News from Sue in Sierra Leone.

Pic is of sunrise at 7 am over the ICU tent.  So hazy in the morning from overnight fires, smog from vehicles and perhaps a bit of marine mist.  Our ETC backs up onto the ocean.
We went 6 days without a new confirmed case.  Today we confirmed one – the 10 yr old brother of the man I sent you the smiling picture who was so grateful for himself and his siblings.  We discharged his 15 year old brother today cured, but admitted his 25 year old brother into Suspect.  I’m not sure why this family continues to be plagued – I’m assuming the house has been decontaminated and they are well off and educated, so not sure why we continue to get siblings infected …
I was in Triage today and admitted 9 new patients.  I think 2 or possibly 3 will be positive.  No one looked especially sick, so hopefully they will all do well.  If their symptoms have been for 3 days, one negative test sends them home.  If it’s been less than 3 days and the test is negative, they have to stay for another few days and retest before being sent out negative.
So now we have 4 confirmed cases total.  That’s down from a high of about 50 when I arrived.  So many national and expat staff per patient, we’re all tripping over each other.  Monday afternoon, they will announce national staff decreases and perhaps in a week or so, we’ll also decrease expats.  ASSUMING the decrease in new cases continues as is.  Overall, all 3 affected countries have very few new cases and it seems the outbreak emergency may be over.  There might still be the odd case here and there, and still a need for vigilance and surveillance and a place to appropriately treat.  But MSF might be starting to fold up the tent and move on to the next crisis.  
There is always another crisis.
One thing I noticed that will make you smile.  Remember I told you about the humidity here – well over 90%.  Yesterday, I was making copies, slightly bleary eyed at 7 am … The laser printer started to “smoke” – I first thought “FIRE!” from the poor quality electrical components here  …. but then I realized the paper was so damp, when it went through the heat of the printer, it was steaming!  Paper went in soggy and limp and came out crisp and dry!
Thank you all for always sending your positive thoughts in this direction.  These people need them so much.  Life may return to “normal” minus many family members, minus nearly a year of school, minus nearly a year of salary for many where businesses, schools and medical facilities have been shut down … I hope some of the “development” charities come to help rebuild what’s been devastated by this disease.  I hope the reflection and review process finds Lessons Learned that can be applied to the next disaster.  I hope the statistics and studies and research can lead to cures and early detection and better treatment modalities.  I hope we can avoid another horrific loss of life as we’ve seen with this epidemic.  I hope the world stops thinking “If it’s not my country/continent/people, I don’t have to deal with it.”. I hope drug manufacturers and vaccine producers and the FDA all work together for PEOPLE and not PROFIT.  And I hope all of you will remain engaged and curious and interested in events beyond our borders, whether or not they directly impact you.  If you can’t go yourself, please donate to good charities who can. Support people who can.  Stay informed.
Much love to all,