Panorama.S2014E43.Ebola.Frontline
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00:00Tonight on Panorama, Ebola.
00:11But from a very different angle.
00:16We get a doctor's eye view of this horrifying disease.
00:22Sometimes you stumble upon good news and sometimes you stumble upon bad news.
00:29This is the story of a month in an Ebola treatment center where medical staff battle
00:35to save what lives they can.
00:58At Saint-Saens-Frontieres Ebola treatment center in Kailahun, Sierra Leone.
01:05It's one of two MSF run treatment centers in the country and has the capacity to treat
01:1096 patients.
01:14It's been over 10 months since the first victim of this Ebola outbreak died, known as patient
01:20zero.
01:21We've got two teams getting ready, put your mask on.
01:26Ebola cases are now in their tens of thousands and multiplying every few weeks.
01:31And there have been over 5,000 reported deaths.
01:35Hang on, there's four bodies, yeah, two in each ambulance.
01:40I can't get in to confirm because it's too dangerous.
01:45Dressed head to toe in a biohazard protective suit known as a PPE, Dr. Jay Archa and the
01:52medical staff receive another ambulance full of Ebola infected patients.
01:56OK, they're coming.
01:58Ah, we don't need the stretcher.
02:03Just the first one.
02:05In the PPE you've got big boots on and it's very hot and slippery, you don't want to have
02:10an accident in there because obviously dead bodies have very high levels of the virus
02:14in all of their body fluids so it's a risky place to be to acquire Ebola.
02:21No, no, no, no.
02:26You want only hygienists or also body bags?
02:29Two more grey body bags and a few more hygienists.
02:33Just check that they're organising themselves.
02:36OK.
02:37It's all new here, you can't basically use your experience that you had before in a war
02:44context or in a refugee camp or in whatever emergencies, natural disaster, it's so different.
02:51OK, where is the third ambulance?
02:54Where did it stop?
02:55We lost it on the way.
02:56We only received two ambulances.
02:58OK, sir, there are four dead on arrival because there were too many in the second ambulances
03:07so this is why you need to put the patients in three different ambulances.
03:11We have on the phone every night people calling.
03:14We have 30 patients, we have 100 patients, we have 100 patients.
03:2030 patients, we have 50 patients.
03:22For example, three days ago we had one district calling us, they had 38 patients.
03:28They called me yesterday, they have 75.
03:32To prepare the body is the most dangerous work because the content of the virus is very,
03:38very high.
03:39OK.
03:40You mistake, you are gone.
03:42If we don't do this job, then who will do it?
03:44I'll get some metoclopromide and a syringe if you want to give it IM.
03:50Just give them a number.
03:51It's clear to say that it's a complete disaster.
03:54I think it's beyond the scope of one organisation just to say, yeah, we'll cover this.
04:00Even with MSF's experience and resources, this is too much.
04:05This one's probable.
04:07This one's suspect.
04:09It's three whole countries potentially and there's the prospect of it going to other
04:14countries.
04:20It's 8 o'clock on Friday the 12th of September.
04:24The headlines this morning.
04:25The Ebola outbreak in West Africa is the worst the world has seen since the disease was first
04:31identified 38 years ago.
04:33Sierra Leone is about to put a three-day nationwide lockdown into place to try and contain the
04:38spread of infection.
04:39And across the region, more than 2,000 people have died in six months.
04:44Christopher Stokes...
04:46When I see those disasters or when I see that sort of medical need, I just feel antsy sitting
04:53back in my comfort zone here doing nothing.
04:56When I know I can pick up the phone and call the MSF office and say, right, give me a mission.
05:02Something's going on down there and I want to go and help.
05:0535-year-old A&E doctor Javed Abdelmonem has been on previous MSF missions to Haiti, Iraq
05:13and Syria.
05:14But this will be his first time on the Ebola front line.
05:19My main worry has definitely been if I get Ebola, to be honest.
05:27And you have to be an idiot not to think about that.
05:30But then I say no.
05:32There have been no international MSF staff infected by Ebola since the outbreak began.
05:44I'm not going to be the first.
05:45I'm just going to follow the rules and keep myself safe.
05:54My government has declared a three-day stay at home.
05:58Preparing for lockdown in Sierra Leone.
06:01It's a desperate attempt to stem the spread of Ebola.
06:04It is better to stay at home for three days than to lose thousands of people.
06:10Volunteers went from home to home handing out soap, advice on how to control infection.
06:19Over the next ten minutes we'll have the latest developments on the Ebola outbreak
06:23in Sierra Leone, Guinea and Liberia.
06:26The three-day national lockdown allows health workers to distribute vital public health information.
06:34But it's difficult for communities who have strong cultural traditions of communal living
06:39to stop eating together and avoid touching.
06:43We usually go out and get our livings.
06:45And if we are kept for three days without going out,
06:49it's like we find it difficult to get what to eat.
06:54I'm a businessman. I live with my family here.
06:57I thank God we are alright.
07:00I thank God we are not attacked with this sickness at all.
07:09The first day of lockdown
07:15Liberia. A French worker who contracted Ebola is still waiting evacuation to Paris.
07:20Doctors Without Borders has criticized...
07:22Dr Javed begins his one month deployment in Kailahun
07:25just as the first MSF international staff member catches Ebola.
07:30The risks of the job are clear.
07:33I'm trying to tell myself every few seconds
07:35you don't want Ebola, you don't want Ebola, you don't want Ebola.
07:38Be careful, be careful.
07:50From the moment he arrives at the treatment center,
07:52Dr Javed is subject to strict disinfecting protocols.
07:55Thank you very much.
07:59I haven't done anything yet and we're disinfecting already.
08:01It's good.
08:08MSF relies on an army of doctors, nurses and support staff
08:12from all corners of the globe
08:14who are willing to put their own lives at risk.
08:17Running this 96 bed center
08:19are four doctors, 52 nurses and over 200 support staff.
08:26So I can give you a hug now because I'm clean.
08:28I don't want to.
08:30Yeah, let me give you a shake. Hi, nice to see you.
08:33We were at uni together.
08:36He looks terrible ten years on.
08:38He hasn't aged well.
08:40Just all the way in.
08:44Those who are going to be working inside the high-risk zone
08:47will have had two days training in biohazard safety procedures.
08:52This is the first time I'm going into the high-risk zone.
08:55I've practiced putting this on once before
08:58but I think this is the first time that it's sort of hit home
09:04and I'm going in.
09:09The personal protection equipment, or PPE,
09:12has been specifically designed to shield the wearer
09:15from infection by the Ebola virus.
09:17It consists of a protective bodysuit, headgear,
09:21mask, thick plastic apron,
09:25multiple layers of chemical-resistant gloves
09:28and a pair of plastic goggles.
09:32The doctors must complete their rounds quickly
09:34under all that equipment
09:36as they endure temperatures that can reach
09:38up to 100 degrees Fahrenheit.
09:40The nerves have started.
09:42There's that healthy dose of fear.
09:45In addition to his PPE,
09:47Javed will be wearing a miniature camera
09:49attached to his goggles
09:51to provide a unique doctor's eye view
09:53inside the high-risk zone.
10:02It's sparse.
10:04They're in a tent.
10:06It's hot and humid.
10:08They get given a blanket, a set of clothes,
10:10a toothbrush, toothpaste and a washing bowl
10:12when they arrive, and three meals a day.
10:14But if they're too weak to walk,
10:16they're basically just lying in bed alone.
10:18The people who are newly really sick with it,
10:20they're just flat, you know, can't even talk.
10:24Thank you very much.
10:27It's a feature of the Ebola,
10:29to have this complete fatigue,
10:31so much so that they can barely even open their eyes.
10:35So they're either unconscious or just super fatigued.
10:37It's really quite nasty.
10:39There's always this woman sleeping on the mud.
10:41She's breathing.
10:45Of course, so while the risk is reduced,
10:47there's still accidents and there's still mishaps
10:49and so forth.
10:51It's really quite nasty.
10:54There are restrictions to your sight with the goggles.
10:56There are sharp edges on wood.
10:58There are metal posts.
11:00You can trip and fall.
11:02There are restrictions to your movements
11:04with everything that you're wearing.
11:08You go in with a buddy,
11:10and if they go,
11:12oh, you're not allowed to move,
11:14you're not allowed to move,
11:16you're not allowed to move,
11:18you're not allowed to move,
11:20you're not allowed to move,
11:23and if they go, oh, your goggles slipped,
11:25you have to walk out of there
11:27regardless of what you're doing straight away.
11:43The riskiest part of the process
11:45is the careful removal
11:47of the now infected protective equipment
11:49with chlorine washing
11:51and spraying at every stage.
12:03Even the camera gets a chlorine bath.
12:09It's a meticulous procedure
12:11that can take up to 20 minutes
12:13to complete safely.
12:21So, I had to come out early
12:23because my yellow overall
12:25had slipped down
12:27and my second pair of gloves,
12:29which is to my skin,
12:31had slipped up,
12:33so I only had literally
12:35just the one layer of latex
12:37instead of the three layers
12:39between me and the outside world.
12:41My blue glove had just crawled up with sweat
12:43and I had just had this area
12:45and this area exposed.
12:47And I noticed, so I asked Dennis
12:50and he was like, yeah, we have to get out right now.
12:52It's just not safe.
12:54So, I've sort of spoiled it
12:56for him. We couldn't finish what we went in to do.
12:58Yeah, I'm super paranoid.
13:00I mean, I've just itched my face
13:02even though I've washed my hands 400 times
13:04in coming out of there,
13:06but I've just done this and now I'm like,
13:08this is exactly what I thought
13:10I wouldn't be like.
13:12Here I do it again.
13:14So, yeah, it does play on your mind.
13:16It does play on your mind. It's funny.
13:18I'm going to wash again.
13:49I hold the power to turn this horrific epidemic around
13:51and I appeal to you
13:53to do more.
14:03When an ambulance arrives at the admissions tent
14:05containing 10 patients
14:07in the one vehicle,
14:09it's clear how Sierra Leone's crumbling
14:11medical infrastructure
14:13is contributing to the spread of Ebola.
14:16It's almost like
14:18shooting yourself in the foot, throwing them all in
14:20in the ambulance at the same time.
14:22The handle is broken.
14:24That's how it works. You have to get as many people here
14:26as possible from wherever in the country.
14:28So, I think anybody that arrives
14:30off that ambulance
14:32is immediately going to have
14:34to be admitted. There's no way to send them home
14:36and say, oh, well, you're fine,
14:38because they've definitely had a really significant
14:40contact in the ambulance alone
14:42and that's just sad.
14:45Be careful.
14:47The patients that arrive
14:49have either exhibited signs of Ebola sickness
14:51or have had direct contact
14:53with someone who has.
14:55The doctor's first task
14:57is to identify their symptoms.
14:59Diarrhoea,
15:01vomiting, cough,
15:03nothing else.
15:05Did you have any bleeding?
15:07No, from the gum,
15:09from your eye, from there?
15:11Anything from flu-like illness
15:13sore throat, runny nose, cough, headache,
15:15fevers, aches and pains, to
15:17upset stomach, diarrhoea, vomiting,
15:19loss of appetite, to
15:21hemorrhagic symptoms, bleeding from the eyes,
15:23nose, anything else.
15:27There's no privacy, there's no
15:29confidentiality in there.
15:31This is a tent full of people and they're just
15:33screaming across the barrier, through a duckbill,
15:35in two languages.
15:37Ebola often spreads through communities
15:39due to a burial tradition
15:41where they wash the dead body of a loved one.
15:43So he told me it was the 6th of August
15:45when his father died.
15:47Did you prepare him in his burial?
15:51And you touched him and
15:53washed him?
15:59Hang on, just wait.
16:01It seems to be a family
16:03that's come in, in the second ambulance.
16:05And it seems that
16:07maybe the mother is quite agitated
16:09and having to give her something to calm her down
16:11because she's quite a large woman
16:13and it can be dangerous for us to
16:15help her around if she's
16:17bleeding around.
16:19I mean their father, he seems really nice
16:21and he's looking after his children, he's encouraging them.
16:25Whole families often arrive at the treatment centre
16:27together. Each individual
16:29is given a case number to track their
16:31progress.
16:33This is the Koroma family.
16:35Does he have any vomiting or diarrhoea?
16:37Diarrhoea?
16:39Ebola tears families apart because it turns
16:41your loved one into a biohazard.
16:43And you know, in this situation where
16:45if one of your family members turns unwell
16:47you are the caregiver,
16:49not like in England where you take them off to
16:51an NHS hospital and they're cared for.
16:53The first person will fall ill,
16:55then the second and the third, the fourth, the fifth
16:57and that's how Ebola works.
17:07The United States Centers for Disease Control
17:09projects that 5,000 people
17:11in Sierra Leone between now
17:13and the next six weeks.
17:15The World Health Organization says it fears
17:1720,000 may die before it's under control.
17:19The number of Ebola cases
17:21could reach 1.4 million
17:23by mid-January unless
17:25efforts to curb the outbreak are significantly
17:27ramped up. Well we're practically full today
17:29so we've had to say
17:31no to an ambulance today
17:33and our
17:35survival rate has gone up 1%
17:37so 41% survival.
17:39Of course this is only looking at people
17:41here who make it here.
17:43God knows how many are dying out in the villages
17:45and even the vice president acknowledged
17:47that today, or yesterday,
17:49acknowledged that their
17:51counts are
17:53horribly underestimated
17:55because we are
17:57and they are not counting people who die
17:59outside of health facilities.
18:03So the family that arrived
18:05about 48 hours ago
18:07have had to be split up unfortunately
18:09so the mother was quite sick
18:11and I believe she died yesterday
18:13and then the three
18:15children with the two adults have had to be
18:17split up because of their blood tests
18:19so two of the children and the father
18:21have a blood test that
18:23confirms the presence of Ebola.
18:25The Koroma family
18:27is headed by Sule Koroma
18:29who is the head of the
18:31Koroma family.
18:35After his wife died
18:37his two sons were discharged
18:39cleared of the Ebola virus
18:41while he and baby Wara
18:43remain in the treatment centre
18:45awaiting more blood test results.
18:49The baby was tested and was negative.
18:51The father who is
18:53wearing the blue PPE, at the moment
18:55we are not sure if he is just in the beginning
18:57of his disease
18:59or at the end stage.
19:01We don't think that he
19:03is very sick because we can see that.
19:05The reason
19:07we don't take away the baby is because
19:09they have been spending three days together
19:11anyway
19:13he is not very contagious, he is not very
19:15viremic at the moment
19:17so we think if just he takes
19:19measures, it's better to have the baby
19:21together with the father.
19:29We have been waiting for three days
19:31to have the baby
19:33and we have been waiting
19:35for three days
19:37to have the baby
19:39and we have been waiting
19:41for three days
19:43to have the baby
19:45and we have been waiting
19:47for three days
19:49to have the baby
19:51and we have been waiting
19:53for three days
19:55to have the baby
19:57and we have been waiting
19:59for three days
20:01to have the baby
20:28In the laboratory
20:30a war is being fought
20:32An experimental treatment
20:34ZMAP was developed in a lab in California
20:36They are growing the antibodies
20:38in genetically engineered tobacco plants
20:40used to treat two American aid workers
20:42who were infected and survived
20:44ZMAP has also been given
20:46to two Liberians
20:48a Spanish priest
20:50but supplies have now run out and it will take time
20:52to make more, to make more
20:58As there is no proven cure
21:00or clinically tested vaccines available
21:02the treatment that is given
21:04is purely supportive
21:06to help the patients have the best chance
21:08of fighting off the Ebola virus themselves
21:10We have moved away from calling it
21:12a treatment centre because little treatment
21:14is available
21:16So we call it now
21:18a case management centre
21:20The treatment is supportive
21:22not curative
21:24So every patient on arrival
21:27receives full malaria treatment
21:29a broad spectrum
21:31antibiotic treatment
21:33rehydration
21:35painkillers
21:37if they need antisickness
21:39antidiarrheals
21:41and of course nutritional
21:43with the aim to keep a patient alive
21:45until their immune system can kick in
21:47It's good for you to eat
21:49Get those antibodies out
21:51fight off the virus
21:53and survive
21:56Only around 30%
21:58of those infected with Ebola
22:00will survive and be cured
22:04But 70% of those infected
22:06will die
22:08most after just one week
22:12So normally we would
22:14do the pupillary reflexes
22:16with a torch
22:18no breathing, no pulse
22:20and then you say rest in peace
22:22Do we know his name?
22:24No, no, no
22:26Not given, nobody know him
22:28for three nights
22:30Many patients have a very sudden death
22:32so sudden that they literally
22:34are found in the very
22:36position in which they were
22:38either sort of casually sleeping
22:40praying, sitting
22:42just slumped like this
22:44upright
22:46I just went in there to do a transfer
22:50We had a boy
22:52He was sitting in his bed
22:56Folded over
22:58folded onto himself
23:00just slumped right forward
23:04You go in and you find a cold body like that
23:08That's how it's happening
23:12I don't even know his age
23:14You know, these patients are not
23:16John Smith 37
23:18They're 616
23:20and that doesn't help you
23:22get close to them emotionally
23:24and maybe that's purposeful
23:28While it's common practice
23:30to try to keep a professional distance
23:32from your patients
23:34many doctors and nurses
23:36working on the Ebona front line
23:38can't help taking a personal interest
23:40in the lives of the people they treat
23:42Two weeks into his deployment
23:44Dr. Javed has developed
23:46just such a connection
23:48and her father Sule
23:50who he was pleased to see
23:52were making an improvement
23:54She's in with her dad Sule
23:56He's been moved to the convalescent area
23:58with Wara which is nice
24:00so that means that clinically they're better
24:06So he looked a little bit
24:08more energetic today which was nice
24:10and even Wara managed to
24:12give out the tiniest of screams
24:14when I came near her
24:16which is a good sign of energy in life
24:18so that was nice. Hopefully they'll just keep getting better
24:24When patients are over the worst of the virus
24:26they are moved to the convalescence tent
24:28where they are monitored and supported
24:30by psychosocial counsellors
24:32who get to know the patients
24:34on a more personal level
24:36Idrissa has spent a lot of time
24:38with Wara and her father Sule
24:40When I spoke
24:42with Wara's father
24:44I was very close to him
24:46discussing
24:48and he told me he's going to take showers
24:50I saw him, he took the bucket
24:52and went into the washroom
24:54to take showers
25:00He's lying in here
25:02Please hold it
25:04God, this is terrible
25:06Oh no
25:08Stephanos is also
25:10my little brother
25:14After about 45 minutes
25:16I heard that someone
25:18in the washroom is dead
25:26I went there
25:28Unfortunately for me what I could see
25:30was Wara's father lying there
25:32dead
25:34It was one of the most
25:36distressful days ever
25:38in my life I've been working
25:40in the CMC here
25:42For you to see someone
25:44and you just communicated with him
25:46all of a sudden within a few minutes
25:48he passed away, it was very, very terrible
25:50for me. I couldn't
25:52stand, I even shed tears
25:54because for me it was one of the
25:56most difficult days for me
25:58It's too early
26:00He can't stay here
26:04What made the situation
26:06worse was Wara is just
26:08a month old, she cannot do
26:10anything for herself here
26:12Breathe, breathe
26:16It's really difficult
26:18to know why Wara's dad
26:20Sule had a sudden death
26:24Either it's something to do with Ebola
26:26or it's something to do with the fact that he was bedridden
26:28and hadn't eaten
26:30and possibly dehydrated for days
26:32So
26:34if it's to do with Ebola, did it attack
26:36the heart directly and give him
26:38some sort of fatal heart problem
26:40or was it
26:42to do with the fact that he was actually bedridden
26:44for days and dehydrated and
26:46septic and that gives you three
26:48big risk factors for having a huge
26:50clot in your lung
26:54You've got to think what could
26:56drop a human being instantly
26:58from being strong enough to walk to the shower
27:00alone and not strong enough to come
27:02out and look for help
27:04Either way
27:06it's left Wara in a precarious situation
27:10And then it hits home that this confirmed
27:12Wara's status
27:14as an Ebola orphan
27:30The supportive treatment
27:32the doctors are able to give
27:34can improve patients' chances of survival
27:36from 30% to around
27:3845%
27:42That's very good news
27:44for the lucky ones
27:52We are negative
27:54and we will go and tell them
27:56that Ebola is real
28:00We are going to discharge
28:02a huge number of patients today
28:08Today they have cured
28:10and we are going to discharge them
28:14Congratulations
28:16For the newly cured patients, this shaking
28:18of their hands is a highly symbolic
28:20gesture and it's the first
28:22contact they've had with their doctors
28:24without them being in their protective suits
28:26It's a big group, we've never discharged
28:28seven in one go
28:30Have we ever discharged seven at once?
28:32Oh, yes we have
28:38Some of the happiest times at the centre
28:40come when children are cured and are able
28:42to be discharged
28:44It's estimated that 5 million children
28:46have been affected by the current epidemic
28:48and some 4,000 children
28:50have been orphaned
28:52Most of the children are here
28:54without family members
28:56but they all come together
28:58and play together
29:00they look themselves as a family
29:02and all of them interact together
29:04We give them toys
29:06and that can make them
29:08happy
29:12When parents have either died
29:14or are too ill to look after their babies
29:16round-the-clock care is needed for them
29:18inside the high-risk zone
29:20Fortunately for Wara,
29:22she and another baby, Alpha
29:24had found themselves a surrogate carer
29:26Wara was in the
29:28suspect area
29:30alone with another year-old child
29:32called Alpha
29:34and being looked after by Abdul
29:36who was a five, six-year-old
29:38It's been astonishing to see that
29:40although we would have liked for Abdul
29:42to maintain his own safety and not
29:44handle the infants
29:46at the same time, whenever one of them cried
29:48he would instinctively go and pick them up
29:50out of their crib and play with them
29:52A perfectly human
29:54and natural
29:56instinct and reaction
29:58surprising in such a young one
30:00nice to see
30:02and he, miraculously
30:04after handling both of them, still proved
30:06to be negative
30:08and thankfully he was discharged
30:10having not contracted Ebola from them
30:14Most Ebola-infected babies in the treatment centre
30:16are eventually matched up with an
30:18adult caregiver
30:20Usually another patient who is convalescing
30:22in the high-risk zone
30:24but no one could be found
30:26for Alpha
30:28and in the days that followed
30:30he took a turn for the worse
30:34I went to see Alpha
30:36the poor little Alpha, he's all alone
30:38he looks like he's in pain, he looks scared
30:40He's bleeding
30:42He's too weak to even cry
30:44and he's bleeding from one eye
30:46just dribbling out
30:48Sorry my boy
30:50I've just come out of there
30:52and I couldn't last any longer
30:54I want to go back in
30:56or get someone to go back in to give him some
30:58painkiller and a sedative
31:00if that will quieten
31:02if that will ease his pain at the end
31:04and ease his load
31:06Hey baby
31:10Sorry
31:12OK
31:14Sorry
31:16Since he's been here
31:18he's been alone
31:20in suspect, he was alone being cared for
31:22by a six-year-old, Abdul, if you remember
31:24with Wara
31:26So I don't know where his family are
31:28I could look in the book and see if I have any case contacts
31:30Can you see him?
31:42Next time
31:46It's sad news to see Alpha died
31:48but it's expected
31:50That's why I gave him the morphine and the diazepam yesterday
31:52so I can
31:54tell myself that he wasn't in pain
31:56at the end
31:58Alpha the boy, 604
32:00the little 11-month-old
32:02who died this morning or last night
32:04Did he have family?
32:06He doesn't have family
32:08Why were they already dead?
32:10It's almost better
32:12that he died, isn't it?
32:14You don't want to say that
32:22Those that die
32:24are taken to a purpose-built cemetery
32:26several miles out of town
32:28in the dense jungle
32:30Today, baby Alpha
32:32is due to be buried
32:40Alpha died a
32:42very painful death alone
32:46Bleeding from his eyes
32:48he looked frightened at the end
32:50Do you know which one 604 is?
32:52What?
32:54604, Alpha
32:56Do you know where?
33:02Oh, he's going in now?
33:04Yeah, just Alpha the little boy
33:06So this is his grave
33:08He may
33:10be remembered by a number
33:16We do identify the bodies
33:18with name, age and origin
33:20but here
33:22they've not managed to do that
33:24So there's a huge number
33:26of unmarked graves here
33:30I know for a fact
33:32having filled out the death register last night
33:34number 300 and 301
33:36that means there should be
33:38301 bodies here
33:42This is what 300
33:44fresh graves look like
33:50It's a very unselective
33:52cruel disease, this
33:54and these people can't be buried
33:56in a normal city cemetery
33:58because they're biohazards
34:00These bodies are biohazards
34:02and they're just marked by a number
34:06Anyway, I'll say a prayer
34:08for Alpha a little bit
34:10I don't want to talk about it
34:14That's why I don't want to talk about it
34:16It's not nice
34:18little boy
34:20I'll always say
34:22what if, you know, what if
34:24I'd paid him closer attention
34:26whenever I went in
34:28what if I got another caregiver
34:30to give him closer attention
34:32what if
34:40In the United States,
34:42there's a lot of people
34:44who have died
34:46from this disease
34:48In the United States,
34:50this hospital in Dallas
34:52has been battling to save a Liberian man
34:54The first man to develop Ebola
34:56on American soil
34:58Ebola has arrived
35:00on European soil
35:02In this hospital in Madrid,
35:04one of the nurses is now an Ebola patient
35:06The first person known
35:08to have contracted the virus
35:10outside West Africa
35:12Because if we want to protect Americans
35:14from Ebola here at home,
35:16we have to end it over there
35:18Officials have announced they're planning new measures
35:20to screen some incoming air passengers
35:22The world cared too little
35:24when Africa was suffering
35:26Now the reality of the Ebola virus
35:28has moved closer to home
35:30The first man to develop Ebola
35:32on American soil
35:34We've passed a milestone
35:36of 4,000 deaths today
35:38It almost feels like the world's
35:40waking up to it
35:42and they only wake up to it
35:44when a few white people are infected
35:46Sorry to say, but it's true
35:50It bugs me that that's the nature of the world
35:54It bugs me that that's the nature of the world
36:02Most patients who survive
36:04and go on to be cured
36:06are usually discharged by day 14
36:08But Wara has been at the treatment center
36:10for over three weeks now
36:12and is still not clear of the virus
36:16We know here that
36:18children who are orphaned by Ebola
36:20are having
36:22very small chance of being adopted
36:24So her future
36:26is precarious
36:28We can go in, give feed, give medicines
36:30change a nappy two, three times a day
36:32but you can't leave a one-year-old alone
36:34So we've had to ask a lady in the tent there
36:36who's just another patient
36:38herself convalescing
36:40to take up that responsibility
36:42for this orphan
36:44Her body's still warm, still has fever
36:46Is she eating?
36:50Is she drinking?
36:52We've now got a tent of
36:54two, four, six, plus Wara
36:56seven children
36:58who are without adults to look after them
37:00Placing Wara with Kadir
37:02was a relief
37:04as having round-the-clock care would greatly improve
37:06her chances of survival
37:08However, the relief
37:10was to be short-lived
37:12I went in to
37:14administer morphine
37:16to a few patients that we knew were poorly
37:24In one of the tents
37:26I found a dead lady
37:28and I'd been
37:30following her and giving her some painkillers
37:32over the previous few days and actually thought she was getting better
37:34Fatmata
37:36and she was dead
37:38in the sleeping position
37:42She looked really quite peaceful sleeping like this
37:44So I confirmed her death
37:46and carried on with what I was doing
37:48and on the way out
37:50of course Kadir sits there
37:52with Wara, so I stopped to say hello
37:54as I usually do
37:56Hey, how are you doing?
37:58I'm fine
38:00Where are you going to go?
38:02I want to go to the next hospital
38:05I thanked her in fact
38:07for staying behind despite being
38:09cured
38:11staying behind to
38:13Is the ambulance here?
38:15OK, I thanked her
38:17for staying behind
38:19to look after Wara
38:21and just as she said
38:23Yeah, that's cool, but I've stayed also because of my sister
38:25and she pointed back towards the tent
38:27from which I'd just come
38:29and I said, what's your sister's name?
38:31What's her name?
38:34I just went on
38:36and for a minute I thought I'm actually just going to walk away
38:38and just go OK, and not tell her
38:40but I couldn't, you have to tell her
38:42So I had to tell her that
38:44Fatmata just died
38:53I'm sorry
39:03Do you want to come and see her?
39:17Her mother and father have already died of this
39:21so unexpected
39:23and it just goes to show, I've been seeing Fatmata
39:25for days, I've been seeing Kadia for days
39:27and never knew they were sisters
39:29and this keeps happening
39:31Sometimes you stumble upon good news
39:33and sometimes you stumble upon bad news
39:35like just happened now
39:37I've not seen a reaction like that at all
39:39since I've been here
39:41I don't know if the people are just too traumatised
39:43to process that straight away
39:45you know, having entire
39:47members of families die
39:49I don't know
39:51but do you know what, for me that was
39:53a normal reaction
39:55as opposed to the absence of reactions
39:57that I'm seeing a lot here
39:59to be honest
40:11Today Kadia decided to go
40:13and I think that's completely understandable
40:15while her sister was alive
40:17she was entirely prepared to stay here for Wara
40:19but today
40:21she's reflected over that overnight
40:23I think she's decided to go
40:25and of course we're not going to force her to stay
40:27and so we'll find another
40:29catering for Wara
40:31but she was smiling, so it was nice
40:45But just so you see
40:47that it's not all doom and gloom
40:49Saturday night barbecue
40:57Oh baby
40:59You are the one
41:01The strain of working at the treatment centre
41:03means the doctor's deployment
41:05is limited to just four weeks
41:07As Dr Javed
41:09enters his final week at the centre
41:11one of the few patients that has been there
41:13longer than him is Wara
41:15whose health seemed to be deteriorating
41:21I've got Wara here with a temperature
41:23that just hasn't gone away
41:25otherwise
41:27since the day she came in on the 17th of September
41:29and so that's pushing three weeks now
41:31I thought she had a chest infection
41:33four days ago
41:35started her on antibiotics
41:37she's gotten a lot better since
41:39eating more, less diarrhoea
41:41less breathless, less cough
41:43but that fever just isn't budging
41:45so you have to just start thinking
41:47right, is there malaria in the background
41:49even though we've treated her for malaria on admission
41:51is there Lassa?
41:53There's always background
41:55levels of Lassa fever
41:57in this part of the world
41:59It's probably the virus
42:01it just seems to be taking so long
42:03and the fact that she's
42:05now on the sort of brink of
42:07acute malnutrition
42:09so she's going to get a broad spectrum
42:11antibiotic as a course now and hopefully
42:13that may treat whatever
42:15was lingering and stop her fever
42:23Every morning
42:25the medical teams
42:27check the patient's blood results
42:29that are posted on the whiteboard
42:31and it can often be a highly emotional
42:33occasion, particularly
42:35as it's Dr Javed's last day
42:37I thought I could see
42:39from a distance that Wara's blood tests were back
42:41and I'm going to go and look now
42:43and I think they're good ones actually
42:45so let's go and look
42:48Oh!
42:50Check it out!
42:52What is it? What is it?
42:54Oh no!
42:56Yeah?
42:585.4
43:00Shooting score everyone
43:02The blood results
43:04confirmed that Wara was
43:06free of Ebola
43:08So we've got a discharge
43:10for Wara, huh?
43:12We've got a discharge for Wara
43:17Wara's going to be discharged today
43:19I'm happy
43:21because I know
43:23the ordeal Wara's been going through
43:25and for any reason
43:27she's going to be discharged cured
43:29She's a very strong girl
43:31Very strong
43:33It's great news
43:35so we'll see her washed
43:37and out here and give her a cuddle
43:39not in yellow and she'll probably still cry
43:41but that's good news
43:43Our strongest lady
43:46Well there you have it
43:48We've got
43:50quite a few here, we've got Wara being hugged
43:52She's got a big turnout
43:54She's got a big fan base
43:56because she's been here a while
43:58She's got a sad story
44:00It's nice to have a very happy ending
44:04She must be tough
44:06She's pulled through
44:08and I really hope that she stays well
44:10into adulthood
44:12and carries on
44:16Wara will go now to a children's centre
44:18where staff hope to reunite her
44:20with her family
44:23While the world may have woken up
44:25to the horrors of Ebola
44:27the international community
44:29has yet to rise to the immensity
44:31of the challenge
44:34The future looks extremely uncertain
44:36for her country
44:38and for Wara
44:45There's a nightly update
44:47on the Ebola outbreak
44:49on the BBC News Channel
44:51at 7.30
44:53with reports from BBC correspondents
44:55and experts from around the world
44:57But next on BBC One
44:59Welsh athlete Jamie Bolch
45:01is looking for his birth mother
45:03But next on BBC One
45:05Welsh athlete Jamie Bolch
45:07is looking for his birth mother