William Pooley, the British nurse who survived the deadly Ebola virus, is planning to return to Sierra Leone to help fight the outbreak, a move his mother, who had hoped he would not go back, hesitantly concedes will make her “very proud.”
In an interview, Pooley, 29, the first known Briton to contract the virus, called on British Prime Minister David Cameron, who sent him get-well wishes while he was in hospital, and US President Barack Obama, to do more to mobilize the international community to get the epidemic, raging through west Africa since March, under control.
“It’s a global problem and it needs global level leadership, so Obama and Cameron ... need to show some more leadership on this issue,” said Pooley, while acknowledging his “huge gratitude” to the prime minister for his role in his repatriation and care. “Sierra Leone needs lots of international healthcare workers working with big NGOs [non-governmental organizations] like MSF [Medecins Sans Frontieres] and Red Cross. All of that needs to be increased.”
Relaxing at home in Suffolk, England, after being discharged, virus-free, from the Royal Free hospital, in London, a week ago, Pooley is happy to have survived his ordeal, but also desperate to carry on helping. Some in the profession call it survivor’s guilt.
“So while I’m happy to be recovered and alive, there’s a lot of stuff on my mind with what’s going on back there. It would be relatively safe for me to go back and work there... It’s the least I could do to go back and return the favor to some other people, even just for a little while. The more help they get, the less chance there is they get sick. If they get sick, they are just going to end up in a ward in Kenema with less chance than I had,” he said.
Pooley had not discussed his plans to return with his parents, but when asked how she would feel, his mother, Jackie, took a few sharp breaths.
“Well, it would be his choice. We would want him to go back, not as an individual, but with an organization of some kind so he’s got the backing. Obviously, in a way we don’t want [him] to, but I can see I would feel very proud of him if he decided he was going to, because he knows what it is going to be like,” she said.
Certainly, it would be different from the state-of-the-art medical treatment Pooley received at the Royal Free, where he was treated after his emergency repatriation. There, he lay inside a polythene “patient isolator” tent, tended by dozens of staff in a unit tailor made for “category four” infectious diseases. The tent alone cost £25,000 (US$40,660).
He was the first patient in the unit in two years. There were protocols for everything, covering food to removal of materials, including body waste through heat-sealed containers.
Stephen Mepham, the infectious diseases and microbiology consultant who flew to Sierra Leone to accompany Pooley home when he was evacuated by Britain’s Royal Air Force (RAF) 18 days ago, said that the ward kept its air at negative pressure and that it was systematically replaced because of the possibility of “aerosolization” of particles.
Thousands of kilometers away in Kenema’s government hospital, there were few resources and little dignity existed for the dying and convalescing patients.
“Those wards A and B when I first started were pretty grim. Corpses, blood, the place was really dirty — people just dying in quite unpleasant ways. When I first started, there were not enough materials, there was no running water, no sheets or towels to clean a patient with. They might be incontinent, they are often confused, so you can imagine, with diarrhoea and vomiting, patients get in horrible condition,” Pooley said.
“When I first started, there was not a thing that you could use to help them. You’d just have to improvise, find a way of cleaning them and try and find something to cover them with,” he said.
Death can be swift. He felt safe in his personal protective equipment (PPE), but frightened because the infection was liable to be anywhere. His first sign of illness was a sore throat. Overnight, he developed aches, a headache and felt “pretty rough” but still went to work. That afternoon he was tested and he went home to await the results.
“I went to sleep, then later when it was dark I woke to [see] Ian Crozier, a wonderful doctor who is working with the World Health Organisation. I woke to his voice and his voice was muffled, and when I saw he was wearing PPE, I knew it was bad news. He was saying to me the kind of stuff I said to patients myself loads and only ever half-believed. He was saying to me: ‘You are young, you are strong, you are going to be fine’ — and it’s amazing how that can reassure you,” Poole said.
Behind the scenes, Crozier and others worked on the evacuation. Two US doctors had already been airlifted out of the region. At 4am the following morning, British Minister for Foreign Affairs Philip Hammond, and British Secretary of State for Health Jeremy Hunt, talked. At 6am, the evacuation was confirmed. By 10am, Mepham was preparing for his trip to Freetown.
Pooley still had not told his parents, delaying it until the evacuation was in progress.
“Telling mum and dad about having Ebola was just horrible. It was definitely the worst thing of it all,” he said.
His father, Robin, recalls the conversation.
“I think he said: ‘Dad, I’ve got it.’ I said: ‘You mean?’ and he said: ‘Ebola’ and there was a long pause after that,” Robin Pooley said.
“They had loads of support from the Foreign Office [British ministry for foreign affairs] and things like that, but it doesn’t take away from the fact that I had just told them I had a 50 percent chance of not surviving,” William Pooley said.
His father coped by going into “emotional lockdown.”
His mother said she could not let herself feel pessimistic.
Buoyed by the “magnificent” treatment at the Royal Free, they gained comfort from two doctors who had worked with their son in Kenema, and from Hunt, who spent time with them at the Royal Free.
William Pooley said he has been touched by the cards he has had from the public. A Sierra Leone family went to the hospital to give him children’s drawings and thank him; another sent 50 red roses to his house, joking that he now needed to find a “Salone” (Sierra Leonean) wife.
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