Q: What made you decide to become a nurse?

FS: I want to take care of the sick. My mother was a midwife—state-certified midwife—so, at times when she tried to take care of patients, I grew closer to her. I like the nursing profession.

Q: Since you joined nursing, what role have you been playing?

FS: I was an active matron during the Ebola at PTS1 [Ebola Treatment Unit PTS1]. I also went to the treatment ward to take care of patients—together with the doctor.

Q: When you first heard about the Ebola, did you have any idea about what that could mean? And then, did you understand what the disease was all about?

FS: I knew that Ebola is a hemorrhagic fever disease. You can’t get contact with fluid, or even body contact. You can’t be in contact with someone that is positive. You will be infected, obviously. You can’t sleep in the same apartment with the person, share things in common—no, it should not be done. You will be infected.

Q: So, when the government declared that we had that problem, how were you engaged?

FS: When we were called by the then CNO [Chief Nursing Officer]—this is Hosinatu Koroma– that we should go for training at the Siaka Stevens Stadium I told my husband, I wanted to go. He said, “No.” I said, “No, I’m here to serve humanity. So, I just have to.” He said, “OK, you can go ahead, but I’m going to leave you here. I’m going to work in the provinces.” I said, “No problem.” So, we went for the training for three days, then the fourth day we were taken to Hastings and we started to work immediately. I was committed to the job, because I was acting in the place of a staff nurse, SRN.

They appointed me as the acting matron and I was second to the Ministry. The then CNO approved, so I started working in the capacity of a matron. But notwithstanding the fact that I was a matron, I always went into the treatment center, to give IV fluids to patients.

Q: When you were summoned by the Chief Nursing Officer for a three-day training, what were you trained on?

FS: The precautions, how to wear the PPE—the protective attire, that we should not ever make any attempt to treat someone at home when the person is sick. We should report to the emergency line, so that the person should be taken to the treatment center. We should work in the treatment center according to the rules and guidelines of the treatment center how to remove the PPE. We should do that correctly, then after treatment, we should wash ourselves—take care of the body, change the clothing, only then do we go home. We should not get in contact with anybody that is sick.

Q: How many other nurses did you have?

FS: About 225 nurses, the hygienists, the doctors, and Dr. Cecil was the coordinator.

Q: So, what exactly was your specific role as a matron then?

FS: I was doing administrative work, then I was even going into the treatment center to assist doctors to treat the patients.

Q: You were going there yourself?

FS: Yes, I was doing monitoring for the food stuff of the patients and the kitchen. In the morning, I would make preparations for food for the patients, see that they have their breakfast—because they would have four meals a day. Breakfast they had by eleven, then midday, at night is their dinner—I would go and make sure everything is okay there, then I would put on my PPE, and go into the treatment center. I would ask patients, “What is your problem? What do you need?” Maybe they need toiletries, maybe they will need to change their clothes, or change the bed linen—because all those things, when they use it once, we throw it away. We put them into the body pits. We don’t allow them to use underwear, or any linen twice. I ask them to take off their things—they go and take their bath, then I pack them according to their request. I ask one or two nurses to go with me and we change the linen. We ask whether they need pepper soup, or what?” If they said yes, we would immediately request this soup. Mango. We prepare it for them like goat soup.

Q: That’s good. So, other patients that you had there. Were they already positive, or some of them?

FS: Positive. All the cases we had were positive cases.

Q: So, how were you protecting yourselves to make sure that you were not infected?

FS: I was protecting myself very well, because even if they say to wear two gloves, I will wear three [laughs]. And we never reuse any gloves, and we never treat any patient at home. I make sure when I want to go into the treatment center I will dress properly. When we set up the IV, I make sure not to recap the needle, because that was what was giving many nurses problems. When we peel off the plasters I make sure I peel them off and put them on a strip before going to the treatment center. Because if you make attempt to peel it inside the treatment center, it will pierce the glove. Then obviously fluid will enter. You will be infected.

Q: So, in terms of ward management and management of the patients that you had, what were the roles of the doctors and other professional colleagues?

FS: They go in every two hours but most times during the ward setting, there is always a nurse present. When there is a problem they will call, “Matron, this patient—something is wrong with this patient.” The nurse will actually explain what is happening to the patient, so the doctor will prepare the drugs and go in. We call for all the nurses to go with him in, and go in. We don’t leave the patients in the treatment center without any medical staff in. We always make sure there is someone—after the forty-five minute span, they come out, they change and someone else will go in. They will be going around to monitor the patients in the various wards.

Q: So, at no point in time was the patient left alone.

FS: We don’t leave them alone. There are medical staff there always working. If not, you will see the hygienists cleaning, because they clean twenty-four hours, because we don’t want vomit, also any other feces to be in the ward. It will upset the other patients. So, they make sure it is clean. We even have a ward here that we call the “Critical Ward.” When you have some patients that are helpless, there is always a doctor there.

Q: If we think back about this situation now, what is it that you think that maybe we needed? If they were there for the outbreak, maybe things could have been controlled better.

FS: Make sure that we have enough medications, enough staff. Then, if we get any news—God forbid, we are not pulling for that—if we have any news there is a breakout here of Ebola, we just quarantine the whole village and open a treatment center there while we tackle the disease. It can’t go out. It can’t spread.

Q: But when it just started, what was the reaction of the communities itself?

FS: When the Ebola disease started, people were denying, saying, it’s a lie. “We don’t have such diseases.” For some that are educated, you need to advise them on preventative measures that you should take—not to take care of someone that is sick, not to loan clothes out to people like that.

Q: What were some of the things that you think you did very well, during the Ebola outbreak? You personally, and also the colleagues that you used to work with.

FS: I always advised them “Don’t treat patients at home, even if it’s your husband or your child. Bring them to the center. We’ll know what to do.”

Q: For some of the patients that you managed or some of the people that you discharged—are you still in touch with them today?

FS: Of course, of course. Many of them. When they are discharged I have to take them with a bus—I take them to the community people, I talk to them. One time I went to buy fish, and I’d forgotten the guy. And he started shouting——“Oh, Matron, Matron, Matron.” I said, “Who is calling me?” Well, immediately I heard “Matron,” I knew that this is someone that knows me. I did not pay for that fish. He says, “Matron, every time you come here, just look for me, and here I will give you fish.” I am ashamed now to go there, for him to be giving me fish all the time.

Q: So, what message do you have to fellow nurses out there—not just in Sierra Leone—about how we should be ready to respond and help as you have just explained?

FS: They should be committed to the job. Even if they say there is an Ebola outbreak here, don’t run away. Tell your family “I’m going to serve the community.” Don’t treat patients at home. Make sure you put on your PPE the correct way, and remove it the correct way. Don’t take drugs from the treatment center to your house to treat patients. Anything that concerns the treatment center, don’t take it home. It is not nice. Just commit yourself to the job. Say, “God, I’m working for humanity, save me.” Obviously, you will be protected.

Q: I’m really encouraged and impressed with the level of dedication, and I really like the aspect of saving humanity. Because true, money will never be enough to pay us. I just hope that the awareness sessions are still going out, you know, being taught to the communities about how we can prevent the infections—not just today, but also in the future.

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Fatmata Samura was interviewed for Frontline Nurses by Margaret Loma Phiri on August 12, 2019 in Freetown, Sierra Leone.

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