hans 3 børn og en onkel. Moderen var.. næh, moderen var kommet med ambulancen lidt før, men var rigtig rigtig dårlig og var blevet taget hurtigt ind, så hun kunne komme ind og ligge. Det er. det er rigtig hårdt at se hele familier sidde og være så syge. Man kigger på dem og ved, at de sikkert ikke kommer til at overleve. Hmm og det viste sig også at alle tre børn.. var smittet med ebola og moderen døde to dage efter hun var kommet... at vi havde indlagt hende. Tid: FORTÆLLER Det er anden gang Astrid er udsendt med Læger uden Grænser. Første gang var hun i Den Centralafrikanske Republik. Her kom patienterne med sygdomme som meningitis eller malaria - sygdomme der kunne helbredes eller behandles. Sådan er det ikke med ebola. Page 23 of 49