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Danger everywhere: A hygienist approaches patients classified as suspects wearing a boiling hot Hazmat suit to protect them from the invisible killer
A doctor who has fought the Ebola virus in Liberia where it infected two American doctors today gave a terrifying insight into how medics put their fears aside and their lives on the line to treat patients in the current outbreak taking a grip in Africa.

Doctor Hannah Spencer revealed how she wills herself to feel safe inside a boiling hot air-sealed Hazmat suit - her only barrier between her and catching an invisible killer that kills 90 per cent of those who are infected.

Dr Spencer, who is British, volunteered for medical charity Doctors Without Borders in Guinea and Liberia - the crucible of the current outbreak which has killed more than 600 and infected around 1,200.

She spoke out before news emerged that two Americans, Dr Kent Brantly, 33, and Nancy Writebol, 60, had contracted Ebola and are fighting for their lives to explain the risks, the courage, the physical toll and fear endured by doctors battling to contain the virus from killing more.

To minimise the risk of infection they have to wear thick rubber boots that come up to their knees, an impermeable body suit, gloves, a face mask, a hood and goggles to ensure no air at all can touch their skin.

Dr Spencer, 27, and her colleagues lose up to five litres of sweat during a shift treating victims and have to spend two hours rehydrating afterwards.

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Boiling: Doctors and nurses lose up to five litres in sweat during an hour-long shift in the suits and have to spend two hours rehydrating after
They are only allowed to work for between four and six weeks in the field because the conditions are so gruelling.

At their camp they go through multiple decontaminations which includes spraying chlorine on their shoes.

Dr Spencer, who is from Surrey in the UK, said that she signed up to help Doctors Without Borders for three weeks after hearing about the outbreak of Ebola in West Africa.

First she went to Guinea where she worked in an isolation ward and then to a rural clinic in Foya, Liberia, which is not the same location as where the Americans were.

Dr Spencer said: 'I wouldn't say I felt completely calm - obviously you have some anxieties before you go. But once you've done your first day in the isolation ward, when you're wearing all the protective gear, you feel safe to work with the patients.

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Gruelling: The volunteer doctors are only allowed to work for between four and six weeks in the field
'It's difficult working in the protective clothing - it's very hot, and you can't spend more than an hour inside it. So when you've got a large number of patients, it's hard to feel that you are spending long enough with each one.

'I also found that, with the mask and the goggles and the layers of protective clothing, it took much longer than normal to build a relationship with the patients.'

One of Dr Spencer's colleagues is Canadian GP Tim Jagatic who is on the ground in Kailahun, Sierra Leone, also affected by the outbreak.

He said: 'Because we're wearing personal protective equipment, it limits the amount of time that we spend inside the isolation unit.

'We would like to keep a visit between 45 minutes and one hour, but now, we're stretching it to almost two hours. We put ourselves through a very strong physiological stress when we're using personal protection gear.

'We sweat, we're losing water; we're getting hotter and it wreaks havoc on the body. Our own endurance starts to wear down.'


Doctors Without Borders has established strict rules about treating Ebola and encourages doctors to treat patients using oral medication and not needles.

They are given a 'buddy' to watch out for symptoms and when they return to their home countries, staff have to remain within a short driving distance of a hospital in case they later discover they are exposed.

Dr Spencer said that the 10-bed isolation unit she worked at in Foya became crammed with 22 patients within days of her arrival, with many lying on mattresses on the floor.

She said: 'One day four children, all aged around three and four, were brought to us from another health facility, sick with fever.

'They were from two different families but lived in the same house, where two adult family members had died of the disease.

'The children arrived in the ambulance accompanied by a mother and an aunt, but the mother refused to let them out. She didn't believe the children had Ebola, or that their family members had died from it - she was convinced they had been poisoned by something.

'It took us over an hour to persuade her to even leave the ambulance.'


Dr Spencer added that funerals were among the times that an Ebola victim is the most contagious, even though they disinfect the bodies. During the ceremony it is customary in Liberia to touch the body as you pay your respects.

She said: 'At traditional funerals, it's common for the body to be displayed and for all of the mourners to touch it as they say their final goodbyes. If someone has died from Ebola, the level of virus in their body is extremely high.'

Dr Jagatic also explained the climate of fear gripping villages and the stigma the virus brought with it. He said that when doctors entered villages in their protective 'spacesuits' and began spraying disinfectant they would be accused of spreading Ebola rather than fighting it.

He added: 'There was a group of seven people dropped off at our hospital yesterday, because they were believed to have been in contact with somebody who had Ebola.

'They were shunned. Rocks were being thrown in their direction. When our ambulance showed up to deal with the dead body, the leader of that community forced our ambulance to take those people.

'Two of them ended up being feverish, so we kept them in our ward for suspected cases. But we had to have a long discussion with community leaders.'
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Rudimentary: Plastic buckets for disinfectant or even possibly vomit from patients stand in front of simple partitions put up to make cubicles for the ever-increasing number of patients
According to the World Health Organisation, Ebola is transmitted by direct contact with bodily fluids or by touching anything that has had them on it.

It is often spread through family and friends because they come into close contact with victims as they care for them.

The incubation period is two to 21 days and after that it can kill within days due to internal bleeding. There is no known cure.

Dr Brantly had been treating victims when he showed symptoms whilst Mrs Writebol was helping to disinfect workers as they left the Ebola unit in the hospital on the outskirts of the Liberian capital, Monrovia.

They are currently being treated in isolation in the same hospital where they were working, which is run by the US-based Christian charity Samaritan's Purse and SIM Liberia.

Pictures made public by Samaritan's Purse show Dr Brantly wearing a white full body suit and goggles in the chapel of the hospital where he works.

Others show him wearing the same protective clothing whilst bending down on a ward to treat a patient who is lying on a bed. Dr Brantly's wrists can be seen tightly bandaged to stop any air from getting in.

Other photos show that crude signs have been erected around the isolation unit made of white sheets with the words: 'Stay Away!' written on them. Currently it is in a converted chapel and workers for the charity posted on Facebook the rudimentary buckets, spray machines, latrines and bedding they have to work with.
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Courage: Dr. Kent Brantly is pictured left in an undated handout treating a patient at the case management center on the campus of ELWA Hospital in Monrovia, Liberia
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Grim: Dr Brantly helps carry the body of an Ebola victim. Once the patient dies their bodies have to be disinfected as they become highly infectious and in Liberia it is tradition to touch the dead at funerals
Dr Brantly
Protection: Dr Brantly in his goggles, mask, gloves and suit before he came down with the virus
Friends said Dr Brantly is 'terrified' that the disease will get more severe but has told friends that he will have 'no regrets' if he dies as he is putting his trust in God.

His wife Amber and their two children had left Liberia several days before he began exhibiting symptoms.

Mrs Writebol and her husband David waited until their children had grown up to become missionaries and moving to Liberia.

They gave up careers in computers and education in order to work for Samartian's Purse.

Dr Spencer said that she had faced little resistance from her own family when she told them about her volunteering and her mother told her: 'As if I could stop you from going!'

She said: 'Naturally my family were concerned, but I explained that MSF has a long history of working with the disease. Ebola is highly infectious, and while you can never say there's no risk, if you follow all the procedures, the risk of catching it is low.'

Despite the virus' devastating mortality rate, she explained just why they are there.

Dr Spencer said: 'One 15-year-old girl was inside the isolation ward for over a week, along with her seven-year-old sister and her mother, who was very unwell at first - I really thought she was going to die.

'But then they all started to get better. When, finally, the girl's test came back negative, she had a shower in chlorine to disinfect herself, changed into new clothes and was then discharged from the ward.

'Her family were all there to meet her at the gate and she was crying because she was so happy. That was a wonderful moment - to see that and to know that her mother and sister would soon be well enough to join her.'

Dr Spencer said she found it 'frustrating' there was no cure for Ebola and thought that if it affected more people in the West then it would get more attention.

She said that not enough was being done to stop the outbreak in West Africa and that it left her feeling 'powerless'.

The only effective treatment that medics can give is to rehydrate patients by putting a drip into their arm.

They can also give them medication to control symptoms like diarrhea, vomiting and headaches, which are the first stage of the virus.

The second stage is haemorrhagic fever in which patients endure difficulty breathing and swallowing and agonising bleeding inside and outside the body. If patients enter the second stage they usually die.

Doctors Without Borders, or Medicine Sans Frontiere, set up an Ebola treatment Centre in northern Liberia which it has since handed over to Samaritan's Purse.

It also has teams in Voinjama in Lofa County and Monrovia but says there are 'critical gaps' in care and more help is needed.