The strategically arranged white Unicef tents, tight, windows rolled up and tied, house asynchronous oscillating fans.  Four giant whiteboards serve as the medical command center with columns labeled "S", "P", and "C" for suspect, probable, and confirmed cases of Ebola.  Patients are brought in after being evaluated at an outside screening and referral unit or are brought directly for triage to our unit.  The cachment area serves mostly the Port Loco District about two plus hours north of Freetown.  Once patients arrive they come through either the confirmed cases ambulance bay or the triage bay.  Every motion in the treatment center is calculated with infection control processes that need to be followed.  We have to have our rubber boots sprayed coming into and leaving the center.  The chlorinated water and wet rubber cling to the humid air to create a fragrance of an industrial laundry room on whites day.

Today I practiced putting on and taking off the Personal Protective Equipment (PPE) that will allow me to safely care for patients.  It is a methodical process consisting of two pairs of gloves, a zip up white suit, a hood, a mask, an apron, googles and those rubber boots.  I have had to gown and glove and wear masks before but these conditions are certainly different and demand meticulous attention to detail.  Putting on the equipment is called "donning" and there is a whole team to ensure you put it on correctly.  Today I put the PPE on to get used to the heat and sweating for 65 minutes without going into the unit.  The key is to hydrate well beforehand but not so well as to have to urinate for the 1+ hours you are in the treatment center directly caring for patients.  You are paired up with a buddy to go in and come out who will inspect your equipment every 15 minutes while you are inside.  Any signs of breach in your armor and you will have to leave.

Equally, if not more important, is the taking off or "doffing" of the PPE which involves a step-by-step disrobing of all the gear all the while being sprayed with chlorinated water and carefully doing it in a way so as to not touch any of your clothes or skin.  I have two more days of this training before I am allowed into the confirmed cases ward.

Overnight our unit had 6 patient deaths, ranging in age from 3 yrs old to 60 years old.  Families are ripped apart.  Children become orphans.  We have a baby in the center now with Ebola who has lost both parents and several other family members.  A woman who has recovered from Ebola (and is now protected from being re-infected) takes care of this baby all day and night, feeding and trying to hydrate the baby.  Our essential character is reflected not so much in our prayers but in our acts of love.  I am humbled to be reminded of this, as long as I am open and looking.

Before my shift finished, I met an ambulance in the confirmed bay, yellow and red lights slowly spraying out from the back of a converted land rover.  Inside a mother and her 3 year old daughter who tested positive for Ebola after her husband died recently waited for our nurses to come in full PPE to take them into the treatment center.  As I stood in my rubber boots, aware of my feet resting on newly placed gravel, aware of the white hot mid-day sun, aware of the gurgle and grind of the generator in the distance, I just stood there. And stood there.  And into my inner world flowed currents...