Helping the fight against Ebola

Alumna Laura Holding is helping the fight against Ebola in Sierra Leone.

Laura Holding, UWE Bristol Alumna

Graduating last year with an MSc in Medical Microbiology, Laura Holding made the brave decision to help the fight against Ebola in Sierra Leone.

Laura told us UWE Bristol armed her with a good knowledge of clinical diagnostics, as well as information on the treatment of exotic pathogens. This was her favourite topic, but she didn't imagine she’d be applying this knowledge first hand so soon in her career. We asked Laura what day-to-day life is like in her lab and what we need to know about Ebola to stop the spread of the virus, wherever we live. Markets are still bustling, people are out with nets fishing and seem upbeat, but there is an ever-growing undercurrent of fear.

About your role

What are your daily routines? We heard that it can be extremely hot, sweaty work in those protective suits.

"There are two shifts currently at Kerry Town, 06:00–14:00 and 14:00–22:00. A typical day involves setting up the lab and cleaning all surfaces with a very strong bleach solution and ensuring we have enough disinfectants, consumables and reagents for the day. We also run through safety checks. There are five people in at any one time and we rotate between duties such as isolator work, RNA extraction and PCR (Polymerase chain reaction, a technique used in molecular biology), although this depends on the experience and expertise of each person and how many samples there are.

"We have a varied skill set in each team with people from different scientific backgrounds, some from Public Health England, The Ministry of Defence, the NHS and also PhD students. Personal protective equipment, used at sample reception, does make it very difficult to communicate. We also wear respirators and a face visor. Samples don't always come in a uniform manner, so it can take time in the heat to sort through and check that they are in a safe condition to process. We are very lucky to have air conditioning in the lab, a luxury I know previous deployments have not had, so although it can get hot, it's never unbearable. The chlorine we use to clean does start to sting your eyes though!

"Another ritual that has become routine in Sierra Leone is washing your hands in a weak chlorine solution and having your temperature checked on entering and leaving various sites.

"We receive samples from the Ebola Treatment Centre and also larger collections from the community. After they are checked they are then taken into the flexible film isolator to be inactivated and prepared to perform PCR on. Results are validated and reported in as little as four hours, depending on batch size. It’s important to get the results out fast so that positive patients can be treated as quickly as possible and negative patients can be released back to their families and away from any infectious patients.

"As the first lab team at Kerry Town, we had to set up the lab from scratch so the first few days were a bit hectic and hot! It's really incredible how much it’s changed from an empty building into a fully functioning lab in so little time!"

Understanding Ebola

What do you think people in the UK really need to understand about Ebola?

"It's important not to create panic through the media, which can impact on the crisis response, for example, the threat of quarantine for returning volunteers may deter others wanting to help. The risk to the general UK population is very low and we have a world-class healthcare system in place to deal with any isolated cases. Although it is highly infectious, the simple precautions you can take reduce the risk greatly.

"The earlier people receive treatment the better chance they have of survival. The Sierra Leonean people are very positive and have adapted their lifestyles to help stop the spread even though it contradicts some of their strong beliefs, such as not carrying out traditional burial techniques and separating villages to opposite sides of the road, one for sick and one for healthy. They are also very aware of the no body contact rule and you can see this with everyone you meet. There are posters all around the villages encouraging Ebola avoidance procedures. I think they are genuinely really grateful for the international response that is happening which inspires you to want to help more."

Applying skills learnt at UWE Bristol

Could you tell us about your course of study at UWE Bristol, what skills or experience you gathered here and how they relate to your current position?

"My course at UWE Bristol was MSc Medical Microbiology, which was really useful to me in coming here, as my normal job is in a food, water and environmental lab. It gave me a good knowledge of clinical diagnostics as well as information on the epidemiology, transmission, diagnosis and treatment of exotic pathogens. This was my favourite topic; I didn't ever envisage I'd have to use the knowledge first hand, you just never know!"

Reasons for going to Sierra Leone

What factors made you decide to go to Sierra Leone to help fight this? Were you concerned about any risks to your own health?

"Like most of my colleagues here, I wanted to use my training and education to help a genuine cause. As we are based at the treatment centre, you do feel part of the bigger picture, so it's rewarding as well as sad. And obviously there are good times too, for example when a very sick patient makes a full recovery and can go home.

"I was scared at first because you just don't know what to expect but we have the training and PPE (personal protective equipment) and a team of experts which is reassuring. The country is beautiful, it translates as ‘Lion Mountain’, which I think is cute and its people are doing all they can too. Many of them helped build and work at the centre. It's also a great opportunity to learn new skills and meet people involved in all aspects of the service we’re delivering. Everything from logistics, to nutrition, finance, doctors and wash staff."

Perceptions of the health crisis

Is there a contrast between what you think the British public perceives about this health crisis, and the reality as you find it?

"Before I arrived I imagined a broken country, so initially I was surprised at how life was carrying on as normal, on the surface anyway. However, there are a lot of other consequences of the outbreak such as economic downfall, hospitals and schools closing and various other projects in the country coming to a halt. I've noticed an increasing number of scared people. In a way, we have been sheltered from the horror of the disease as we rarely go into the community so it's hard to say for certain if I've seen the reality of Ebola."

How people can help fight Ebola

How can people in the UK help fight Ebola? Are there any charities you would like the public to donate to?

"It would be amazing if people would like to donate to either Save the Children, who I came to work here for; the money goes towards running treatment centres as well as to the protection of orphans as a result of the crisis. Or Médicines Sans Frontièrs, who are an independent organisation who provide emergency aid and develop vaccines. I've heard there's a Bob Geldof song out, so buy that as well! Thanks!"

Country differences between the UK and Sierra Leone

How different is your life in Sierra Leone compared to the UK, is there anything you miss?

"We are very fortunate to be staying in above-average accommodation for an emergency response due to the effect of Ebola on tourism, so I can't complain about missing creature comforts. But I do miss my family, friends and colleagues, so I can't wait to see them. It will be good to have some freedom as we are restricted to just the hotel and the centre as a preventive measure. It's also going to be really weird being able to hug or just touch people, but hopefully in a good way!

"One main difference that I think I'll experience when I return is being able to reflect on what I’ve done. It all just flies by and as much as you're aware of the situation and patients names come and go, I think some of it is suppressed… it’s a lot to take in."

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