1. 6/11/15, 1:13 PMWHO | Sierra Leone: Challenges and rewards of working on Ebola outbreak
Page 1 of 4http://www.who.int/features/2014/challenges-ebola-outbreak/en/
Sierra Leone: Challenges and rewards of
working on Ebola outbreak
July 2014
WHO/ T. Jasarevic
“It was great that Mauricio and I arrived the same day; we were able to
share first, very shocking, impressions and to go through the process of
adapting to difficult working conditions together,” says Dr Catherine
Houlihan, an infectious disease doctor from the United Kingdom
deployed through WHO to help respond to the Ebola outbreak in Sierra
Leone.
For Catherine this is her first deployment in an outbreak setting; “On my
first day, I felt shocked by the enormity of the challenges. The day after, I
started to adapt.”
Dr Mauricio Ferri, a Brazilian intensive care specialist who has worked
for 7 years in various hospitals in Canada, laughs: “Before coming, I had
to convince my wife to let me go”.
Both Catherine and Mauricio are mid-way through their three-week
deployment to Kenema, one of the most affected areas of Sierra Leone
since the outbreak was declared in late May.

2. 6/11/15, 1:13 PMWHO | Sierra Leone: Challenges and rewards of working on Ebola outbreak
Page 2 of 4http://www.who.int/features/2014/challenges-ebola-outbreak/en/
They are part of a team of four internationally-deployed doctors providing
clinical care inside a newly established Ebola treatment centre located in
the city hospital and managed by the Ministry of Health.
They were deployed through the Global Outbreak Alert and Response
Network (GOARN), a WHO-based network of experts and institutions
that can assist with the international response to disease outbreaks.
In Guinea, Liberia and Sierra Leone, WHO has currently 126 experts on
deployment, sourced from staff, external recruitments and partners
through the GOARN.
Personal safety and patient care
“I knew it was going to be hard but I did not expect this extent of
challenges, in terms of lack of equipment and gaps in infection
prevention and control measures,” says Mauricio. “However, after the
initial shock, I started to see those difficulties as opportunities for
improvement.”
Mauricio and Catherine spend 7 hours per day inside the treatment
centre, fully dressed in personal protective equipment (PPE), caring for
between 40 and 50 patients a day. WHO has supplied PPE to health
workers responding to this Ebola outbreak. Everybody – from security
guards, ambulance drivers, cleaners and professional health workers –
should be trained to properly use the PPE so that they can keep doing
their job safely.
Some patients leave their mark. “On the first days I was seeing bodies
being taken away; on my fourth day I saw the first patient discharged. It
was my greatest moment so far,” recalls Catherine. For Mauricio, it is a
story of a 4-year old boy who survived Ebola, the only one in his family
that was decimated by the disease.
The issue of personal safety is another concern for response teams,
especially for medical workers in direct contact with patients. “Prior to my
arrival to Kenema, I was scared about my own safety but I realized later
that we can be in control of the risk,” says Mauricio. “We need to strike
the right balance between caring for patients and our own security.”
The infection and death of several local nurses who worked in the
treatment centre has had a profound impact on all the health workers in
the ward, especially national staff who had worked with them for a long
time. “We need to lead by example on how to properly use the protection
gear and to continue despite setbacks,” says Catherine.
Unique experience

3. 6/11/15, 1:13 PMWHO | Sierra Leone: Challenges and rewards of working on Ebola outbreak
Page 3 of 4http://www.who.int/features/2014/challenges-ebola-outbreak/en/
Would the doctors return to Sierra Leone or accept a deployment
elsewhere if there is a need? “Absolutely”, both reply simultaneously.
“Being part of such an operation is a unique experience. Not only can we
contribute to the effort to stop Ebola transmission but it is also a good
personal learning experience, allowing us to be better prepared for future
deployments.”
Both Catherine and Mauricio applied immediately when they received the
email that WHO sent out to various medical associations asking for
volunteers to help with the Ebola outbreak in West Africa. “So far, no
regrets,” concludes Catherine. “I feel this is where I should be.”
Video: WHO responds to
Ebola virus disease outbreak
in West Africa
More about Ebola virus disease
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Features

4. 6/11/15, 1:13 PMWHO | Sierra Leone: Challenges and rewards of working on Ebola outbreak
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