Saturday, October 4, 2008

Uganda – Bundibugyo: Part Two


Accepting a stranger with a camera into your home must have been awkward to say the least for the Myhre family. Who is this guy? What does he want? And awkward doesn’t begin to describe what emotions surface reliving a difficult past.
Arriving with the Chedester family, I was welcomed to a weekly team meeting dinner party. Today’s menu: brick-oven roasted pizza, plain cheese to supreme and everything in between. Not that I dislike east African cuisine, in fact I very much enjoy the native dishes, especially the charcoal barbequed bush meet speared and sold on the street. From the bus window, I would spend the thousand Ugandan Shillings (~.65 cents USD) for two long toothpick-like skewers knowing very well my digestive track would hate me for it that night and day after. But a change in menu is very appetizing, especially a taste from home. Odd I would find it here far removed from anything near western civilization, and better tasting than most pies back at home. After a brief astronomy lesson navigating around tree canopies, followed by an episode of Band of Brothers on DVD, Scott and I sat across from each other in the family living room and talked about Ebola. I looked at my arms; the skin looked like a few dozen mosquitoes had bitten me. The pink blotches in fact were bukukuni bites, a gnat-like fly with a taste for human skin. Bob had warned me earlier about wearing a long sleeve shirt at night, and that in conjunction with not taking his advice about getting on an empty bus because it won’t be leaving anytime soon (that morning, resulting in a three hour departure wait), were now two things I should have listened to.
“Don’t say too much, you’ll end up repeating it,” Jennifer suggested from the kitchen, switching off the lights. Jack, Julia and Caleb, three of the Myhre’s four kids had already retired on the school night. The next day would be a whirlwind event at the school celebrating Parents Day, which in addition to their respective doctor roles at two different local institutions, both Scott and Jennifer are heavily involved with the school’s development.
“I, Dr. Sessanga, and Dr. Jonah were in the room together looking over Jeremiah Muhindo’s chest x-ray trying to figure out what was causing the illness, this was before knowing it was Ebola,” Scott recounted the days just before the announcement. “He was having shortness of breath, his eyes were real red, and I remember putting my hand on his hand to check his pulse. His hands were just cold as ice; the man was in shock. We all came in contact with the patient. In a way, it’s not fair two of the three of us would get Ebola, and one of us would die.” “Were you afraid?” 
“After Jonah got sick and Sessanga gets sick, then Ebola is confirmed … I was afraid. It was right at that point we decided we had both been exposed because of our visit to Kikyo and having been in contact with a number of patients that had died, we had twenty-one days to determine if we were developing symptoms or not and decided we needed to send our kids away from us. If we got sick, we didn’t want to expose them.”
“What were you going through those twenty-one days?” I feel like the answers to my questions are obvious, but I needed to ask. Scott and later Jennifer were pros; going beyond what I thought was an obvious response.
“You’re super-sensitive. After Jonah was buried, I was sitting at church and had a headache. I don’t usually get headaches. I leaned over to Jennifer and said, ‘I just don’t feel well,’ and she said, ‘Well go home and go to bed.” There was a knowing exchange of looks that this… and I laid down and I thought, ‘Well, this could be it.’ And I told her, if I really felt like I was sick, I was going to go across the street to a vacant missionary house and lock myself in there, because I wasn’t going to have her take care of me and expose herself and leave our kids as orphans. Nothing ever came of that, but I talked to an MSF worker [Doctors Without Borders] and she said that, ‘Typically if you do come down with Ebola this late after contact, you’ll get sick, but probably not die of it.’”
The following morning, Scott drove me the thirty minutes to Bundibugyo hospital. We stopped 
at the gravesites of the four healthcare workers, including Dr. Jonah Kule, whom died caring for Ebola patients during the outbreak.
“Not many people came to Jonah’s burial in fear of getting Ebola. Afraid they might get Ebola from the air, or from the bodies. It doesn’t help to see the MSF burial team, dressed in their Tyvex spacesuits disinfecting the bodies sealed in bags then dropping the coffins into their graves,” Scott quietly explained before he and I walked across the medical campus. Men and women of all ages loitered through the open covered pathways. Some women waited outside the x-ray building for an ultrasound. Some just sat on the sidewalk ends looking at the many people passing by. Through the antenatal ward where the Ebola infected healthcare workers we treated, an education workshop was underway. Nurses sifted through disorganized books and records; I honestly couldn’t guess what was going on. Over a shallow hill of drying grass took us to a chain link fence enclosing the isolation ward.
We walked around the two-car garage-sized building to an unlocked door. I walked inside.
Sunlight seeped through a gap where the wall would meet the floor, and from the middle seam between blue painted wooden window panels. Eight bed frames, four on each side are planted on the grey polished cement floor, their white latex coatings peeling from its metal bars. I visualized the beds made and occupied. A suited individual examines one patient through his plastic helmet mask and thick blue gloves, checking the still individual’s pulse and examining his eyes.
“I was partially conscious, but not alert to all my senses,” one Ebola survivor told me. “I would not be able to drink. I would not be able to turn my body. I would sleep like that until someone could assist me. The thinking was not so easy. You could think of either surviving or death. And you just hand everything to God to decide on your fate.”
I then pictured myself inside one of those Tyvex suits and contending with the heat and humidity compounded underneath the protective garment. Leaving the isolation ward, I further imagined drenching myself with a concentrated bleach solution in one of the many white tents established by the MSF team, sealing the suit in a biohazard bag before redressing into my clothes and allowing the thickness of the air become a sad refreshing relief.

“You. What are you filming? What are you doing here?” a burly man in a suit approached me mounting the back of a motorcycle, the camera gripped tightly by my left hand over my lap.
Denato spoke to him, but the man ignored whatever was said stepping over banana bundles charging forward. People in the market stopped in mid-commerce to witness the exchange. In particular, I recall one older woman holding a food item frozen in transaction.
Being the only mzungu around draws enough attention, regardless of the few white families residing on the outskirts of town. But a mzungu with a camera rivaling anything the country begs special attention whether by lens happy children or protective elders.
“I ask you, why are you here?” The man stood dangerously close. I looked to Denato; no more help there.
“I’m filming a documentary,” I calmly stated, knowing I’m not going anywhere unless I direct Denato to drive.
“What again?”
“A documentary on the Ebola outbreak here last year.”
“On Ebola?”
“Yes.”
He smiled. And almost immediately, his whole body relaxed and he said shaking my hand, “Oh, that is good. Thank you. Welcome. Be free, you are welcome here.”
Not quite the reaction I expected, but a welcome one. Denato, Scott’s assistant, revved the engine and I prepped the camera to film over the driver’s head while riding the uneven dirt road. Even after replaying the footage days later, I’m still shocked at myself for putting faith into a motor bike and its driver at the stake of breaking my camera—or injuring myself. I did regretfully pack the camera for the thirty-minute return drive back to the Myhre’s on a motor-boda. Over steep inclines and sharp drops, dodging people and potholes, the choice was probably a good idea, although the mountain and valley views were breathtaking.

In her blog, Jennifer drew a parallel between the Ebola and HIV viruses, “HIV attacks the disease-fighting cells of the body, so that a person succumbs to other illnesses. Few AIDS patients are technically killed by the HIV virus alone, almost all die from things like TB or fungi or common bacterial infections that can no longer be resisted. On a macro level, Ebola acts in a similar way. Ebola attacked the disease-fighting personnel and programs of this society. Only 37 people died of Ebola during the epidemic, but many more, untold numbers, have died because of the lack of medical services. I think we will never really know the true impact.”

*Pictures from the 2007 outbreak courtesy Scott and Jennifer Myhre.

No comments: