Dear Family and Friends,
Greetings from Cameroon. As many questions have been coming our way related to Ebola Viral Disease, it seems appropriate to focus on Ebola relative to the work here. We’re very grateful that we’ve not yet seen this disease in Cameroon. Over 2 months ago, however, we did encounter a patient whose symptoms were very suspicious for Ebola. Evans was a 27 year old Cameroonian man who came to the hospital from the coastal city of Douala – the location of one of the country’s two major international airports. He described a four day history of fever accompanied by headache and cough with blood-streaked sputum. Shortly following his admission to Men’s’ Ward, the patient started to hemorrhage from his nose and mouth. As it was not possible to keep up with his massive blood loss, the patient quickly died.
We were alarmed by both the mode and the rapidity of his death, as Evans had been previously healthy and was gainfully employed in a physically demanding occupation. His illness moreover had been acquired in a major urban environment rife with opportunities to interface with others transiting into the country. We therefore had to consider the possibility of a viral hemorrhagic fever, such as that due to Ebola. Accordingly, blood drawn prior to the patient’s death was preserved for analysis and quickly shipped to Cameroon’s major laboratory in the capital city of Yaoundé, where we had been told that testing was available for Ebola virus. Considerable alarm was expressed by regional health officials who heard about our patient.
After the trauma of losing the patient, another distressing matter arose when Evan’s family presented to the hospital to collect his remains. Under the circumstances, how was the hospital to handle his corpse? The reference lab in Yaoundé had initially promised to promptly process the blood; yet they continued to delay. The hospital worried about keeping the patient’s body in the mortuary; as his remains had to be considered infectious. We therefore sought the family’s permission for a rapid burial on the hospital grounds. Their anguish was painfully evident. The family had been informed of the suspicion of Ebola – which placed one of Evans’ brothers, who had been closely tending to him, at considerable risk. In addition, longing to pay their final respects to their son and brother, the family sought to commit Evans’ remains to the grave they had already prepared for him on their compound. Continuing to plead with the hospital administration for the body of their loved one, a solution was reached as Evans’ family brought in a coffin. This was taken to the mortuary and placed alongside Evans’ body. Hospital workers, dressed in protective gear, hermetically placed Evans’ body into the coffin – which was immediately nailed shut. Having elicited a promise from the family not to open the coffin, but instead to proceed directly with burial, they drove away with heavy hearts.
The patient’s brother, Frederick, subsequently made a trip to the hospital inquiring about Evans’ test results. As the lab was continuing to delay, I took his phone number and promised to call him when we had any news. Finally, a week after the patient’s death, we were informed that the test results for Ebola were negative. On calling Frederick to relay this information, his reply was, “You mean I’m not going to die?” I told him it did not look like he would die of Ebola – but urged him to put his faith in The Lord Jesus Christ. His reply was, “That’s what people keep telling me.”
Just two weeks ago, it was surprising to receive in the standard mail a formal laboratory report from Lyon, France, which tabulated Evans’ test results for Ebola along with other causes of viral hemorrhagic fever. What had not been shared with us at the time was that the patient’s blood specimen had been shipped out of the country for analysis. This explained the reason for the delay. Fortunately, in the space of the last 2 ½ months, Cameroon’s central laboratory in Yaoundé has geared up for in-country testing. Another physician working at one of our sister hospitals nearer Douala contacted us after a woman presented to his facility with signs and symptoms suspicious for Ebola infection. When her blood was sent to the same laboratory, results were available within 24 hours. Thankfully, that specimen was also found to be negative.
While our hospital staff was greatly relieved to receive news of the negative test result for Evans, the circumstances associated with these events were a clarion call to preparedness and vigilance. Since that time, our Cameroonian infection control staff has been engaged in “sensitization” of Ebola Virus Disease…how to recognize it, identification of an isolation area for Ebola victims, and how to care for these patients. In October, two groups of screeners (consultant nurses) working in Health Centers affiliated with BBH were invited to the hospital for a one-day briefing. I was asked to address both groups on the subject of Ebola Viral Disease. One of the groups is shown at left.
The incident shared here offered us just a hint of the devastation facing the countries of Liberia, Sierra Leone, and Guinea. We grieve for these people and can only but ask that those affected might know “the God of all comfort, who comforts us in all our troubles” (II Corinthians 1:3-4).
With Love & Appreciation,
Banso Baptist Hospital (BBH)