'Working on an Ebola outbreak isn't just about reacting to physical challenges'

Henry Gray, Médecins Sans Frontières (MSF) logistics emergency coordinator for the Ebola outbreak in Uganda, describes his team’s preparations to care for fearful patients and their families, and to help prevent the disease from spreading.

“The team landed in Uganda at the weekend and, since then, we’ve been working flat out trying to implement a comprehensive outbreak response in the Kagadi area. MSF has a lot of experience with Ebola – we are using the same approach as in previous outbreaks which we’ve found to be effective in stopping the spread of the disease.

We are in the process of installing a treatment centre in Kagadi, which should take seven to ten days. Patients will come here to be treated. Isolating them will help reduce the risk of contagion in the community.

Working on an Ebola outbreak isn’t just about reacting to the physical challenges of an outbreak – educating people is also vital. Health workers are particularly susceptible to catching it so, along with treating patients, one of our main priorities is training Ugandan health staff to reduce the risk of them catching the disease whilst caring for patients. We have to put in place extremely rigorous safety procedures to ensure that no health workers are exposed to the virus – through contaminated material from patients or medical waste infected with Ebola.

The general public is understandably concerned, because this isn't a disease that they regularly encounter. This is the biggest Ebola outbreak in Uganda since 2007, and lots of people don't really understand what Ebola is. While they know how to recognise malaria or cholera, Ebola is much more frightening for them – partly because the early symptoms can be very similar to well-known diseases.

The symptoms can include fever, vomiting, sore throats and headaches and, in severe cases, internal or external bleeding. Patients with a severe case of the disease will need intensive care. Often they are very dehydrated and need to be given fluids through a drip. Unfortunately there is no specific treatment or vaccine for Ebola ­– several vaccines are in development, but it’s likely to be several years before one is available.

Ebola spreads quickly and can be deadly, so the social effects can be very severe. The patients we are treating are very frightened, for obvious reasons. Their families are also very scared, so as well as our treatment centre, we are setting up psychosocial support for the patients, their families and also our own staff, who may also be traumatised by what is happening.

Many people have stopped kissing or shaking hands when they greet each other – even though people are only actually infectious when they have Ebola symptoms. There’s a lot of media publicity about how to reduce the risk of catching the disease and to seek medical help immediately if someone becomes ill, and these public messages are vital.

Once we’ve finished constructing the treatment centre and training the staff over the next few days, we will have the capacity to treat and care for between 50 and 60 patients at a time. At the moment we're hoping for the best but preparing for the worst.”