Jurre van Kesteren finished his specialization in international health and tropical medicine. He is trained in general surgery and gynecology/obstetrics and gained this experience at Haga ziekenhuis, The Hague, The Netherlands. In December 2013 he graduated at the Royal Tropical Institute after completing his degree on infectious diseases and public health. Together with his colleague Bart Waalewijn he is stationed at Masanga Hospital Rehabilitation Project, Tonkolili district, Northern Province in Sierra Leone since early 2014. Jurre is the medical officer in charge and provides handsQon clinical work, teaching within CapaCare’s surgical training program and he is responsible for daily management of the hospital. Bart functions as the international coordinator of the surgical training program CapaCare. During the first 5 months of the outbreak both of them were responsible for the Ebola preparations at Masanga Hospital in a serious attempt to give best resistance to this emerging epidemic.
“These are extraordinary times, and extraordinary times require extra ordinary measures.”
With these words the Sierra Leonean President Dr. Ernest Bai Koroma referred to the threeQ
day ‘stay at home campaign’ during the Ebola Virus Disease (EVD) outbreak. The EVD
epidemic is unprecedented in scale and ongoing in Sierra Leone and neighboring Guinea and
Liberia. With limited resources Masanga Hospital Rehabilitation Project (MHRP), in Northern
province Sierra Leone, started to prepare itself months before global interventions of major
international organizations and governments. Preparations commenced directly after the
announcement of a local EVD outbreak in Guinea, as declared by the World Health
Organization at 23th of March 2014. Besides the daily struggles of working in a low resource
setting; absence of running water, three hours a day electricity, scarce qualified staff,
crowded wards, no telephone coverage and financial constraints, Masanga Hospital
managed to set up a functioning EVD isolation unit in the middle of the jungle. The MHRP
medical team faced numerous challenges while setting up the isolation unit, the
implementation of a screening area and the training of international and local health care
workers. The scale of the outbreak and the non specific clinical presentation of a possible
Ebola patient forced the medical doctors to make difficult decisions whether or not to
perform (emergency) surgical procedures. As a consequence some emergency procedures
were postponed until test results irrefutable demonstrated a negative RTQPCR for Ebola.
Patient care was under pressure and good medical practice was at direct risk.
Despite all delivered efforts on hospital, district and national level, evacuation of the
expatriate health care workers – and consequently temporarily closure of Masanga Hospital
– could not be prevented.