LONDON Aug 11 After a month on the front line battling Ebola in a hospital in Sierra Leone, the memories that both haunt and inspire British doctor Tim O'Dempsey are of the children.
Many memories of children dying in isolation wards while their parents wailed outside. And one of a small girl who fought her way out of a coma and was reunited with her father.
"Seeing a mother come in with a little baby, and within a few days the baby die - it's very difficult," he told Reuters. "What you do is just get on with it. There are lots and lots of patients that need to be attended to. Occasionally, entire families would be admitted. You can't stop."
O'Dempsey, a doctor with three decades' experience studying and fighting tropical diseases, was seconded to Sierra Leone by the World Health Organization to help battle the biggest outbreak of the deadly hemorrhagic fever in history.
He ended up as part of a team of between two and four doctors, plus a handful of nurses, caring for 40-60 patients a day with one of the most lethal known diseases.
Kenema hospital's three Ebola wards - one for suspected cases, the other two for confirmed infections - had barely 10 or 12 beds each, so patients lay on mattresses on the floors and in the corridors.
Many of the staff themselves became ill, and many died, including the head nurse on the Ebola wards, Mballu Fonnie, and the doctor in charge of the unit, Sheik Umar Khan - declared a national hero by the government when he passed away last month at 39 after treating more than 100 Ebola sufferers.
Amid the misery, it was the small triumphs that made the work worth doing, like that of a girl aged around six or seven.
"Her father had brought her in, but because he wasn't a suspect case he had to leave, so she was on her own," O'Dempsey said. The girl was soon confirmed with Ebola and moved to the isolation wards. There, she had "a pretty stormy course" with high fever, vomiting and diarrhea. She slipped into a coma and was close to death.
"But we managed her as best we could, and she came out of her coma, and very, very slowly we were able to encourage her to drink, and then begin feeding her," he said.
"Just before I left - four weeks later - I arranged for her to go into a side room so her father could see her and look after her again. I hear that she is getting stronger every day."
Such stories, he said, are important because they encourage people to come forward and seek the medical attention that can save lives and prevent the disease from spreading. They are also a blessing for staff who risk their own lives to provide succor.
"It's quite fantastic to see people convalescent and waiting to be discharged - walking around the place, joking, singing and looking remarkably well."
WHO Director General Margaret Chan said last week that one of the most important factors in being able to bring the outbreak under control was to ensure healthcare workers were cared for and respected.
"Governments affected need to send a very strong signal that the local healthcare workers' contribution is appreciated, they are properly paid, and security is provided to make sure they can work quietly and do what they are best at," Chan said.
INFECTED HEALTH WORKERS
O'Dempsey saw the struggle faced by local doctors and nurses at first hand.
"When I arrived the nurses had been on strike since the previous day. There were no nurses inside the wards at all, so conditions were really pretty grim," said O'Dempsey. "There was a high infection rate among healthcare workers and nursing staff. It was very difficult for people to see their colleagues becoming ill and in some cases dying."
The death toll in this Ebola epidemic - the largest and most deadly ever seen - reached 961 on Aug. 8 from a total of 1,779 cases, according to WHO data. In the four countries hit so far, Guinea, Sierra Leone, Liberia and Nigeria, the virus has infected some 140 or 150 healthcare workers, killing around 80 of them, WHO Director General Margaret Chan said last week.
Many epidemiologists and infectious disease specialists - including O'Dempsey, a senior lecturer at the Liverpool School of Tropical Medicine - fear it could get far worse.
"It's unlikely we've seen the peak," he said. A lot more needs to be done to improve and expand treatment facilities to ensure all patients who need to be contained and isolated can be, and to make sure fear and stigma were not made worse, he added.
Nurses and other health workers were not only exhausted and fearful for their lives, he said, but are also shunned by family, friends, landlords and other members of the community, some of whose traditional beliefs lead them to see Ebola infection as a punishment for doing something wrong.
"We need enough nurses who are properly trained and we need clinicians able to offer support and expertise," he said. "You can't have nurses working 12, 14 hours a day, seven days a week for months without a break."
(This version of the story was refiled to correct timing of Khan's death in paragraph 7. The doctor died last month, not last week)
(Editing by Peter Graff and Peter Millership)