‘Everybody panicked, thinking it was going to be Ebola all over again’
ASWANSEA GP has found himself on the Covid-19 frontline in Africa. Dr Mikey Bryant is an out-of-hours Swansea GP working for Swansea Bay University Health Board.
He has found himself fighting Covid-19 in Liberia on the west African coast, running one of the few hospitals there with an isolation ward and plenty of oxygen.
He initially arrived in Monrovia, Liberia’s capital city, to set up a large paediatric programme, mainly working with malnourished children.
It’s a husband-and-wife team – Mikey’s wife Dr Bethany Bryant is a paediatric doctor at Morriston Hospital when they are working in Wales.
Mikey felt he and his team were making inroads into improving the healthcare of youngsters in Liberia. Then Covid-19 hit.
The money for the isolation ward, the oxygen, antibiotics and staff has been funded by Swansea Bay Health Charity’s Africa Health Links Fund and the Welsh Government’s Wales and Africa grants scheme.
He’s been in Liberia since January 2019 and has spent a fair bit of his career between Wales and Africa.
Not only has Wales played its part in funding Mikey and his team’s work out in Liberia, he also drew on the experience of his Welsh contacts in the early days of the pandemic. He modelled a lot of how he wanted his hospital to deal with Covid-19 on how colleagues in Swansea reacted.
He said: “I still do telephone medicine for the Swansea out-of-hours service. I do about 15 hours a week from Liberia. I would be doing my shift but then calling other GPs asking, what are you doing, what does Morriston look like, what’s the set-up there? Without that link I think we would have really struggled.”
From arriving in Liberia as Swansea Bay’s paediatric lead, to being asked to become the hospital’s medical director and then taking on a third role as Covid-19 response lead, you have to ask what drives Mikey to take on such responsibility.
He said: “I actually spent most of my childhood in Senegal. I’ve always had an interest in Africa. I remember, when I was a child, my brother got really, really sick. He was so unwell, he almost died. Thankfully, he recovered.
“I remember at the time thinking wouldn’t it be great if this level of care was extended across the country. And that has been my drive, to mostly help in paediatrics.”
Africa, and in particular Liberia, is unfortunately no stranger to an outbreak of a deadly disease.
Ebola swept the country in 2014 and lasted for two years.
Mikey remembers when those first Covid-19 patients came through his hospital doors in March.
He said: “At first everybody seemed to think it was going to be Ebola again and everybody was in a panic. It was terrifying.”
Liberia’s experience with Ebola has helped the country’s response to Covid-19.
Mikey thinks the Liberian government has been strong in its response to the pandemic.
The Ministry of Health has been clear in its directives, locking down certain areas and trying to test as many people as resources allow.
But he doesn’t think they’ll see a “peak” like that seen in other parts of the world, as it’s impossible to get an exact picture.
He said: “There is still a huge part of the population who don’t engage with the health services.
“We have some sense of where we are, but we don’t know the exact figures. I would say we have had more of a steady rise, rather than a peak. Part of the reason for that is mobility. People aren’t flying around the country, transport is very limited.”
He also finds it difficult to envisage a time when Liberia will be able to declare itself free of Covid-19.
He said: “We’re still steadily rising in case numbers. I think it will be here for some time. It’s very hard here to actually go for a zero-case situation as everything has consequences. If you say right, we’re going to have a total lockdown in the country, then most people here are living day by day, they’re living hand to mouth.
“Their whole survival might depend on them being able to sell some goods that they’ve made, on the street. If you lock everyone down and say right, you can’t sell any more, then overnight that is people’s incomes just gone, just disappeared.”
Looking to the future, Mikey is still facing the challenge of dealing with the Covid-19 threat while also trying to keep other health services going.
He said: “The main goal of what we’re doing is to try and keep our hospital open for everything else.
“Covid-19 is huge, of course, but there are also so many things that are so dangerous. Malnutrition is a huge problem. So is malaria. Emergency childbirths are frequent.”
Another challenge has been building people’s confidence to re-engage with the health system.
Mikey said: “When we had our first Covid deaths here at the hospital in April, the effect was huge.
“People just stopped coming to the hospital.
Things have picked up, as confidence slowly built and families returned to take part in the malnutrition programme that is funded by Wales.
Mikey is planning to return home soon – but before he leaves his aim is to leave a “Liberian-owned” strategy in the fight against Covid-19 and make sure the malnutrition programme is well-established too, to continue helping the 600 malnourished children attending monthly.
He added: “In Liberia, I suspect long term coronavirus will probably be here longer than I will. So it is so important to me that there is local ownership and engagement with the population to keep these programmes moving forward.”