National

'We could have saved more lives': Canberra doctor Kamalini Lokuge on fighting Ebola

When a nine-year-old boy who had just buried his family arrived at an Ebola treatment centre, a Canberra doctor was struck by his resemblance to her nephew.

After watching the infectious disease steal his loved ones, he was kept in a holding room for days with no food; the Sierra Leone community was afraid he'd infect anyone who came near.

Dr Kamalini Lokuge, a fellow at the ANU National Centre for Epidemiology and Population, spent time in Guinea and Sierra ...
Dr Kamalini Lokuge, a fellow at the ANU National Centre for Epidemiology and Population, spent time in Guinea and Sierra Leone during the Ebola epidemic. Photo: Graham Tidy

The sick, frail and starved boy was placed in an ambulance with other red-eyed patients. He endured a 10-hour trip in 35-degree heat with closed windows, during which another life was taken before his eyes.

Despite years of researching Ebola and seeing it deteriorate many bodies and minds, Dr Kamalini Lokuge was particularly touched by this child's story.

He died two days after telling it.

"That boy was one of thousands of unnecessary deaths," she said.

"I feel like if we had done the job properly in Guinea [when the outbreak started], it never would have gotten to the point that it did.

"There were delays in our government officially supporting people to go and I think really that's what would have made the difference, what would have saved many more lives."

The senior research fellow at the ANU was part of an international team in West Africa during the Ebola outbreak that ended in Sierra Leone in November 2015 and resulted in more that 11,000 deaths.

She visited Guinea in April and Sierra Leone in September 2014 through Doctors Without Borders to care for patients and help limit the disease's spread.

Dr Lokuge recently undertook research that found the outbreak could have been stopped far earlier if there weren't delays in enough staff working on the ground to educate communities, give proper patient care and ensure safe burial practices.

Throughout two decades of studying and fighting Ebola, delays had brought her to tears.

She had worked in more than 10 war-torn and disadvantaged countries, but the inability to touch a child sick with Ebola, coupled with a lack of support, was uniquely challenging.

"It's one of the times where you can't even touch a child without protective equipment.

"It's really sad to see sick children and not be able to give them a proper human touch."

Most of the hospitals in the communities Dr Lokuge visited in West Africa had lost around half of the local health staff to Ebola, and more had run away frightened. Many of those who were left had watched their families die.

While the little available resources were used up with patients at the centres, many more sick people were too scared to seek help from strangers in white spacesuits.

Dr Lokuge and her team had to use an undercover blue pickup truck to visit one of the first families infected in Guinea, before the outbreak had spiralled out of control.

The family "was very angry" when she arrived with surveillance staff and anthropologists, so they explained why they were there and answered questions for two hours.

"When we left that afternoon, the family brought two young men who they had been hiding and they both turned out to have Ebola. The next day they brought two more.

"Everybody is scared of this disease, wherever they are, whatever their culture, and the same way you build understanding is the same as anybody. The problem was that there was not enough people to do that, when there could have been."

The West fretted about the slight chance this evil plague would creep into their homes.

Meanwhile, Dr Lokuge risked her life alongside staff who were watching their community crumble and working long hours for three months without a day off.

One local doctor told Dr Lokuge their community had began recovering from the civil war when this new tragedy came along and slashed their population again.

"Everyone forgot about them when the war stopped, but half the kids under five were still dying from malaria," Dr Lokuge said.

"We can't let people forget these countries until the next disaster."

After Dr Lokuge left West Africa, she felt like she went from being part of the solution to part of the problem. She spent 21 days in the Doctors Without Borders's Amsterdam office before going back to Canberra.

"When you come home people around you don't understand," she said.

"Here were politicians saying these people are bringing diseases ... I didn't want my family to go through that.

"But the people around me were incredibly supportive. My boss rode a bicycle over the day I got back and gave me a hug."

She said many did not understood that Ebola was hard to contract, much less contagious than other common diseases and only spread through blood or bodily fluids.

Because it is not airborne, good infection-control practices stopped its spread, not the "magic bullet" people were looking for.

But for every piece of negative media, Dr Lokuge remembered the many more lives she had saved.

She thought of the first time a child was discharged in the treatment centre after so many had died and the joy that filled the room.

She thought of the people who knew her work had value, "even though it doesn't bring in big money and it's not for rich communities".

But above all, she thought of the broken and fearful communities she had left behind.

She said symptoms of miscarriages and even normal pregnancies mimic those of Ebola, confusing and frightening societies already battling a high maternal mortality rate.

She's now working on building long-term partnerships to strengthen health systems in those countries.

"It's not us and them. Everyone is our neighbour.

"Small victories mean a lot."