By Sam Pratt
The death of a Dutch doctor leading a surgical training program in Sierra Leone died of Lassa Fever on 24th November 2019 has been described by many as a tragic situation.
Dr. Wouter Nolet, a medical doctor who specialized in global health and tropical medicine, got infected when he carried out surgical treatment procedures on two pregnant women. The two women were later diagnosed to carry the disease.
The medic was flown home after being infected in the northern town of Masanga, an area not previously known to have been affected.
Sierra Leone has declared a Lassa Fever outbreak. The disease is prevalent in the Eastern parts of Sierra Leone but a new case of Lassa Fever was recorded in Northern Sierra Leone in 2017, where Dr. Nolet worked.
Dr. Nolet was the Program Coordinator for CapaCare Sierra Leone, an innovative surgical training program that builds the capacity of doctors and community health officers to carry out common emergency surgical and obstetric emergencies.
As of 24th November 2019, a total of 7 cases have been diagnosed with 3 reported deaths. Lassa Fever is similar to Ebola Virus Disease with gradual onset of malaise, fever, headache, sore throat, cough, nausea, but can later progress to vomiting, diarrhoea, myalgia, chest pain hearing loss.
Sierra Leone has the fifth lowest doctor to population ratio in the world at just 2.4 per 100,000 people and with an unmet surgical need of 92.1% in 2012, CapaCare has been working alongside the Ministry of Health and Sanitation to fill the gaps by providing surgical training to community health officers.
“The best part of working in Sierra Leone is that, I can be of real value here and can be part of an important development,” said Dr. Nolet in an old interview. He added “In my country, I am part of a big system which is already in place, but here you are really building a system and creating something essential”.
His death has been a shock to the medical community and many young doctors have offered their commiserations to his family and CapaCare locally.
A press release by the Junior Doctors’ Association of Sierra Leone read: “Dr Nolet was such a kind hearted and spirited person and had always been a great asset to the healthcare sector in the country. He will be remembered for his tremendous contributions in supporting our membership in surgical skills trainings and many more”.
Ten European doctors – Seven Dutch and Three British doctors – were evacuated from Sierra Leone this week. Three were confirmed and the others were said to be “high risk” having come into contact with infected patients.
There is no vaccine for Lassa Fever yet and just like Ebola virus, Lassa virus can be spread through contact with the bodily fluids of those infected. It can also be contracted from food that has been tainted by the urine or faeces of rodents.
The Ministry of Health and Sanitation has initiated case management, surveillance, and social mobilization efforts. A total of 45 contacts have been line listed so far.
Sierra Leone has been having sporadic outbursts of Lassa Fever for more than a decade now and it is hoped, Dr. Notel’s sacrifice, hard work to build the Sierra Leonean health system will not go in vain and more resilient efforts will be put in place to eradicate the disease.
Lassa fever: Key facts
- Endemic in rodent population in West Africa
- Spread through exposure to food or household items contaminated with urine or faeces of infected Mastomys rats
- Person-to-person infections, especially in health facilities, can occur
- Can affect many organs, and damage the body’s blood vessels
- Most people have only mild symptoms such as fever, headache and general weakness
- Fatality rate is about 1%
A Sierra Leonean anaesthetist has also been infected by the virus.
