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Health workers in Sierra Leone celebrate the discharge of an Ebola patient. – (Picture by Fabio Basone). Inset is Dr Innocent Muleya

“Ebola is a frightening disease. When the outbreak hit, there was a call of need for assistance in West Africa. Someone had to answer it,” says Zimbabwean doctor Innocent Muleya.

Muleya (34) is one of a few Zimbabwean medical professionals who travelled to the region to join the fight against Ebola by lending their skills to the cause with international medical humanitarian organisation Doctors Without Borders.

A graduate of the University of Zimbabwe, he joined MSF in August 2014. He’d heard about MSF’s work while studying medicine, and decided he wanted to one day work with the organisation to provide medical care to people affected by armed conflict, epidemics and natural and man-made disasters around the world.

Skilled Zimbabwean medical personnel and other professionals play an important role in MSF’s medical humanitarian work internationally. Since 2010, MSF SA has recruited 23 fieldworkers from Zimbabwe. These fieldworkers have worked in 18 different countries including Swaziland, DRC, South Sudan, Somaliland, Uzbekistan, Mozambique, Somalia, Afghanistan, Kirgizstan, Syria, Sierra Leone, Philippines, Lesotho, Niger, Papua New Guinea, Yemen, Myanmar and Malawi.

On his first MSF assignment, Muleya worked in Sierra Leone’s northern Bo district, where he spent six weeks running the paediatrics department in MSF’s Gondama hospital and referral centre. But providing regular medical care “was an insurmountable task in the Ebola context,” says Muleya.

As he boarded his flight for Sierra Leone, news of the Ebola outbreak had just hit. Almost all flights to the region had been cancelled.

“There were only about 15 passengers on the large Airbus. It was clear we were going where even the brave feared to tread,” says Muleya.

He was one of 34 fieldworkers MSF Southern Africa sent to join the organisation’s massive Ebola response.

“On my first day in the Ebola project, I walked in to find five dedicated doctors. When I saw them, my confidence fired up, and I realised I was in the right place,” he adds.

Fellow members of his MSF team supported and watched out for one another. Innocent gained courage from those around him – especially when the fear of contracting the disease became very real.

While in Sierra Leone, he met fellow Zimbabwean fieldworkers Melt Ndlovu – a nurse – and Caroline Masunda – a nursing team supervisor.

“It was good to meet people from home all the way up in West Africa,” says Muleya.

But his previous experience in running a district hospital in western Zambia, which served a community of approximately 107 000 people, prepared him for the challenge.

“Infectious diseases have always been a daily part of my work. Armed with confidence and along with my experience as a biomedical scientist in laboratory settings where safety and protection were already imbued in me, I felt prepared to tackle the disease.”

In Sierra Leone, the MSF teams are very rigorous in wearing protective gear and following safety protocols to prevent medical staff from being infected with Ebola.

“The first time I put on the yellow suit, I realised how many tools and processes we take for granted as doctors,” says Muleya.

“As I came to examine a patient, I realised I couldn’t even use my stethoscope to do a chest exam. I had to step back for a second and process the magnitude of the situation.”

Teams adhered to their staff safety protocols, checking their temperatures every day, and keeping an eye out for colleagues showing Ebola symptoms.

“But with tiredness and the rising temperatures outside a daily part of our work in the Ebola centres, non-Ebola related symptoms such as fatigue and fever were difficult to identify because the fist focus was always Ebola,” he says.

Muleya describes his time in Sierra Leone as “a life-changing experience on both personal and professional fronts”.

He witnessed countless children dying not only from Ebola but from easily preventable diseases, as the country’s health system and its health workforce came under severe strain. Many of the patients he treated left an impression, he says.

“It was always amazing to walk into the centre to find a child smiling and recovering from Ebola when just the day before they had been close to death. For them, MSF was a last hope. They showed me that there was a real need to provide the care we did.”

Muleya feels he gained invaluable experience while working in Sierra Leone.

“It was the most challenging work I have ever done as a medical doctor. As the number of Ebola cases began to rise, there were fewer doctors arriving in the country than there were doctors leaving.”

After leaving the country, he came face to face with the stigma surrounding the disease.

“After leaving Sierra Leone, I travelled to Brussels. On my second day, I was evicted from my hotel when management found out I had come from West Africa,” he says.

MSF has specific guidelines and protocols for staff members returning from Ebola assignments which dictate that upon completing their assignments, fieldworkers undergo a full 21-day observation period and are regularly monitored for possible symptoms of Ebola.

After 21 days without symptoms there is no risk of developing Ebola and people are regarded as safe.

“Even my loved ones were nervous to see me within the 21 days following my departure from Sierra Leone. Most of my friends thought I was crazy to go there in the first place.”

But not long after he returned from his assignment in Sierra Leone, he again embarked on another assignment with MSF.

This time he headed off to Lesotho where he is working in an MSF-supported hospital in Roma, where he’ll focus on treating HIV/Aids, TB and work to improve maternal health, while implementing new guidelines for HIV treatment.

More than a year after the Ebola outbreak, new cases still emerge.

The already weak public health systems in Ebola-hit West Africa are collapsing under the damage wrought by Ebola, with many hospitals shut and very few places for the non-Ebola sick to turn for help.

MSF operates eight Ebola case management centres in West Africa. Since the beginning of the outbreak, MSF has admitted more than 8 100 patients, among whom around 4 960 were confirmed as having Ebola. More than 2 300 patients have survived.

“But Ebola is not over until there is no single case for 42 days. There is still a need for support in West Africa,” says Muleya. – MSF.