As COVID-19 continues to affect people in the UK, we spoke to IHP supporter and A&E nurse Rachel Duncombe-Anderson. During the Ebola outbreak of 2014-15, Rachel volunteered to go to Sierra Leone, where she worked with our partner International Medical Corps. At the moment, she’s working shifts at the Royal London Hospital, helping COVID-19 patients. We talked to Rachel about what it’s like on the frontline and why it’s so important to send medicines overseas.



Q: When and why did you train as a healthcare professional?

A: Initially I did a history degree. About six years later, in conjunction with setting up a disability arts charity, I started training to be a nurse. I’ve nursed on and off for 17 years, the last 15 in emergency care.  


Q: You went to West Africa to nurse during the Ebola outbreak. What motivated you to get involved there?

A: I’d finished my Tropical Medicine Diploma at the London School of Hygiene and Tropical Medicine and had been nursing at the Royal London Hospital, so I had a lot of A&E experience. I was watching the crisis and thinking: ‘Why aren’t we doing anything?’ When there was a call for volunteers, I said ‘I’m going to apply’ and did so that day. Two months later, I went to Sierra Leone.


Q: What was the Ebola situation like, and what stayed with you?

A: The Royal London is one of our country’s biggest trauma centres, so I had seen shocking things, but this was definitely one of the hardest health situations I’ve ever seen. Young people walked in and died within 24 hours. It was movie horror: visible and scary, and with high mortality because the healthcare system was decimated by other issues.


Q: How did working with Ebola patients affect your thinking?

A: Knowing we really couldn’t do much, it was about keeping ourselves safe, keeping the community safe, and then keeping the patient safe. That was a very different way of nursing, and it’s similar for the COVID-19 crisis. Individuals who won my heart have also stayed with me. A young girl, three months old, came in with her mother. The mum died within two days and we knew this little girl had a high risk of getting Ebola, but she was symptom free. She went home at first but showed symptoms and came back shortly after. We realised too late that what this little girl needed was good palliative care. It was very traumatic. (image right: International Health Partners have continued to support Sierra Leone with vital medicines since the Ebola response in 2014)


Q: During the Ebola outbreak, International Health Partners sent essential medicines to Sierra Leone. How important were these?

A: When I was there, a lot of people were dying not of Ebola but of diseases such as typhoid and malaria. The medical system was dealing with Ebola so often help for other areas wasn’t provided. The medicines, supplies and equipment sent by IHP and others helped to furnish very poorly resourced areas. Those medicines would have been used after the crisis, too. There’s an absolute need for IHP and others to keep sending help.


Q: Working at Royal London, what’s it like on the frontline of COVID-19?

A: Six weeks ago, we saw people snuffling. Five weeks ago, we began to take PPE (personal protective equipment) very seriously. This week, I was in the designated COVID-19 area, and people were really sick. COVID-19 seems to accelerate symptoms in those who might normally have a few more months or years to live: it brings down other body functions. Also, young people are getting it and becoming sick. This morning I heard a specialist say: “I’ve just come through it, it was pretty rough”. We don’t want to overplay it, but we don’t want to downplay it either.


Q: What are the challenges in your working environment, and more generally?

A: All of us are asking "Why aren’t we being tested for COVID-19, why aren’t we testing the population more widely?" Getting the right PPE is a stress – none of us want to put our families at risk. I heard the story yesterday of an ITU nurse who had to share masks with a colleague. The NHS is trying, but although we’ve had time to sort this out, it feels like we’re two months too late.


Q: How will more fragile healthcare systems cope with the pandemic?

A: Some sub-Saharan countries have younger populations in contrast to somewhere like Italy, and that will benefit them. But PPE will be a problem, and asking a country such as India to self-isolate won’t be easy. I suspect the countries hit by Ebola will find it easier to self-isolate, to obey the rules, because they’ve seen first hand a huge numbers of deaths. It will be easier to set up a lockdown in Sierra Leone, Liberia and Guinea. In contrast, in Britain, there are people not taking any notice, I’m still seeing people in supermarkets far too close, and just pottering about as if it’s not going to affect them. 


Q: During March, IHP is celebrating ‘women in healthcare’. From your experience, how will COVID-19 affect them particularly?

A: The majority of NHS nurses are women, so this is already having an impact on their home lives, especially if they have children or are main carers for older people. As the situation gets worse, should people self-isolate after their shifts before going home? Where do they stay? And does that mean they can’t see their children for ten days? This crisis is putting an inordinate amount of pressure on women working in healthcare, all around the world, and these are difficult decisions to make.  


Q: As the pandemic progresses, why should we keep supporting IHP?

A: It’s a hard time, because people in the UK are losing their jobs and feeling poorer, and that’s the reality here. But the impacts of COVID-19 in other countries will be more devastating, and we do need to keep supporting these people by sending essential medicines. It’s tempting to have an ‘island’ mentality but we all need to check our hearts and try to look beyond ourselves.



Health systems are breaking down in the most vulnerable countries as they juggle the dual burden of managing the COVID-19 pandemic and dealing with their already overwhelming healthcare needs.

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