Medical evacuation and quarantine

Having a doctor address you while wearing a protective face mask and full-length disposable gown is a surreal experience.

But our being confined to quarters at Liverpool’s Alder Hey Children’s Hospital was only the latest in a bizarre sequence of events involving an emergency flight home and ambulance ride from the airport.

Note my choice of language. This wasn’t the angst-ridden ordeal it might have been, largely because our child appeared perfectly healthy throughout.

Just 48 hours earlier, The Flump had been running a high temperature, was lethargic and – in a sure sign that all was not well – clinging to her dad like a limpet.

She’d also vomited, although we thought that was more to do with a wayward crust of toast bringing up the morning’s milky-milk than any underlying illness.

In fact, there were signs she was on the mend from early on:

Still, when she failed to perk up after picking listlessly at lunch, we decided it was time for our first trip to the clinic. Probably just teething but better safe than sorry, we thought.

In this context, “clinic” might conjure images of a hot and dusty room, creaking beds, a single underqualified nurse and outdated, ineffective drugs. In fact, Aspen Medical’s centre is the swankiest health facility I’ve ever seen, with an X-Ray room, emergency surgery, critical care equipment, pharmacy and in-house lab.

Obviously this isn’t typical. It’s difficult to find accurate statistics on access to government-funded healthcare but the World Health Organization says 69% of treatment is financed by private out-of-pocket payments. If – as US analysis suggests – 72% of the population live on less than a dollar a day, then you can imagine how few can pay to see a doctor.

Expectant or breastfeeding mothers and under-fives have been entitled to free care since 2010 but reports suggest many are still forced to pay by corrupt workers – and that’s if they can find their way to a hospital in the first place.

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NGOs provide vital support – but it’s a far cry from the kind of facilities we’re lucky enough to access [Image: Direct Relief/Flickr]

There is good support, of course, via charities and foreign aid. The BBC World Service reported recently that one positive outcome of West Africa’s Ebola crisis was that it had left Freetown’s British-backed Connaught Hospital with a Western-standard casualty department.

But you can’t overemphasize how privileged we are to have the insurance provided by The One With The Common Sense’s employer.

It was unusually quiet in the back of the car as I drove to the Flump for her check-up.

As is the wont of ailing children, she perked up the minute she got within a mile of a stethoscope. I spent the best part of an hour chasing her around to stop her from charging into various consultation rooms.

Despite her dramatic recovery, the doctor was keen to check for malaria just to be sure. The test – using “golden standard” equipment – came back negative.

However, she’d taken an extra look at a slide of the Flump’s blood through a microscope and been surprised to find a small number of “parasites”.

Worms? That’s odd, I thought, given she’d not really had the symptoms. Then I realised she was telling me that poor Flumpo had indeed contracted malaria.

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Malaria parasites among red blood cells [US Centers of Disease Control and Prevention]

Malaria was one of the things we worried most about before we came here. Some 1.7 million Sierra Leoneans (over a quarter of the population) contracted it in 2013 and 4,326 of them died, according to the World Health Organization.

Young children – particularly those of migrants like us – are among those most at-risk. That’s why we’ve been giving The Flump daily prophylaxis. We’d not missed any doses and the doctor was concerned that this was the second case when the drugs appear not to have worked fully.

However, she assured me that the parasite count was very low and that a few doses of antimalarial medicine would lead to a full recovery.

I left the clinic about as unconcerned as you can be in such circumstances, particularly when the doctor said she’d be fine to go to nursery provided she didn’t have a fever or upset stomach.

The insurance company, however, had other ideas. The following day, they demanded more extensive tests and booked us on the next flight back to the UK. That certainly spooked us.

It felt a bit unnecessary. The doctor we’d dealt with has an excellent reputation and we were satisfied with the treatment, while the second opinion came from 2,000 miles away. But there’s no room for complacency and so we gathered up our passports for what must have been one of the least-panicked air evacuations ever undertaken.

While she’d still been a bit off-colour in the morning, the Flump brightened steadily throughout the day as we hurriedly packed, stocked up on travel snacks and made arrangements for our watchmen to be paid in the event we couldn’t return for a while.

By the time we got to the airport, the child was back to her old self. She was charging about the waiting lounge – high on E-numbers from the sickly-sweet medicine – when the call went up to board our overnight flight.

As we touched down in Manchester, a well-rested toddler was looking several shades brighter than her parents who – despite the excellent Air France service – had each managed just a couple of hours’ sleep.

We were met by two chirpy ambulance technicians who were puzzled as to how we’d managed to pick up a tropical disease in France, having been told only that we were flying in from Paris.

They pulled in to a quiet spot at a petrol station and left me up front while they carried out an initial assessment, surrounded by suitcases and carry-on baggage, in the back.

If sitting alone in the front of an ambulance wasn’t an odd enough experience for an exhausted traveller, you can imagine my shock when a hairy Mancunian loomed at the side window, asking: “Can you move please?”

We were blocking the jet wash.

The tests found the Flump in normal working order, so I enjoyed a leisurely drive to Liverpool chatting to the driver about the coming football season.

On arrival at the hospital, the staff seemed a bit unsure what to do with us. But we were eventually escorted into a private room, with the paramedics wheeling our suitcases like hotel bellboys.

Only later did we twig that our arrival from Sierra Leone must have rung alarm bells and that someone decided – just to be on the safe side, what after Ebola and all – they’d better put us in “strict contact isolation”.

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Not your average hospital visit: Protective clothing and a suitcase

Consequently, the doctor breezed in wearing a disposable yellow cloak, thick blue latex gloves and the kind of mask worn by decorators and Chinese commuters.

We thought she’d come directly from attending to another patient and only realised the get-up was for our benefit when the ambulancemen exchanged looks as though to say “why didn’t we think of that”.

One-by-one, a couple of nurses, a pharmacist and the cleaner turned up, each donning protective clothing and explaining in apologetic – even slightly embarrassed – tones that it was just a precaution.

It did seem a bit of a half-hearted quarantine. When I emerged to ask for some toys for the Flump, I was told I shouldn’t really wander about the ward. I was, however, free to head to the canteen to stock up on food – and presumably pass on any infections to whichever dinner lady was unfortunate enough to hand me my change.

The Flump, meanwhile, showed no sign of having ever been ill as she troughed her way through cheese butties and chips. Still, she seemed determined to make the most of having expert care on hand – clambering over everything in the room and twice smacking her head.

The One With The Common Sense and I, on the other hand, were exhausted to the point that when the Flump was napping she fell asleep upright in a chair while I passed out face-down on the floor.

I was eventually allowed back to my mum’s to enjoy a night on a proper mattress but The One With The Common Sense stayed overnight on a fold-out bed. While she didn’t get the best night’s sleep – as nurses regularly checked the Flump’s (bang on normal) temperature – there can’t be many more comfortable public hospitals in the world.

The light and airy room had its own en-suite with walk-in shower. I’ve used many less-inviting hotel rooms. And the lobby, canteen and gardens are just lovely. The staff, too, seemed so kind, genuine and positive.

The hospital relocated from its old site – which dated back to 1914 – last October and they’ve done a fantastic job of creating a welcoming environment for some very sick children and their parents.

Even so, it was nice to get the all-clear to leave, as tests on the Flump proved negative.

As I write, we’re still awaiting official clearance to fly. It’s been nice to be back in Liverpool, particularly seeing The Flump dash into her gran’s arms. I’d been a bit worried that their special bond might have been affected by our prolonged absence but there was no sign of that.

The weather has come as a bit of a shock. I initially scoffed at my mum’s suggestion that the nights had been humid but I was soon pining for our air conditioning. The combination of heat and torrential rain has meant Liverpool hasn’t been too different to Freetown.

We have, though, been enjoying the light evenings – something we miss being so much closer to the equator – and the mod-cons, particularly WiFi, that aren’t available to us back there.

It’s been frustrating to have our life in Sierra Leone interrupted just as we were getting into the swing of things, particularly as we’re due an extended spell at home next month.

But it’s also reassuring to know that the insurance was so vigilant. It did exactly what it’s supposed to do when something serious crops up.

Let’s just hope we don’t need it again.

And spare a thought for the vast majority who don’t have access to that sort of safety net.

  • Before all the drama, I was half-way through a blog post about the Sierra Leone Marathon – organised by British charity Street Child. I’ve finally published my verdict on a very special event.

2 thoughts on “Medical evacuation and quarantine

  1. Pingback: Our expat experience – the last word | Home Salone

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