The St. John of God Catholic Services are both located in two extreme chiefdoms as indicated in the district map above. In Port Loko district, there are 11 Chiefdoms of which Marampa(about 55,000) and Kaffu Bullom (about 65,000) inhabitants. Kaffu Bullom is the chiefdom where the International airport is located and Marampa is where the country;s highest revenues from Mining is derived. So these two chiefdoms are crucial for the Government and these are where we find ourselves.

Patients attendance

Since the commencement of providing services to the public on January 6, 2015, the hospital only provided Out Patient Consultaions and Dispensary to sick persons. In the table below illustrate the data of patients attendance. In total, we consulted 275 patients in January 2015.

From the data above, there are all indications that patients were not too familiar and comfortable with the triaging process and as such they were a bit scared to enter the triage. It is a fact that the level of safety established in the triage is high all because to avoid the past experience in September, 2014. The International medical Corps are constantly mentoring our staff to run the triage.

During this period, all other services were witheld until we ensured that the staff are very familiar with the triaging and are confortable and have build inner confidence.

Challenges are in the future

• The economic management of Personal Protective Equipments especially that many of these items are not available in the local market in Sierra leone.
• Sustainability of safety protocols established in the services.
• Increase cost of user fees to meet the demand of safety for both staff and patients.

Health services financing

Presently, the General Curia in Rome(Italy) the headquaters of the Hospitaller Order of St. John of God is financing 70% of the expenditure activities of the Hospital, clinic and Nursing Training School. We are greatful to all the donors who are helping the Prior General, Br. Jesus Etayo Arrondo, to support this hospital and we thank all the other donors who are supporting the hospital and clinic social activities in the containement of Ebola within the communities where we work.

What is next

As I mentioned in my recebt updates, the plan to offer increase services at the OPD and In patient department, will depend on the solid preparation of the staff on Universal preacutions and transmission based precautions in the wards. This process has been facilated by the provision of a specialist doctor in Infection Prevention and Control from Italy by the Italian Government to prepare our staff and hospital setting in order to fully open the hospital at all levels. The process has started since last week and is going on.

The process is in 4 ffold:

1.  Assessement- Week 1(2-7 February, 2015)
2.  Training and simulation-Week 2(9-14 February, 2015)
3.  Monitoring & Supervision on IPD admission of Patients- Week 3(16-21 february, 2015)
4. Monitoring & Supervison and Evaluation on IPD activities- Week 4( 23 – 28 February, 2015)

At the same time, the laboratory services, Ultrasonography, radiography and surgical services will be available as from this period. We have agreed to start with a 30 beds capacity. We shall use the approach of classifiying patients by symptoms(dry or wet and respiratory) after the triage screening. Protocols shall be put in place to ensure that early response are taken as evidence might give indications of new symptoms developing and also handling of corpses.

Current trend of outbreak

Really, it may appear as if the number of new infections is reducing as compared to the previous weeks. However, few people still continue to remain steadfast to their perceptions and unacceptable behaviours. Currently, some parts of Port Loko district are hotspots reporting new infections. This is particularly in Lokomassama chiefdom. As experts continue to foresee, the ending road is bumpy and it is at this period that a collective surveillance needs to be done for the single cases. Port Loko district is prone to remain most probably the last district to become free from EBV simply because of its intertwined connections with all the parts of the country. We hope to end the battle by June 2015.

Conclusion

I want to thank each one of you for your great contributions in helping the St. John of God Brothers and Co-workers continue to help the people most in need at this moment and always. We are also getting ready to re-open the clinic in Lungi by mid February .

Br. Michael M. Koroma