I met Will Pooley for the first time about six weeks ago in Kenema, we were both staying at the same shabby guesthouse. For me it was just a short visit, I live in Freetown and had travelled up-country to sniff out stories on the growing Ebola outbreak. He had been working as a nurse on the Ebola ward of the Kenema Ebola Unit, one of the two main clinics in Sierra Leone treating patients.
It was a brutal week at Kenema Hospital. The slowly diminishing nursing staff was reeling in the wake of respected colleague and friend, Sister Mbalu Fonnie’s death who became infected with the virus after treating patients on the Ebola ward. Her passing closely followed the death of seven other nurses who worked on the ward. A few days after she died, the unthinkable happened, and the much-loved Dr Sheik Umar Khan, Sierra Leone’s only haemorrhagic fever specialist, had tested positive with the disease.
Will finished his shift late the night we met, a dramatic day involving a riot outside the hospital followed by a walk-out by most nurses meant that he and his colleague Sister Nancy Yoko were left to hold up the crumbling fort. They were both exhausted after having worked 14 hours and at 9pm were forced to make the painful decision to leave the 45 Ebola patients unattended as no one had turned up to carry on the night shift. They both needed a break in order to gather their strength so they could do it all again the next day. Will was rattled by the terrible dilemma of having to leave the patients alone, “We gave them water and paracetamol and then we had to walk out. Patients are dying the most horrible deaths, I’m expecting to find several corpses tomorrow morning”.
One beer turned into two and a string of traumatic stories about what he was confronting each day on the ward. His tales were unadorned and honest and explained some of the practical struggles of dealing with so much death when you only have one set of hands. He described patients dying in front of him and then being unable to find help to shift their corpse, which meant having to leave bodies laying next to other patients who were conscious, sometimes for hours at a time and occasionally overnight.
As well as death, he talked about ‘life’ on the wards, there were people up walking and recovering, children playing, sometimes singing and even rare moments of laughter. He described one situation with a group of women who were recovering, “They were sitting around singing songs, you wouldn’t see that on a ward in England, you wouldn’t see people singing like that, “.
As the anecdotes kept coming I wondered what was motivating Will, a young British guy, who arrived quietly without the backing of an international organization, but who was determined to perform a role that so many others refused to do. “I know it’s the easiest situation in the world to make a difference, in nursing terms I’m not particularly experienced, or skilled, but in this situation I can really make a difference and make things a lot less bad,” was how he explained it.
I went to bed that night shattered by the grim details of Will’s experience and overwhelmed by what was unfolding at the hospital. How were this guy and the few local nurses remaining, able to keep turning up each day under such obviously unsafe circumstances with so little support? And why was no one paying them any attention? Why were there more people sitting in task force meetings in Freetown than there were on the ward of one of the biggest treatment centres in Sierra Leone?
I continued to check in with Will from Freetown with text messages and a few phone calls. I was worried for his safety and I wanted him to know that he hadn’t been forgotten. He remained cheerful despite the overwhelming challenges he was no doubt facing. There were rumours of Red Cross turning up to provide more staff and logistical support from MSF but things were moving slowly and nothing concrete had happened a week later. He still spoke of the few (if any) staff on night shifts, more nurses getting sick and case numbers continuing to rise.
On my second visit to Kenema two weeks later it seemed that the hospital was turning a corner. Support had arrived at the Treatment Centre in the form of MSF and WHO. Patients were being moved into a new ward, there was better sanitation, staff training and a restructuring of the unit were improving conditions in the hospital for both patients and health workers. Will assured me “It’s a lot safer, it’s a lot cleaner environment for the patients and the staff.”
I interviewed Will outside the hospital one afternoon during the daily discharge of Ebola survivors. All patients who receive a negative test result on any given day are showered, provided with a fresh set of clothes, a certificate declaring they are Ebola free and a small amount of money for the ride home. Relatives usually gather to meet them and there are emotional outpourings of thanks to the hospital staff and of course to god. It’s a beautiful moment for patients and staff that lets at least, some light in to an otherwise dark situation. “It’s great, it’s great, seeing them walk away after some of them have been in a terrible state and seeing them on the wards and thinking you know, they’re probably going to die but to see them recover and walk out the door is great, “.
Will was flanked by a group of up beat young women who had all been discharged and were keen to take a ‘snap’ before they said goodbye to their favourite nurse. He was clearly popular among the patients and he was fond of them. “They were all together on this one ward’, he said pointing to the girls, “and they were a nightmare, as soon as you went in (to the ward) they would all be going ‘Doc Doc Doc’, but they are really nice, nice girls. It will be so quiet in there now”.
It was not only the patients who held ‘Nurse William’ in high esteem but his colleagues as well. Nancy Yoko, his tough-as-nails Sierra Leonean colleague spent a lot of time on the ward alongside Will and is clearly a fan. “We have a lot to thank William for, he has motivated us, he has encouraged us“. The gutsy leader of the hospital, Matron Josephine Sellu shared a similar sentiment, “William has come here and offered to help in this war against Ebola, we thank him for that. He has taught us things he has helped our nurses”.
Will had been in Kenema for five weeks when I last saw him and I suspected the emotional burden of dealing with so many deaths each day was taking its toll, but he seemed to be just getting on with things and perhaps less vulnerable than when we first met. “At the start, especially, I could feel the weight of the horror that is the inside of the Ebola ward but you quickly get used to it. I don’t go onto the ward each morning with that same dread of the corpses and blood that I did to start with. It has become a bit routine now”.
The issue of personal safety and that of his colleagues was obviously an ever-looming concern for Will. But the possibility of becoming infected just didn’t seem like an option. He assured me at one point, “The PPE that we wear protects you against Ebola, full stop really. If you wear it and you don’t make any mistakes and everything is done properly then you will never catch Ebola when you are working.”
He also said that he didn’t take the same risks that his colleagues had taken, “I operate very differently to local nurses. A simple example is that it’s very normal for staff to eat on site in a moment of going in and out of the ward. I don’t do that. So I’m protected by circumstance in some ways and also I’m a lot more afraid than the local nurses so I take more precautions”.
When myself and my colleagues in Freetown (several who are frontline Ebola ward staff) heard of Will’s positive test result on Saturday it was a devastating blow and cruel reminder of what we all know – those most at risk of catching Ebola are health workers.
I’ve spoken to Sister Nancy several times in the past few days following Will’s medivac. She was quiet, no doubt shattered by the news, and unsure of the details of how he became infected. “He will be OK, he will receive proper care in England, we will miss him though”.
Watching the grainy news footage of Will being loaded off an RAF plane inside plastic casing surrounded by a scrum of medical experts, I wondered what was going through his head. To arrive in one of the poorest countries in Africa and spend two months nursing patients suffering one of the world’s deadliest diseases is in itself an extraordinary experience. But to then contract that same disease and be transported to the most sophisticated treatment unit on earth is unfathomable.
Will, like so many health workers in Sierra Leone, is quite simply a hero. A very humble one, whose work has literally saved dozens of lives. He confronted a horrific situation in the bravest way possible, under circumstances that most people would turn their back on. Let’s hope, that he, along with all the other courageous health workers risking their lives to save others, are duly honoured for the incredible sacrifices they have made.
Before I left Kenema I asked Will what he planned to do after Ebola, “I’ll get a motorbike and travel around Sierra Leone. I’ll feel great because I know I’ve earned it”.
An edited version of this piece appeared in The Guardian on August 27