When I learned of British Nurse Will Pooley’s positive Ebola test result a couple of weeks ago, I immediately called his colleague, Sister Nancy Yoko, who worked alongside him at the Ebola Treatment Unit in Kenema. It was a terrible piece of news to receive and I wanted more information, an explanation, a conversation and a reason why this had happened again to a health worker in Kenema.
Nancy’s voice was soft when we spoke that day almost languid, she was reluctant to talk, no doubt processing this latest cruel blow Ebola had served up. “He will be OK, he is being flown to London”, she reassured me. “Are you alright Nancy?” I asked. “I’m OK, I’m managing”. Her response was unconvincing but Nancy was tougher than most and at that point the concern in my mind was Will.
The first time I met Nancy was in Kenema towards the end of July. The hospital had just suffered the loss of one more nurse to Ebola, this time a good friend of Nancy’s, and widely respected colleague of the wider staff, Sister-in-Charge Mbalu Fonnie. It was business as usual in the treatment centre though, Nancy had stepped up into Mbalu’s role and was leading the relatively upbeat proceedings for the discharge of a group of Ebola survivors that afternoon. “Tel god tenki tel em, tel papa god tenki,’ she sang in a rowdy chorus with the other nurses as each survivor was presented with a certificate of good health. “I feel happy today for these people, but sad as well. I’m thinking about Mbalu, our late sister. She was always here for us, she taught me so much, even on her sick bed’. Nancy wore the strain of this unconscionable situation on her brow, always furrowed and on that day the lines were deeply set.
During this visit I was also introduced to Will, Nancy’s unlikely side-kick, bonded by the same burden, horrors and fears that are carried when working day-in and out on an Ebola ward. They were both among the small group of nurses who dared to treat patients, working relentless hours to keep the terminally dysfunctional Kenema Treatment Unit afloat.
I met her again two weeks later, this time in what seemed like less critical circumstances. The hospital was improving, international help was arriving and a feeling of optimism had lifted the mood in the hospital. Nancy’s forehead was less crinkled this time, stomping about in her gumboots and scrubs, shouting orders and directing staff, it seemed her confidence had been restored.
I continued to keep in touch with Nancy over the phone in the week after Will was taken out of Kenema, reporting on what I knew of him in London. They were always short conversations, usually me enquiring if she was OK. By ‘OK’ I was referring specifically to her health, I couldn’t bring myself to explicitly say it out loud, but she knew what I was inferring. “I’m ok, I’m fine I’m safe”, was her stock response.
After just nine days at the Royal London Free Hospital in Hampstead, several doses of the experimental drug ZMAPP and the best clinical care available in the world, we learned on Tuesday that Will had made a stunning recovery. As quoted by the Guardian when he was discharged “I have only praise for the level of care I have received here (at the London Free), and amazing level of skill, compassion and kindness that I’ve received. Of course it’s not the same in West Africa, I wish it wasn’t the case”.
The day of Will’s release, I called Nancy, looking forward to a chat. Her phone was once again switched off, this had happened several times in the days preceding. I couldn’t shake my uneasiness around her silence so I called Matron Josephine Sellu who delivered the words I didn’t want to hear “Nancy is infected”. Three days later I checked in again with Matron, “She is very, very sick, she is confused”. Confusion sets in during the late stages of infection when the virus attacks the brain, I immediately knew things were bad but part of me was clinging to something that Nancy herself had said, “Sometimes patients come onto the ward very, very sick and I can’t even believe that they recover”. Last night I received a call from Matron confirming that Nancy was not one of those miraculous cases. “We lost Nancy,” she announced through a heaving flood of tears.
I haven’t spoken to Will but I expect he has already learned of Nancy’s death and I doubt there are many people feeling this loss more deeply than him. As her colleague who was infected in the same circumstances, but then afforded the privilege of a medivac and world class treatment, I imagine it must be painful to reflect on his friend who died in the grossly inadequate medical facilities that are offered at the Ebola treatment unit in Kenema Hospital.
Ebola has glaringly brought to light a gamut of development problems that Sierra Leone has been facing for decades. The outbreak has also served to acutely highlight vast Global inequalities in healthcare, which somehow represent so many other less obvious disparities. As Matron Josephine rightly reminded me, “When William was infected, he was taken straight away to London, but who will pay for us to do that when we get sick? It’s really painful for us, we are Sierra Leoneans, we have to work here to fight this disease, but who will save us?” There is no acceptable answer to that question right now.
WHO announced that it hopes to make available a vaccine to be administered to health workers who are braving death traps like the Ebola treatment unit in Kenema to treat patients. This is a positive step but sadly too little too late for heroic Sierra Leonean health workers like Sister Nancy Yoko who continue to step up and put their own life before that of others.