By Martin Zinggl
In the ‘Ebola-confirmed’ area of the Médecins Sans Frontières/Doctors Without Borders (MSF) Case Management Centre (CMC) in Foya, Liberia, roughly two thirds of patients don’t survive the Ebola virus. The patients gather on wooden benches and plastic chairs. Out of a transistor radio plays loud Azonto, music originating from Ghana. People are weak, lying in their beds while their immune systems are trying to fight the deadly invader in their bodies.
Except one: Mamadee, a young boy of eleven years, is performing an Azonto dance, as the crowd watches him. He jumps, he ducks, he steps to the side, first left, then right, then left, then right, jumps again, turns, swings his hips and shakes his arms. And he doesn’t stop, he doesn’t get tired.
It is difficult to believe but Mamadee is a patient. An Ebola-confirmed patient.
As all clothes and objects that enter the CMC with the admitted patients have to be burnt, Mamadee has been dressed in a new shirt, large enough to fit two of him. He wears grey pyjama pants and blue sandals, at least three sizes too big.
But neither his clothes nor Ebola can stop the young dancer. Some patients envy him, while the nurses and other medical staff have fallen in love with him. Mamadee is the star of the CMC in Foya, as his story is rather exceptional.
When Mamadee was firstly admitted on 15 August, he tested negative for Ebola and was discharged. Staying overnight in the guesthouse as his village Sarkonedu was too far to travel to, he developed some signs and was readmitted the next day. He was displaying symptoms of nausea, fever, muscle pain, intense fatigue, abdominal pain and diarrhea.
“He was a clear Ebola patient,” says Dr. Roberta Petrucci. “Only the jaundice made us doubt.” The doctors treated him with multivitamins, paracetamol, oral rehydration solution, antibiotics and with antimalarial pills, as Mamadee had also tested positive for malaria.
On 20 August, the second Ebola test result returned and it was as expected – positive. The only thing that didn’t fit into the picture was that young Mamadee in the meantime was already feeling good and running around.
“We couldn’t believe it,” says Dr. Petrucci. “We thought it must have been a mistake.” When the medical staff took another blood test a few days later, they realised that there had been no mistake. Mamadee still tested positive.
“The lab normally doesn’t make mistakes,” Dr. Petrucci continued. “And especially twice in a row with the same patient.” So, even though Mamadee was everything but symptomatic, he could theoretically infect others. “We had no other choice other than to keep him in the CMC as the result was still positive,” she says.
Surrounded by sick patients, Mamadee was the entertainment. He spent his days sleeping, eating, chatting to the other patients – and of course dancing. He was able to turn anything into a toy, be it a slip of paper, a soft drink can or a water sachet.
But a CMC is of course not the place a child wants to be, and boredom comes easily. “I want to leave,” Mamadee says. “Two weeks have been enough. I miss my home, I miss my friends, I even miss going to school.”
Mamadee never complained, nor asked for his laboratory results like other patients do. “The people in the yellow raincoats took good care of me and they helped a lot of other sick patients too.”
Unfortunately Mamadee’s wish to leave could not be granted as his third test on 30 August was also positive. “His medical record is outstanding but not exceptional,” states Dr. Petrucci. “But his attitude is definitely exceptional. Every day, the boy spreads a good spirit to the patients and staff. He is always smiling and happy. Everybody likes him and we will all be very sad and miss him once he leaves, even though we wish for him that he gets out of here as soon as possible.”
The CMC is no playground. Mamadee has seen terrible things in the confirmed patients’ area. “This place is full of dead people. Ebola is a sickness that makes you vomit and your nose bleed and then you die,” says Mamadee. “This is what I will tell my friends when I go home.”
One week after, Mamadee’s sister, Mayan was admitted to the CMC. The 14 year old girl passed away after a few days, just one tent away from her brother. When his mother tells him about Mayan’s death with tears in her eyes, he stays strong and simply says “Don’t cry, Mama”
On 4 September, Mamadee’s fourth test returns from the laboratory in neighbouring Gueckedou, Guinea. It is negative, finally. Mamadee rushes out of the CMC. “I am very happy today,” says the young survivor, not knowing the deadly game he has just won.
Mamadee may have won the game, but Ebola is quickly defeating far too many others.
MSF currently has 41 international staff and 444 national staff working in Foya, northern Liberia. In its 100-bed Ebola management centre, there are currently around 60 patients. MSF is also running several outreach activities, such as health promotion, safe burial practices, and an ambulance service. In nearby Voinjama, MSF is currently training Ministry of Health staff in the hospital on triage of patients.