Ebola Response Training Day One

I am officially an Ebola responder with Partner in Health!

I arrived in Boston late last night and checked into the Holiday Inn where myself and the 11 other PIH clinicians are staying. I lucked out that I’m here with a friend, Glenn, another nurse who I met on a short mission to Belize last October. This morning, we piled on all our layers and braved the snow for the half-mile walk to Partners in Health headquarters, where we have pre-deployment training.

Boston, the exact opposite climate from Sierra Leone

I was especially excited since we had just learned that the person training us would be Kaci Hickox, who is a huge celebrity in my book. Kaci is the nurse who bravely fought her quarantine last year, after she arrived home from Sierra Leone and was detained at the airport despite having no symptoms of Ebola. With complete disregard for any science or facts, she was ordered to quarantine herself in her home for 21 days. She was vilified by many people who didn’t know the facts, but her taking a stand was extremely important to all of the Ebola responders who came after her. There is simply no scientific reason that a clinician with no symptoms should be quarantined. At some point I’ll be happy to go through the reasoning behind all of this, but I think I’ll save that rant for another day. Suffice it to say that Kaci stood up for her rights and therefore the rights of everyone returning from fighting Ebola. If America treats its humanitarian responders like lepers, it will only discourage people from going to help, and prolong the outbreak.

Me geeking out with Kaci Hickox

It was pretty surreal to be sitting in the headquarters of Partners in Health, an organization whose work I have admired for years but never really thought I was qualified to be a part of. I’ve known of PIH since I read Mountains Beyond Mountains (a fantastic book about Paul Farmer, PIH’s founder) back in college. I’m so proud to be working for them because I feel that their mission speaks exactly to the two passions in my life that I have tried to bring together: healthcare and social justice.

I have to quote part of PIH’s mission statement, because it so clearly explains how I feel about the work we are doing. “Partners in Health strives to achieve two overarching goals: to bring the benefits of modern medical science to those most in need of them and to serve as an antidote to despair… At its root, our mission is both medical and moral. It is based on solidarity, rather than charity alone. When our patients are ill and have no access to care, our team of health professionals, scholars, and activists will do whatever it takes to make them well—just as we would do if a member of our own families or we ourselves were ill.” Awesome!!

Anyway, back to the task at hand: We spent the day learning from Kaci about the history of this outbreak and clinical care for Ebola. I’ll fill you in on some of it because I find it fascinating. This outbreak began in Guinea with a 2-year-old boy named Emil, who contracted Ebola after having contact with bats, which can carry the virus but are not made ill by it. In the next four weeks, all five people who had been in Emil’s household died – but Ebola was not diagnosed, and it continued to spread from there.

This isn’t the first Ebola outbreak, but it has been by far the worst. The first was in 1976, and there have been 25 other outbreaks between then and 2013. The death toll of all of those previous outbreaks COMBINED was less than 2,000. So far in this outbreak, over 9,000 people have died. There are many reasons for that: Ebola outbreaks have mostly been in Central Africa so no one was expecting it in Guinea, so it had plenty of time to spread before it was diagnosed. Previous outbreaks have also been contained to rural villages, but when the virus reached an urban area like the capital of Liberia, it was much harder to contain.

On top of all this, it’s important to point out that the problem isn’t just Ebola – it’s about Ebola showing up in an already broken healthcare system. For example, in one county in Liberia with a population of 400,000 people, there are only 3 physicians. Health systems in Guinea, Liberia, and Sierra Leone simply weren’t equipped to diagnose, treat, and contain Ebola.

The side effect of the Ebola outbreak is that West African healthcare systems that were already weak have completely collapsed. Hundreds of healthcare workers were infected and died before proper protective equipment was used, and most hospitals and clinics have shut down. Maternal mortality has skyrocketed, vaccination campaigns have ceased, and people are dying of common, normally treatable illnesses like malaria.

Fortunately, there are success stories within this outbreak. West Africa is not doomed to failure simply because it is in the developing world. When an Ebola case reached Nigeria, for example, only 19 cases resulted and the country has been Ebola-free since early September. Nigeria is an example of what a robust healthcare system can do, even in a developing nation. Which is where Partners in Health (and my team) comes in! Our goal is to help strengthen Sierra Leonean health systems, in addition to giving Ebola patients the highest level of care possible.

Well, this is a long post and we haven’t even left the country yet! I’ll stop so I don’t scare you all off before I even see a patient :) We have another day of training tomorrow, a free day on Friday, and then ship out to Sierra Leone Saturday morning!

I want to tell you all how much your kind words have meant to me (whether via phone, Facebook, or in person). No matter how I may make it appear, it’s never easy to leave your loved ones and leap into the unknown (though it does always seem to lead to something amazing!) I simply could not do this without the support of my friends and family. Love you guys!!

By Emily Scott, VP  One Nurse At A Time