© Luis Encinas/MSF
26 Mar 19

DRC: Inside an Ebola treatment centre

It is now eight months since the Ebola outbreak in the Democratic Republic of Congo (DRC). The outbreak is not under control and over 1,000 people have been confirmed to have contracted the virus. This outbreak was the second outbreak to affect DRC in 2018. Ebola specialist Luis wrote about his experience working as part of the Médecins Sans Frontières / Doctors Without Borders (MSF) response to the first Ebola outbreak in the Democratic Republic of the Congo in 2018.

It's strange - I didn’t realise until today the height difference between me and the local people. I’m 1.93m (6’4’’) which doesn’t help. 

Tonight, I accompany the two nurses inside the Ebola treatment centre. The name "treatment" is overstating things a little, because while we can treat some of the symptoms, we cannot treat the disease itself, simply because there are no Ebola treatments available yet. 

I ask if there are any children in hospital. There aren’t. Since becoming a dad, the image of a dying child puts a knot in my stomach. 

I'm wearing my canary yellow suit. XL this time. My size. I can breathe. But the boots are another story. The biggest size they have is 43. I sink my feet inside as best I can, but my toes are scrunched.  

I finish dressing in the protective suit and I also check the suits of my two Congolese colleagues: Patrick and Héritier. Their fear transmits to me. One of the patients inside the centre is a colleague of theirs. There is also the priest and another nurse. I open the access to the high-risk area.  

Inside the treatment centre

Here we are, the three sets of arms laden with food, medicine, and new sheets, because we need to welcome and settle two new patients: Josephine and Miraculous (first names changed to protect patient data).  

We enter the first room, which we call the "Almost Exit". It is a room of 12-15 m2, no more. Four beds and two patients wandering, complaining of joint pain. They are waiting for their medication and the evening meal. We exchange some words with them.  

There is a nurse in the process of recovery. He gives me his hand. I rest mine on top. We look at each other without talking much, the words are too much. I give him all my energy and wish him courage.  

"It will be fine!” he says with a half-smile. It’s moving. 

We continue the visit, and before arriving at the second room, we must go through a long passageway. Two patients are lying on the floor. The priest and another nurse. They have trouble getting up.  

They sit up with difficulty, and have trouble speaking. We try to help them inside the room, but they categorically refuse. We understand then that it’s the smell of the omnipresent chlorine that disturbs them.  

Then I arrive in room two. There are four patients inside.  

Room two

A woman on the floor is covered in stool and urine. Her strength has gone, and we have to help her up to her bed. Her IV fluids bag was disconnected, and it is difficult to insert a new one.  

We hear noises of vomiting on the other side of the room. Our eyes meet and we check how each other is doing. I take my time, but I am told off by my two colleagues. I would have liked to have some water, soap, and towels, and to change myself into a woman to be able to wash her. 

Time is running at incredible speed. Here we are in the last room: the antechamber of death.  

A woman lying on the floor. Dantesque scenario. Her lips are swollen, and saliva foams from her nose and mouth. She's barely breathing – fast and shallow.  

Here too, the desire to accompany her to the hereafter accompanies me. I crouch down and take her hand. A few seconds, maybe a little more. A minute or two. I stroke her hair. I feel my throat knotting. To the point where I can’t feel anything. I struggle through the fog on my glasses to define the contours of her face.  

I get up, wash my gloved hands in chlorinated water, and head for the exit.  


At a distance, people are talking to me, gesticulating. I don’t understand much. I’m afraid that they are signalling some danger to me. Is there an opening in my suit? Has it torn? I didn’t hear it tear.  

Looking at the two nurses in the decontamination phase, sagely waiting for my turn, I realise that they are no taller than my chest. I would understand much later what the nurses were saying. There’s a giant behind us. Look!  

And it's true that there is a 35 cm (1’2’’) difference – it’s suddenly obvious to all of us. 

On my return to base, I still have enough energy to take an "old-fashioned" shower and I discover that canned sardines in oil can become the perfect sauce to my daily, sticky rice.  

I close my eyes for a brief moment and I imagine myself in a high-class restaurant. On the menu: small sardines lying on a bed of basmati rice steamed with bamboo, under a Mediterranean sauce with rosemary and fresh thyme. I'm drooling. The reality will be different, but my taste buds have salivated enough to aid digestion. 

Night waking

At three o'clock in the morning, I wake up with a start. I realise that the sheets are soaked. It’s sweat. My heart races.  

What happened? Where am I? A nightmare?  

Where do these cries come from?  

"Help me Lord! Help!" 

It’s the voice of Madeleine* who entered the Ebola treatment centre two days ago. But where is she?  

I open the zippers of my mosquito net and my tent. I go out. No one!  

I realize in my delirium that I’m having a nightmare. I take the opportunity to go outside a little. I open the door gently for fear of waking my colleagues.  

I sit on the edge of the small wall. I look at the sky, and the stars. My head is elsewhere. My back is cold, and my throat knotted. I see the faces of the patients scroll by one by one, slowly. What an injustice. Why here? Why them?  

I take my head in my hands and cry silently. I feel so small, so helpless in the face of this.  

Then I’m filled with incredible energy. I make a promise to fight for them.  


*Names have been changed

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