Rosaline, 29, is a nurse in Sierra Leone. CARE is a partner of the Kakoya health facility in Koinadugu district where she works. She was a volunteer community health worker with CARE when she was younger. She used her monthly stipend to put herself through nursing school. Rosaline was a front-line worker during the Ebola outbreak in 2014 and 2015. Today, she is playing a key role in her community’s response to the coronavirus pandemic.
What is the situation like in Sierra Leone right now? Are people worried?
The situation is not easy. People worry a lot. There are a lot of things that are happening in Sierra Leone. We, the nurses, are putting everything in place. Even traditional authorities, they are putting everything in place, because the counsellors are worrying a lot. There are suspected cases in Guinea, and they are our nearby neighbors. So, we worry a lot about this disease.
What kinds of things are people doing?
We have set up handwashing stations at every public place – in community gathering places, in schools, at the health facility, everywhere. And people don’t shake hands. Most of the gatherings that were happening before have been stopped. No nightclubs, no football, no gathering, no traditional societies, everything has been stopped. Right now the country is at a standstill. Infection prevention and control protocol is our first area of work; we do community engagement meetings, we do our outreach. In our centers, we use our Infection Prevention Control (IPC) protocols, we wear our masks, we don’t touch patients, we take their temperatures, and we wash our hands regularly. Even for deliveries, we disinfect every instrument and we wear our masks. We are focusing on outreach and community engagement for now.
How do you do community outreach, how do you get people to trust you?
I take my motorcycle and go out to the communities within the catchment area, and sit with them to explain this new virus and how they should be aware and start to protect themselves. Sometimes they are hesitant, and they don’t believe me at first, but then I explain it more, and they come around. They trust me, because I’ve come from them, I was born in this area and they know me. So, they know to trust me when I tell them something that is this important.
What are you preparing for in relations to coronavirus?
We are preparing to implement our infection prevention and control protocols. We have taken out our personal protective equipment. We have a small amount that we received from CARE, but we need more to be able to protect ourselves. We’re expecting to receive some from the district soon, but what we have right now is not enough.
What are you worried about – what do you think will be the worst case scenario?
We are worried, because it will affect us as health workers. If there are cases here in Sierra Leone, we are the front liners, because we touch patients, we receive patients, so we are worried a lot, and hope that it will not spread easily, because this is a very dangerous disease.
Me personally I’m worried about this disease, because just a few years ago we had Ebola, and now we worry about coronavirus. Because our population is not so big here. So if it comes here, we won’t be many left…We’re worried as well because we don’t know if we will get sponsors [international aid] to fight the disease, because the whole world is fighting it to, and there may not be enough resources to help us fight the disease here too. So if it happens here, it won’t be easy for us. We worry a lot.
What did you learn from the Ebola outbreak that is applicable with this coronavirus outbreak?
I was at this facility during Ebola. During Ebola the first and most important thing was to wash hands. And then to bring people to the hospital, not to keep them in the house. For now, we don’t have IPC materials. We don’t have much left over from before, and most of it is old.
As a health worker I learned how important it was to follow IPC protocols – don’t touch patients, and refer people to higher levels in the health system when they experience symptoms. I also learned how important it was to do community outreach, to call community meetings, to inform every person about the disease, and how to recognize and to prevent it. It was especially important to emphasize handwashing – each house should have a handwashing station to be able to wash hands, this was a really important thing to have.
What advice do you have for workers fighting the epidemic?
During Ebola, many of us health workers died. But I think that if this disease is to happen in Sierra Leone, we won’t die like we did before, because we will follow our IPC protocols from the start. My advice is to make sure you take care of yourself, think about your life first, about your family, and protect yourself. Don’t rush to the patients, follow the protocols, and take care of yourself.
Why do you choose to work on the frontline and respond to disease outbreaks?
I became a health worker because my father died from sickness, and I wanted to save people’s lives in my community.