Jules*, 42, is the head nurse of a health centre in Ituri, Democratic Republic of Congo (DRC), working at the heart of the Ebola outbreak, managing care while promoting prevention in the community. Chronic shortages of protective equipment and limited funding leave staff exposed and patients without access to treatment, allowing the virus to spread. Jules is deeply affected by the human toll, especially mothers separated from their babies, and fears rising malnutrition and deaths. Despite it all, Jules keeps going, but the fear and pressure are never far from his mind.
Here is Jules' diary, where he shares what a week in the life of an Ebola health nurse in DRC looks like.
DAY 1
I am a nurse in charge of a health facility in Ituri. Today at the health centre, we arranged two activities: outpatient consultations, and we also conducted two referrals. The patient flow at the health centre is set up by having a handwashing station at the entrance, so anyone entering the health centre must wash their hands. There is also a triage service to screen patients for registration. The designated staff member then directs cases to consultation, and we also handle direct referrals.
The crisis we’re currently facing, particularly with Ebola, means that as health workers, we have our own fears. We fear the shortage of PPE, or personal protective equipment, which there isn’t enough of at the facility. There’s a shortage of hand sanitiser and other basic personal protective equipment. We also lack protective head coverings. If we had access to these supplies, it would help with our confidence to better fight this disease and prevent us from becoming infected.
Jules* demonstrates handwashing steps. Save the Children
DAY 2
We started off by inviting mothers to pre-school consultations. When they arrived, they all washed their hands and had their temperature checked. After that, we led sessions on health education, then we carried out weighing, followed by vaccination. We also provided consultations for patients.
There are two main concerns I have for our facility. The first is the lack of protective supplies for ourselves, such as soap, whether liquid, powder, or bars. We are running low on alcohol sanitiser, and we are short on personal protective equipment, including gloves. We also do not have enough boots to protect ourselves. Yet it is through these measures that we can set up a proper barrier against the spread of the Ebola epidemic. It is truly difficult for us as healthcare workers, and we are genuinely afraid.
Another concern is the lack of funding. Without funding, patients will continue to infect others within the community. If funding were available and treatment were free, more patients could come to us, and we could detect cases early. Without funding, patients will stay in the community, and the disease will persist. They might even seek care from private providers or traditional healers. As a result, there will be many deaths in the community, and the disease will continue to spread. These are the two main things we would request: protective equipment and funding. It would be really good if those were available.
Jules* puts on protective clothing during an Ebola outbreak. Save the Children
Day 3
To curb the spread of Ebola, I, the head nurse, together with my team at the health centre, work hard to raise awareness among the community about how important it is to wash hands with soap, to check their temperature when visiting the health centre, and to maintain a physical distance of about one meter when in a group. We should also get used to wearing masks, and when together at a place of gathering, people must not handle dead bodies.
Another thing we are doing is encouraging families and parents, when they learn about someone who is sick, to bring them to the health centre quickly. If it happens that someone is infected, and since it is transmitted through physical contact, we must avoid handshakes. This is how we are able to put barriers in place to stop the spread. That is why we work hard to raise awareness, as these are the measures we try to reinforce here at the health centre.
Marléne*, a 25-year-old mother, brings her two-month-old daughter, Deborah*, to a health facility for vaccination. As a breastfeeding mother, she fears that if she were to become infected, she could pass the virus to Deborah. At the clinic, Marléne received guidance on preventive measures. Save the Children
DAY 4
Within the community and the health centre, it is deeply painful for us to see breastfeeding mothers who have Ebola being separated from their children. The situation is causing a lot of stress, especially since we do not have sufficient support. We don’t even have breastmilk substitutes to meet the nutritional needs of these infants.
The same goes for families, as they are going through similar situations. We are facing an epidemic, and at the same time, there’s ongoing conflict and insecurity, which prevent parents and community members from being able to provide for their family needs. This situation is making me very worried, as without support for the health centre, it will be difficult to respond to the needs and concerns. I believe that in the coming days, we will see many cases of children falling into malnutrition and even cases of premature death.
Donate now to our Children’s Emergency Fund, to help stop this outbreak, protect children, and save lives—before it spreads further. Children here cannot afford another crisis.
DAY 5
I’m on my way to work at the health centre with a lot of concern and a lot of fear. Why? Because there is a rise in infections, and the number of deaths is increasing too.
At the same time, there is resistance within the community. We try to keep going at the health centre, but the uncertainty is making our work more difficult. We don’t have the means to protect ourselves. We work with very little hope of succeeding, yet we keep working despite everything, despite not knowing if this epidemic can be defeated. Without support, it will be very difficult.
Frontline workers at an Ebola treatment centre in Bunia, Ituri, are working around the clock to screen patients and support affected communities. Patou Dombi/Save the Children
DAY 6
We are still in the Ituri province, centre of the Ebola outbreak. Day after day, we’re witnessing the increase of the spread. At the health centre, we’re spreading awareness and delivering messages, for example, in schools. We’ve also installed handwashing facilities in schools to create a barrier against this disease. However, what we have not managed to do is set up a triage screening system in schools. Why the screening system? Because it can help identify suspected cases among students early and isolate them in order to protect others.
Just imagine that here, because education is free, there are more than seventy students in a single classroom. If a child is not isolated as soon as they become a suspected or confirmed case, they can infect an entire class. Even worse, they all play together during recess, and as a result, an entire schoolyard can become contaminated, and even teachers can become infected. This is how the disease can spread into the wider community, and we’re addressing it at the health centre level.
A mother washes her hands at a health centre following guidance on Ebola prevention. Save the Children
DAY 7
We are still in the Ituri province, where we are responding to the Ebola disease. On the other hand, we are also facing insecurity and conflict. The situation of war makes response activities difficult.
Why? Because when there is a contact case, we are required to monitor it. We must identify it, register it and follow it for at least 21 days.
Now, when conflict breaks out in a village, everyone flees, including the contact cases. This is why you can see cases of infection and the spread of the disease increasing very rapidly. Because of that, it becomes difficult for response teams to contain the disease.
Save the Children started working in DRC in 1994. Today, we collaborate with 13 local partners, alongside international organisations and government authorities, to provide life-saving support in health, nutrition, education, child protection, food security, and water, sanitation, and hygiene for children and their families.
We operate in the three eastern provinces most affected by the humanitarian crisis—North Kivu, South Kivu, and Ituri— where nearly six million internally displaced persons (IDPs) and returnees are in urgent need of assistance as well as in Kasai, Kasai Oriental and Lomami on development projects in education, health and nutrition.
Save the Children has been supporting this health centre where Jules works for several years, providing essential medicines, nutrition support for malnourished children, and community awareness on child feeding and hygiene. Since the Ebola outbreak was declared, the organisation has scaled up its support, supplying protective equipment, screening tools, and hygiene materials to help limit the spread of the virus and improve conditions in both the health facility and the community.
