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Ebola epidemic in Africa: Cuban medical experience in this international health emergency (VII)
Epidemia de ébola en África: experiencia médica cubana en esta emergencia sanitaria internacional (VII)
Rafael Rufino Corona Pérez
Villa Clara University Medical Sciences. Cuba.
ABSTRACT
The "Henry Reeve" brigade accumulated a month and a half of experience in the Ebola confrontation at the English hospital in Kerry Town where it made important contributions to the treatment protocol of the disease, and paved the way for the participation of professionals from different countries in the campaign, for which it achieved recognition from the authorities and the local population, and in general, all over the world in the face of the expectation generated by the scope of the epidemic. The sudden illness and the fatal outcome of RN. Reinaldo Villafranca Antigua created a real commotion expressed in solidarity, recognition and support for Cuban medical collaboration. This article shares the experience of the painful death and expresses infinite gratitude to those who accompanied us in those sad days for the loss of our beloved workmate.
MeSH: hemorrhagic fever, Ebola, disaster sanitation, disaster emergencias, international assistance in disaster, education, medical.
RESUMEN
La brigada "Henry Reeve" acumulaba mes y medio de experiencia en el enfrentamiento al ébola en el hospital inglés de Kerry Town donde realizaba importantes aportes al protocolo de tratamiento de la enfermedad, y abría el camino a la participación de profesionales de diferentes países en la campaña, por lo que alcanzaba reconocimiento de las autoridades y de la población local, y en general, en todo el mundo ante la expectativa generada por el alcance de la epidemia. La repentina enfermedad y el desenlace fatal ocurrido al Lic. Reinaldo Villafranca Antigua creó una verdadera conmoción que se expresó en solidaridad, reconocimiento y apoyo a la colaboración médica cubana. Este artículo comparte la experiencia vivida ante el doloroso deceso y expresa agradecimiento infinito a los que nos acompañaron en aquellos tristes días por la pérdida de nuestro querido compañero.
DeSC: enfermedad por el virus de ébola, saneamiento en desastres, emergencias en desastres, asistencia internacional en desastres, educación médica.
Editorial Note
The participation of Cuban health professionals in the global campaign against Ebola was an unprecedented event in the history of humanity, in the history of Cuba, and in particular in the history of Cuban medicine that demands to be studied, researched and divulged. Their contributions and experiences should be introduced in undergraduate and postgraduate study programs not only because of the historical aspects, but also because of their impact in the medical sciences and because it is a serious health problem that is far from being solved, so outbreaks of the deadly disease are possible, since the conditions that originated it remain intact. From volumen 9, No. 2 on, EDUMECENTRO journal has published a group of articles under the title: Epidemic of Ebola in Africa: Cuban medical experience in this international health emergency, authored by Dr. Rafael Rufino Corona Perez, member of the "Henry Reeve" International Specialized Contingent in Disaster Situations and Severe Epidemics and professor of Villa Clara University of Medical Sciences, who writes his experiences as vivid testimony of what happened in those months, where the intellect, perseverance, courage and struggle for life prevailed facing the health disaster and were proclaimed victorious. In these research paper has been respected the writing in first person by the psychological implication of the facts that are narrated in the personality of the mentioned doctor.
Nota editorial
La participación de los profesionales cubanos de la salud en la campaña mundial contra el ébola representó un hecho sin precedentes en la historia de la humanidad, en la historia de Cuba y, en particular, en la historia de la medicina cubana que demanda ser investigada y divulgada. Sus aportes y experiencias deben ser introducidos en los programas de estudio de pregrado y posgrado no solo por los aspectos históricos, sino por su impacto en las ciencias médicas y por ser un grave problema de salud que dista mucho de estar resuelto. Las condiciones que originaron la enfermedad permanecen intactas. A partir del volumen 9, No. 2 de 2017, la revista EDUMECENTRO publica un grupo de artículos bajo el título: Epidemia de ébola en África: experiencia médica cubana en esta emergencia sanitaria internacional, cuyo autor principal es el Dr. Rafael Rufino Corona Pérez, integrante del Contingente Internacional Especializado en Situaciones de Desastres y Graves Epidemias "Henry Reeve" y profesor de la Universidad de Ciencias Médicas de Villa Clara, quien redacta sus experiencias como testimonios vívidos de lo acontecido en esos meses, donde el intelecto, la perseverancia, la valentía y la lucha por la vida se impusieron ante el desastre sanitario y se proclamaron victoriosos. En estas comunicaciones se ha respetado la redacción en primera persona por la implicación psicológica de los hechos que se narran en la personalidad del mencionado doctor.
Continuity of the work of the Henry Reeve Brigade in Sierra Leone. The death of Reynaldo Villafranca Antigua (Coqui)
On Saturday, January 17, Ramiro Guedes M.D., internist and head of the Compañero hotel group, called me urgently to inform, as it was established for cases that presented a health problem, that Comrade Reynaldo Villafranca (Coqui) was ill with a high fever, he had initially been assessed for Ebola infection or malaria, so he was immediately isolated at the hotel. In a few minutes I got there because it was Saturday and it was already dark, so there was little traffic on that route that was usually very busy.
When I arrived at Reinaldo's room, who can be identified in figure 1, I spoke with Dr. Guedes, who described the clinical picture, very concerned to appreciate that he was beginning to present awareness problems. We did the malaria test and tested positive for Plasmodium falciparum, so I thought to start the treatment with Lonard-DS, a derivative of Artemis with Pyrimethamine, by mouth, which was what was available, and at the beginning of the cases it has given very good results, but before the rapid deterioration of his condition it was decided to take him to the hospital in Kerry Town, located at a few minutes, where the Cuban brigade member worked with the English. The test for Ebola was negative and in spite of the painstaking care that was offered to him in the hospital, he died at the end of the morning of the next day due to the worst complication of the disease: cerebral malaria.
Actually Coqui hid the symptoms minimizing them to not stop working and when he went to Dr. Guedes to ask him not to let him die and his condition was very serious, and it was not possible to avoid the fatal outcome. I will always remember the expression of pain and disgust of Dr. Guedes that night because he had great appreciation to Coqui.
That night, when I returned to the Mariam Hotel, I told the brigade's principalship about the inevitable death of our brother, and from that moment we put ourselves in charge of confronting the situation by communicating it to the charge d´affairs , to the headquarters in Cuba, to the WHO headquarter, to the Ministry of Health, of Sierra Leone, and to all the staff of the brigade, because we knew that a whole process of negotiations would begin to apply the agreement signed with the WHO and the procedures for the funeral and burial of the collaborator. We knew that his mortal remains should stay in that country for at least 5 years.
The Granma newspaper published on January 18, 2015, the following information note from the Ministry of Public Health:
On this day January 18 at 7:00 a.m. Cuba time, 12:00 m. Sierra Leone time, the collaborator Reinaldo Villafranca Antigua, RN in Nursing, died at the age of 43, from the municipality of Los Palacios in the province of Pinar del Río, as a result of malaria with a brain complication.
The note explains that the collaborator was part of the Medical Brigade of the "Henry Reeve" Brigade, arrived in Sierra Leone on October 2 to face the Ebola epidemic and was located in the Ebola treatment center of Kerry Town.
RN. Reinaldo Villafranca Antigua worked for more than 10 years in the health sector and voluntarily gave his willingness to join the group of collaborators who left for West Africa - the note says - and concludes by thanking the authorities of Sierra Leone, to the WHO and the British mission for the attention and follow-up offered to the collaborator, and conveyed the most heartfelt condolences to his family.1
During the painful process of negotiations and coordination with the WHO, the Ministry of Health and the local government of Free Town, I accompanied the head of the brigade. In the morgue we had the invaluable support of Dr. Patrick Don Davies, a Dentist graduated in Cuba, who knew the hospital perfectly and was irreplaceable in the processing of the funeral and the place for burial in the local cemetery. We were also accompanied by Andy Mason and some members of the Save the Children organization during the procedures in the morgue of the Connaught Hospital, and later in the transfer and burial ceremony in the cemetery.
The funeral was held in the afternoon of January 23 at the Compañero Hotel. In its yard, all the necessary resources for the funeral ceremony were displayed. The support received from the management of the hotel and all the organizations related to the brigade during the preparation and the realization of the funeral was really impressive. All its members met in full for the ceremony, and the representatives of the different organizations and institutions render tribute to Coqui by holding an honor guard. Some of the images that constitute historical evidences of that moment are figures 2,3 and 4.
In the ceremony, heartfelt words of recognition and farewell were expressed by representatives of WHO, the Ministry of Health, Dr. Guedes and the Cuban ambassador to Sierra Leone.
Coqui´s death affected everyone very much because, besides being a member of the brigade, he was a great worker, and because of his personal charisma, he was a nice person to all of us; that event moved us to elevate vigilance and personal care to successfully accomplish the mission. His death also greatly affected the members of the organizations that faced the fatal epidemic with us. All collaborated in different ways in the treatment and conservation of his corpse, funeral parlor and burial, for which we must thank Save the Children, the Kerry Town Hospital, IHP, Emergency, Partners in Health, the owner and staff of the Compañero hotel and of course to the WHO, the Ministry of Health and the Government of Sierra Leone, by the important support in those difficult days in which I participated together with the Head of the Brigade and the Chargé d'Affaires in the multiple efforts made.
The burial ceremony was really felt by all those present and was held on the afternoon of January 27 in the cemetery of Free Town with limited participation to a representation of the brigade of the Compañero Hotel and the institutions related to the Cuban medical brigade A placard was placed as an indelible mark of the sacrifice of Cubans for humanity, which can be seen in figure 5.
From January 18 on, with the death of Reynaldo Villafranca (Coqui), the demand for the use of antimalarials increased; it was assumed not only as a political and administrative objective but also as a dignity, so that no more feverish cases were presented during the fulfillment of the mission; This situation was maintained until the quarantine of the entire brigade was completed on its return to the homeland, in Jagüey Grande.
Since we joined the brigade for the Ebola confrontation death was always a possible reality for all of us because of the amount of aggressions and dangers that we had to face; but when in fact it was presented, it hit us with great force the loss of that useful and beloved comrade, it only comforts to know that duty was fulfilled with the country and with humanity contributing our effort and dedication for the sake of a better and healthier world.
Declaration of interests
The author declares no conflict of interest.
BIBLIGRAPHICAL REFERENCE
1. Ubieta Gómez E. Zona Roja. La experiencia cubana del ébola. La Habana: Ediciones Abril; 2016.
Submitted: July 5 2018.
Accepted: July 5 2018.
Rafael Rufino Corona Pérez. Villa Clara University Medical Sciences. Cuba. E-mail: rafaelcorona@infomed.sld.cu
This article is published under the license Creative Commons
Copyright (c) 2018 EDUMECENTRO
