Day 13 – Sierra Leone

Hi all,

I haven’t “gone to ground” – just full-on training 75 nurses/docs in Infection Prevention & Control – 10 hrs teaching a day – v rewarding – group is amazing – intelligent, fun and passionate about IPC – all passed Week 1 exam – now in week 2 (practice, practice, practice).

Ebola has devastated SL economically, socially and educationally – schools and univ have been closed 8 months (teachers not paid), still no body contact, all shops must close at 6pm to avoid crowds (beaches are closed to SL’s – but strangely we were allowed to enter beach – ??expats can’t spread Ebola.

Do not touch dead bodies

Signs everywhere remind us of Ebola threat. In developing countries Ebola’s “Reproductive Number” is 2 (i.e. 1 case leads to 2 others) but last week a single case in a remote village led to 57 cases! The reason – “women’s secret things” (incl bathing of children in dead body wash-water to pass on “power’ of female leader) and “exorcism” – emphasizing persistent need for health education in remote areas – hence intense training of 75 to “spread (the correct) word”.

PS. I have never seen so many humanitarian organizations in one place! Amazing inflow of compassion.

Good news is that beds in “Ebola Treatment Centres” are at 12% capacity – we’re meeting this weekend to discuss decommissioning and recovery of resources for distribution to “non-Ebola” resource-poor healthcare facilities (after disinfection of course).

Liberia discharged its last case of Ebola last week – we hope Sierra Leone can do same within 3 months?

Regards to you all, Terry

Sierra Leone – Rule #1 – no handshakes

After a 15 hr event-full trip from WHO Geneva I arrived in Freetown, Sierra Leone (SL) capital, yesterday at 8am to the sound of crowing roosters (they got up late).

Jet lag, hungry (I can never decide) – breakfast won and I was immediately “adopted” by Michael Cosby (USA) and Shoaib Hussan (India), two WHO volunteers.

An hour later I was sitting in the midst of their weekly “Epi” (Epidemiology) meeting – a boiler-room of amazing teamwork and activity coordinating all intelligence on cases as they are confirmed – I say amazing as they are all on 6-12 week deployments, all work 7 days a week – Johann Conzalez (Columbia) was up till 1am completing a survey map for a news release that day. Their dedication under the leadership of Eilish Cleary (Canada) was humbling.

Twice I forgot and extended my hand – only to be embarrassingly reminded “No handshakes here“.

Eilish took me to “IPC” (infection Prevention & Control) and had to reassure Mandy (Canada) she was not poaching me (newbies are grabbed by anyone – there is such a need). To my surprise the IPC Leader is Julie Storr (UK), former UK IPS President.

Talk again soon. My CDC-ICAN Train The Trainer (TTT) colleagues arrive tmrw – we start Monday.

Rooster is crowing again – poor thing needs a clock.

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Sierra Leone – rule #1 – No handsake

After a 15 hr event-full trip from WHO Geneva I arrived in Freetown, Sierra Leone (SL) capital, yesterday 8am to the sound of crowing roosters (they got up late).

Jet lag, hungry (I can never decide) – breakfast won and I was immediately “adopted” by Michael Cosby (USA) and Shoaib Hussan (India), two WHO volunteers.

An hour later I was sitting in the midst of their weekly “Epi” (Epidemiology) meeting – a boiler-room of amazing teamwork and activity coordinating all intelligence on cases as they are confirmed – I say amazing as they are all on 6-12 week deployments, all work 7 days a week – Johann was up till 1am completing a survey map for a news release that day. Their dedication under the leadership of Eilish Cleary (Canada) was humbling.

Twice I forgot and extended my hand – only to be embarrassingly reminded “No handshakes here“.

Eilish took me to “IPC” (infection Prevention & Control) and had to reassure Mandy (Canada) she was not poaching me (newbies are grabbed by anyone – there is such a need). To my surprise the IPC Leader is Julie Storr (UK), former UK IPS President.

Talk again soon. My CDC-ICAN Train The Trainer (TTT) colleagues arrive tmrw – we start Monday.

The rooster’s still crowing – poor thing needs a clock.

Which patient clipboard is more sanitary – wood or plastic?

In this week’s APIC Listserve, Kim Roberts posed a great Q…Which clipboard is more sanitary – wood or plastic/metal?
All answers received to date state that plastic/metal clipboards would be more hygienic than wood as the latter was porous and could not be as easily decontaminated as non-porous plastic/metal.
In this specific case I agree. Wooden clipboards are commonly made of compressed wood fibre and are usually quite porous.
The above conclusion is reasonable, but not evidence-based.
In fact the literature supports a contrary view – that wood is better.
In 1992 Kass et al found that Californian households using wooden chopping boards suffered Salmonella food poisoning at half the state average, and those using plastic boards were twice the state average.
Independent of Kass et al, in 1994 Ak, Cliver and Kaspar at Univ Wisconsin-Madison challenged wooden and plastic boards with pathogens and found they disappeared in a short time from wooden boards but persisted on plastic boards, Furthermore they found nicks in plastic boards were harder to disinfect.
Cliver, now at UC Davis, commented on both studies and concluded in 2005 that, “…wooden cutting boards are not a hazard to human health, but plastic cutting boards may be.”
But I suspect the results with dense-wood chopping boards do not apply to porous fibre clipboards.

So keep writing on plastic and chopping on wood.