On working in Sierra Leone (Guest post by Sean Meaden)

The post below is written by Sean Meaden (a PhD student in the lab working on bacteria-phage interactions in plants) about his recent experience in Sierra Leone volunteering with Public Health England at an Ebola clinic: treatment_centre No hand-shakes, no kisses, no contact: there’s never been a better time to be a socially awkward Brit than in the middle of an Ebola outbreak. Despite life in West Africa being far from normal right now, with deciding on the best no-touch greeting the least of it, new cases of Ebola seem to be falling. This is due in no small part to the coordinated efforts of governments, NGOs and committed healthcare workers. This is a post about a deployment I volunteered for to work in a diagnostic lab run by Public Health England in Port Loko, Sierra Leone. On the 20th of November I applied to travel to Sierra Leone and work in an Ebola diagnostic lab at a recently built treatment centre by the Irish charity GOAL. How does a 26 year old PhD student from Devon end up in a Danish-military run camp in rural West Africa? Despite my high-risk, and at times perilous research on tomato plants, I am perhaps not the most obvious choice for such work. However, a week’s intensive training at Porton Down, the UK’s leading biosafety laboratory, and the support of very capable and experienced colleagues meant I was equipped to perform diagnostic tests on Ebola samples. OLYMPUS DIGITAL CAMERA My day job as a PhD student at the University of Exeter is researching the microbes that cause plant diseases. And whilst the setting is somewhat different, the underlying biology and genetic techniques are all very similar. The chance to take these skills, garnered from an education at UK institutions, to those less fortunate in a country with a literacy rate of 43%, seemed like a unique opportunity. The aim of DFID (Dpt. For International Development) and PHE is to contain the outbreak to the locations in which it already has a stranglehold, thus helping those countries heavily affected and preventing the disease from spreading back to the UK. In my 5 week deployment I, along with a team of 10 other scientists, performed over a thousand tests on samples from suspected cases at the treatment centre where I was based and the many more that arrived by motorcycle courier from across the region. motley_crew The work itself was pretty straightforward, which is a testament to the guys at PHE who design the protocols for the tests. Essentially, you have to safely get the sample into an isolator, which is a big soft plastic box with gloves attached that puts an extra barrier between you and the virus. Once you’ve ‘killed’ the virus you can start working with its genes. It’s still the source of some debate in a couple of ivory towers about whether a virus is truly alive or not: call me old-fashioned but I think if it can replicate, and it’s replication can kill you, I want to call it dead when it stops working. Once it’s dead we can run tests that look for the genes of the virus in the sample, then measures the fluorescence given off by the reaction (qPCR). If it all sounds a bit tech, it is- Douglas Adams’ line “we are stuck with technology when what we really want is just stuff that works” has never been more apt. The reality is that Ebola is tricky to study and not normally a big problem, with outbreaks averaging around 200 deaths, rather than the nearly 10,000 deaths in the current West African outbreak. As such, there’s never been a huge need for a rapid test. Fortunately a new vaccine trial and rapid blood tests will change things in the wake of this outbreak and I hope our line of work will be redundant soon. lab To some extent our stress levels were dictated by the ebb and flow of samples arriving. On some of the quieter mornings we were fighting for menial jobs and some artistic creativity was employed decorating the lab gowns of those not present. Life in the camp was occasionally spiced up with a celebrity visit. The Danish Prime Minister Helle Thorning-Schmidt flew out for a visit, taking time to don the protective clothing worn by doctors, nurses and hygienists in treatment centres. As a huge Borgen fan I was somewhat hoping to get a selfie with the real-life Birgitte Nyborg but sadly our political romance was over before it had begun. IMAG5614 (2) Understandably, our contact with the community was minimal but my naïve interpretation wasn’t that Port Loko was a ghost town, rather a community trying to get on with everyday life in the midst of the outbreak. The same was true when we visited a beach on a day off at the end of the deployment. A burgeoning tourist industry has been stalled as a result of the outbreak. Still, it was pretty refreshing to chat about surfing with some of the local guys- and fortunately it was flat so the temptation to surf wasn’t even an option. Finally, kudos to the doctors and nurses stationed in our camp. Wearing full PPE (the yellow protective suits required for patient contact) in 35 degree heat and 85% humidity takes some guts. So too does couriering a sample on the back of a motorbike from the community hospitals and holding centres over to the testing laboratories, or swabbing a corpse to allow effective contact tracing. In short, I met some very brave people who worked incredibly hard to treat those affected, and by the looks of the current case statistics their efforts are being rewarded. doffing_area

Photo credit: Katina Kraemer

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