The hospital from where you don’t return

There once was a young Czech solder – let’s call him Jiří – who spent a year in the Congo on a tour of duty. In the town where he was serving, there was an outbreak of Ebola. The likelihood that he would contract this almost invariably deadly disease, which causes a person to bleed to death from inside, was very high.

So when he got a nosebleed one day he was certainly scared. However, he knew that he must not endanger his family or anyone else. When he returned to the Czech Republic, the army’s medical unit immediately sent him into quarantine at the Biological Defence Centre in Těchonín.

This is a hospital from where really sick patients almost never return. It’s a military hospital, hidden away in the Orlické Mountains. It is the only facility of its kind in Europe. And it’s the only hospital in the Czech Republic whose priority is less treating patients as much as protecting the population who live beyond the barbed wire.

As the number of BIOHAZARD! warning signs reveal, it’s a hospital for isolating patients with highly contagious diseases and also serves as a kind of back-up hospital in the event of terrorist attacks using biological weapons such as anthrax or SARS.

Empty beds

There is something else exceptional about it: it has almost no patients. Jiří was its only patient, not counting soldiers returning from foreign missions who always have to spend 24 hours in quarantine here. Every year there are around 1,000 of them.

Why do almost all the civilians returning from areas where dengue fever is raging or Ebola not head here? Because no one in the Czech Republic has looked into this kind of protection for civilian employees. Neither does our own army know what to do with this exceptional hospital.

Jiří was lucky. Despite fears he had contracted Ebola, a two-week quarantine showed that there was no infection and he was allowed to go home. Jiří is one of the few people who know what it’s like inside a state-of-the-art facility.

Almost everything here is made of stainless steel, and patients are examined by doctors wearing suits with their own air supply. Doors open with soft clicks, as all the rooms are at less than atmospheric pressure.

Even though patients are close by, behind triple-glazed glass, it takes a few minutes for any of the doctors to reach them. There are no doors directly connecting doctor with patient. That’s intentional.

Security buffers

Even if the patient is choking, the staff must first change into the spacesuits and pass through the security zone. It takes about three minutes to reach a patient. Ward rounds are done here using microphones inside the spacesuits – what the doctor says is entered into a computer by his colleague standing on the other side of the triple-glazed windows. Almost all the devices are disposable, including the expensive monitors. To disinfect them after contact with a patient that really did have Ebola would be unrealistic.

Anyone who arrives here as a patient lives in a kind of aquarium with its own air and water and a closed waste-handling system. Unlike other hospitals, this one is unlikely to operate on patients, even if it does have an operating hall. Provisions for autopsies, though, have certainly been made. The post-mortem room with its laboratory is right next to the patients’ ward.

The spread of deadly infectious diseases is often swift and it’s important to identify the type of contagion as soon as possible in order to protect others.

The hospital has its own petrol station, heliport, a mobile hospital for infectious diseases with its own laboratory, and sewage treatment including a fishpond into which the cleaned water is drained and where fish sensitive to contamination are monitored to ensure the water truly is safe.

One of the hospital’s rooms is full of mice. Here, in collaboration with a team formed under the late Professor Antonín Holý, research is carried out on some viruses, such as the E. coli virus that sparked a diarrhoea epidemic across Europe last summer that left dozens of people dead.

Research is a tradition here, after all: it was in Těchonín that a unique bank of viruses was kept until 1992, and was later destroyed by order of the Minister of Defence. Today microbiologists have to buy these expensive microbes, such as the diarrhoeal E. coli, from abroad.

The Centre for Biological Control has three tasks: the first is isolation and quarantine, for just such cases like Jiří. The second is research, and the third is educational.

Crisis training

The hospital functions as a training site where doctors and lab workers carry out tests under biological hazard conditions. They learn what to watch out for and how, for example, to transport patients in body isolation units without endangering themselves or their surroundings.

“We work with the civilian system. Doctors from infectious disease clinics, emergency medicine specialists, and even medical students come here,” says Petr Navrátil, the Czech Army’s chief public health officer. And of course, soldiers themselves train here in what to do in the event of a biological threat to the population. It’s called disaster medicine.

The danger of bioterrorism remains: biological weapons are cheap to develop, and they are effective. However, the future of the Centre for Biological Protection in Těchonín is unclear, and everything points to its closure. “The decision has not been made, but in view of the cuts to the Defence Ministry budget, how to keep it running is a very difficult question,” says Defence Ministry spokesman Jan Pejšek. At a time when the Army is looking intently at every crown spent, to make sure there is enough for uniforms and petrol, it is hard to justify pouring money into the Centre.

In short, we have a unique facility, which cost an awful lot of money, but which can essentially only be used when some nightmarish infectious disease breaks out. Closing it would mean that we have thrown away 2bn crowns (€80m). If we keep it, it will cost a minimum of 100m crowns (4m) a year just to keep the hospital running.

Preserving the whole facility is impossible; which ultimately means it is doomed, as aging equipment will not be replaced – and certainly not in the middle of an emergency, just when we need it. What about selling it? There’s no buyer. The army has approached the ministries of Foreign Affairs, Health and the Interior, and has highlighted the importance of Těchonín for the security system of the state to the State Office for Nuclear Safety and the Academy of Sciences and all the other institutions – but none want to contribute to the cost of running it. The search has also spread beyond the Czech Republic’s borders.

“Negotiations have been held with the World Health Organisation, the EU Council, the European Commission, the European External Action Service, and bilateral talks have been held with several countries within NATO (e.g. the UK) and even outside it (Serbia). No agreement has been reached, though,” shrugs the spokesman.

Revenue, or security?

Těchonín, though, might earn its own way, if just the upper echelons of the Czech Army would
try harder. The courses that are held there, for example, could invite in paying participants from abroad – both NATO troops and civilian medical professionals. The local labs could be used commercially or could carry out research that pays for itself thanks to grants and patents.

And, finally, the centre could offer its locations, when they are not being heavily used, to filmmakers. The box-office hit Outbreak, with Dustin Hoffman, was filmed in a similar
American bio-centre. Still, all the same, must the Centre really pay its own way?

Such a property always plays an important role in the strategic protection of the nation’s population. The Army has distanced itself from the decision over what to do with Těchonín. The fate of the complex is to be decided by the National Security Council. Perhaps in February.