It has been several months since our last letter, and while I sincerely hope you and your families are doing well, I am sad to report the situation in Sierra Leone has continued to worsen. As most of you know, the Ebola scare dominated the news while there were infected patients here in the United States, but now it seems it has mostly passed as a just small blip on this country’s temporary news radar, almost forgotten by most. Unfortunately, the devastating effects of this disease are still being strongly felt in Western Africa, particularly in Sierra Leone. While the actual number of Ebola cases is decreasing, and the death tolls are not sky rocketing like they once were, the health care community of the country has been completely ravaged. We are VERY, VERY fortunate that we have not lost any of our direct staff, but there have been a catastrophic number of lives lost all across the medical workforce, including doctors, nurses, aids, and many others who had been participating in the care of these very sick people.

As you can imagine, the quality and availability of care has suffered tremendously just due to these losses alone, but even further, the psychological, mental, and emotional well-being of much of this country has been significantly altered, not only from the direct effects, but also due to the wide-spread changes implemented as a result of this epidemic. For instance, the government is trying to enforce a system for the handling of all bodies of people passing away at the hospitals. They are calling for specialized teams to come in, wrap the bodies in protective material, and haul them off to mass graves, so as to not allow for any family members or healthcare workers to be exposed to any potential contamination or spreading of the Ebola virus. This is regardless of whether or not the patient was diagnosed with Ebola-like symptoms. While I am not questioning these particular efforts of the government (as they have an enormous challenge in front of them), you can imagine the pain just this particular change is causing.

I am reluctant to confine this horrible situation to just one story, but below is just one brief account of one day, as experienced and told to me two days ago by Paul Robinson, our Director of the program, in Sierra Leone right now:

Good morning Dr. Maggi,

A child died on the maternity ward this morning (ward 6). Imagine the mother’s anguish at losing her baby and then having to suffer the indignity of seeing its lifeless body bundled into a plastic burial bag to be taken away to a mass burial ground. Ebola did not kill this child, yet the whole family were victims nonetheless. All dead persons are treated this way now, no matter what the cause of death.

Another true story, one of our nurses, Vero, was ordered to go to Daru as part of the Ebola treatment team. She went, but she was the ONLY ONE of that entire medical team to leave that treatment centre alive.  All her colleagues died, every one DEAD! Thankfully she is back with us now amazingly, and as a skilled midwife, she will be invaluable to us and the people of Salone.

Paul

Again, this is just one tiny snapshot of the everyday reality the people of this country are facing. It is almost impossible for us to imagine, but it is so very real.

With that, you can see we have plenty of work to do. I am planning to go back over at the end of July or the beginning of August; meanwhile, Dr. Manna, Paul, and the entire team have done an incredible job keeping our program alive and relevant during this extremely challenging time. We have intentionally delayed as many non-life-threatening procedures as possible, but with your support, we have maintained our staff, maintained our patient flow, and maintained our facilities to enable us to stay in a position to help as many people as possible, as the situation permits.

Now, our patient load is enormous, and our needs are great. We have always been hesitant to directly ask for any donations or support in these “update letters”, as we have been amazingly blessed with the generosity of our supporters all these years. However, at this time, we would like to let you know your help is needed now as much as ever. There are three primary reasons we could use any extra support at this time. First and foremost, our operating costs are undoubtedly going to be higher for the foreseeable future – we have a very large number of patients awaiting surgeries, not to mention the increasing number of emergency cases that are showing up at our doors, looking for any help we can give them. So while our dollars can still do an enormous amount of good, the sheer volume of work is as high as ever. Second, the vast majority of our beds, fixtures, and supplies in our primary ward were sacrificed to help ease the burden of caring for all the Ebola patients at the hospital we share with the government. The influx of patients was incredible, and the space was very limited, so our ward was used as an overflow treatment area, and in turn, almost all of our beds and furniture has been lost or destroyed. Lastly, we could really use one or two more vehicles. We try to be extremely conservative with our spending and our use of any items like this, but they are a necessary part of the program. If there is any silver lining here, it is that the opportunity to acquire vehicles at a reasonable cost is better now than it has been historically. Due to a large number of organizations retreating from this very difficult environment, there is actually a decent surplus of good, used vehicles that are already in country. So these can be acquired reasonably without having the expense of shipping, importation, and all the other costs associated with bringing them in. While it’s a sad reality so many people are leaving, given our needs for a vehicle or two, this is actually an opportune time for us to get them.

I apologize for the length of this letter, but I wanted to try to convey the severity of our situation and let you know we very much appreciate each and every one of you, and we could not do it without you.

As always, please feel free to contact me if you have any further questions.

With Gratitude,

Darius R. Maggi M.D.
West Africa Fistula Foundation
3621 Pottsboro Rd #150
Denison TX 75020