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An Ebola Clinic Figures Out A Way To Start Beating The Odds

Women and children wait in the recovery area at the Hastings Ebola Treatment Center in Freetown, Sierra Leone. About 60 patients at the facility were ready to go home after recovering from Ebola.
David Gilkey NPR
Women and children wait in the recovery area at the Hastings Ebola Treatment Center in Freetown, Sierra Leone. About 60 patients at the facility were ready to go home after recovering from Ebola.

Dr Sangigie Sesay, coordinator of the Hastings Ebola Treatment Center, works with his staff in the administrative offices of the facility.
David Gilkey NPR
Dr Sangigie Sesay, coordinator of the Hastings Ebola Treatment Center, works with his staff in the administrative offices of the facility.

Dr. Komba Songu M'Briwah, left, talks on the phone while staff members disinfect the offices of the Hastings Ebola Treatment Center in Freetown.
David Gilkey NPR
Dr. Komba Songu M'Briwah, left, talks on the phone while staff members disinfect the offices of the Hastings Ebola Treatment Center in Freetown.

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Nurses and healthcare workers get medications ready for patients being treated for Ebola at the center.
David Gilkey NPR
Nurses and healthcare workers get medications ready for patients being treated for Ebola at the center.

A man sits in an isolation area at Hastings Ebola Treatment Center. Medical staff there says survival rate went up after they started giving patients intravenous drips.
David Gilkey NPR
A man sits in an isolation area at Hastings Ebola Treatment Center. Medical staff there says survival rate went up after they started giving patients intravenous drips.

Support staff wash both themselves and and their equipment after leaving the high risk areas of the treatment center.
David Gilkey NPR
Support staff wash both themselves and and their equipment after leaving the high risk areas of the treatment center.

Support staff gather outside of the isolation buildings at Hastings Ebola Treatment Center in Freetown.
David Gilkey NPR
Support staff gather outside of the isolation buildings at Hastings Ebola Treatment Center in Freetown.

Dr. Komba Songu M'Briwah, left, talks on the phone while staff members disinfect the offices of the Hastings Ebola Treatment Center in Freetown.
David Gilkey NPR
Dr. Komba Songu M'Briwah, left, talks on the phone while staff members disinfect the offices of the Hastings Ebola Treatment Center in Freetown.

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Health workers are disinfected with a chlorine solution after treating patients at the Hastings Ebola Treatment Center in Freetown.
David Gilkey NPR
Health workers are disinfected with a chlorine solution after treating patients at the Hastings Ebola Treatment Center in Freetown.

Isatu Koroma baths the patients at the Hastings Ebola Treatment Center and helps to clean the facility. She wears full protective gear during her rounds.
David P Gilkey NPR
Isatu Koroma baths the patients at the Hastings Ebola Treatment Center and helps to clean the facility. She wears full protective gear during her rounds.

One reason the Ebola virus is so terrifying is that it's so lethal. Researchers estimate that the strain circulating in West Africa is killing upwards of 70 percent of those it infects. And even among those getting care, as many as 64 percent are dying.

But some doctors in Sierra Leone say it doesn't have to be that way. An Ebola treatment facility in the capital of Freetown claims to have improved the odds of survival — with little resources or money.

Sierra Leone's government set up the Hastings Ebola Treatment Center in some classrooms at a former police training academy. It's payday when we visit, and the workers lined up to get their wages seem particularly animated.

But the lively atmosphere also reflects the broader mood here. In the midst of a lot of bad news about Ebola — a surge of new infections, way more patients than space to treat them — the workers at this facility feel like they're finally having some success.

After loosing about 40 patients when the facility first opened in mid-September, the staff at the facility realized they needed a new strategy for dealing with the dreadful disease.

"We said, 'No, this cannot continue. We need to do something,' " says Dr. Santigie Sesay, who coordinates treatment at the center.

At a brainstorming session, staff zeroed in on a key problem: dehydration. People with Ebola are wrecked with diarrhea. They vomit. They may bleed.

"So we said, 'If we can replace the fluids that are being lost, we can definitely help these people,' " Sesay says.

But the usual way to replace fluids is an intravenous drip. And it can be dangerous to insert a needle into an Ebola patient. All it takes is one prick to infect a health worker. Plus, running IVs takes careful monitoring.

So Sesay was advised against IVs. "During our training, we were told that we are not supposed to to go into the vein," he says.

Still, the staff at Hastings resolved to give IVs a try — with their most experienced nurses inserting them.

To date none of the workers have gotten infected. And the effect on patients has been dramatic, Sesay says.

It's difficult to pinpoint survival statistics for any one center when the overall number of patients is small, and the outbreak is still unfolding. But based on the data so far, Sesay says, Hastings' death rate is way down.

"Out of every 10 patients, four will die and six will come out," he says.

Sesay has also noticed another effect. The medical staff at the center realize the patients have a fighting chance.

"Everybody has become very, very enthusiastic," he says. The staff started interacting with the patients more, even helping the weakest ones eat.

"We started talking to the patients," Sesay says. "We even started bed-bathing our patients ... we became so motivated, and things changed drastically."

Isatu Koroma, who cleans the inside of the ward, says she's been pulling for an older patient — a woman who reminds her of an aunt, who died recently died of Ebola.

"I fell in love with her," Koroma says. "I love her like my Aunt."

The woman was in bad shape when she arrived.

"She was so sick, so weak," Koroma says. "I encouraged her: 'Please you have to for you family. You have your daughter.' "

Now that woman is among about sixty patients who have been moved to the recovery area, just across the yard.

At the area, a worker is calling out the names of people who will be released soon from the treatment center.

The moment is bittersweet. These people have survived Ebola, but a lot of them have lost close relatives.

One women in the area lifts up a baby high into the air. He's tiny.

"This baby has no have mother or a father," the woman says.

Both of the baby's parents have died of Ebola. The woman has been caring for him even though she doesn't know the little boy's name. "I call him Mohammed," she says.

The woman has two children of her own, waiting on the outside of Hasting's treatment center. Her kids, at least, will be getting their mom back soon.

Copyright 2014 NPR. To see more, visit http://www.npr.org/.