08/18/2015 10:05 am ET | Updated Dec 06, 2017
MARCH 27, 2015
At St. John of God Hospital in Lunsar, Sierra Leone, there is a large courtyard filled with trees.
I
was sitting in this beautiful spot with Margaret Bangura while she recalled her joy at
becoming a newly qualified midwife in the spring of last year.
A mother of five, Margaret has lived in the town of Lunsar all her life. She and her husband
scrimped and saved to pay for her training. Her graduation day was one of the proudest
moments in her life, matched only by the day when she started work at the hospital.
Margaret Bangura is a midwife in Sierra Leone. She was trained by International Medical
Corps in Ebola protection.
At that time, St. John of God’s or Massebeneh, as the locals call it, was the main source of
health care for a population of nearly fifty thousand people and was well known locally as a
place where women, some as young as 15, would come to give birth safely.
The people here are poor, subsisting on farming rice and the local staple, cassava. The rates
of infant and maternal mortality are high, making the services provided by Massebeneh vital.
Margaret smiled as she told me about the early weeks in the job. This happiness was to be
short-lived. Within weeks of her starting, rumors about a strange new disease killing people
in the rural villages began to circulate.
By July, Margaret and her friends knew its name — Ebola.
Margaret felt the stress amongst her colleagues rising as the virus started to spread across
Sierra Leone. But she told me that they had to carry on their work. Every day pregnant
women were still coming to Massebeneh in need of their help.
Then, one of Margaret’s friends, a surgical nurse, died. Fear of the disease began to spread
through the staff and the community. She remembers that the number of women attending
the clinic dramatically dropped off. The patients that still trickled into the hospital did so out
of desperation.
I asked her about how she felt about this turn of events, as a mother herself with children at
home. She shrugged and told me that she did everything she could to keep her family safe,
but this was a job she had dreamed of all her life and she couldn’t abandon her patients.
Throughout July and August of 2014, Ebola tore through Lunsar. Within only a few weeks,
eight members of the staff at Massebeneh died, including the hospital’s chief surgeon, Dr.
Manuel García Viejo. The hospital was closed on September 24.
Margaret still grieves for those friends she lost, but she also speaks empathetically about the
women in the community who had nowhere to go. With no medical intervention she knows
hundreds must have died, not of Ebola, but of other complications common in rural village
communities.
By early October, International Medical Corps began to construct an Ebola Treatment Center
(ETC) a few kilometers up the road from Massenebeh. Brother Michael Karoma, the new
head of Massenebeh, started having regular meetings with International Medical Corps staff
who were to run the Lunsar ETC.
Both partners agreed that to be a success the hospital would have to be perceived as safe from Ebola by the local community.
First, International Medical Corps designed and built a triage facility, called a screening and
referral unit (SRU), which would screen every person entering the hospital for signs of Ebola,
and then would refer any patient with potential symptoms to the ETC.
Then, Margaret and her teammates were trained in the use of Personal Protective Equipment (PPE) at the ETC’s training center. She laughs when she recalls the initial reaction of the villagers to her appearance in the PPE “spacesuits.”
By January, both International Medical Corps and the hospital management were happy that
the SRU would keep Massenebeh safe from Ebola, and finally reopened on January 10 to
outpatients.
In March, the inpatient ward also opened. Margaret says that now the hospital is almost
back to pre-Ebola levels and the SRU has screened more than 7,000 people. Most
importantly, she thinks that the fear people have of coming into the hospital is subsiding, in
large part due to the SRU.
The relationship between Massebeneh and International Medical Corps’ ETC at Lunsar is
now a model for other health care facilities in the area. International Medical Corps has built
five triage units in total, helping reestablish confidence in a primary health care system
devastated by the disease.
Margaret says training staff in Ebola protection and management — more than six hundred
healthcare workers have been trained through courses at the Lunsar ETC — and providing
the backup and support they need is key.
But none of this would work without the bravery and dedication of women like Margaret.
As we said goodbye she smiled again. She has begun to believe that things are getting
better, but knows we must remain vigilant to prevent such an outbreak from occurring again.
