narrative

Love in the time of Ebola

Source: Marrianne’s Blog – September 25, 2014 – in 
“He allowed himself to be swayed by his conviction that human beings are not born once and for all on the day their mothers give birth to them, but that life obliges them over and over again to give birth to themselves.”
Gabriel Garcí­a Márquez, Love in the Time of Cholera

ebola-nigeria-airport-e1407380067222

I stepped off the plane in Harare, Zimbabwe, and down through the glass-enclosed walkway overlooking the nearly empty terminal, down into the dark corridor and on to customs.  It was a quiet night in the Harare airport, and I was fortunate to be one of the first to deplane. I come about quarterly, and am here this trip reviewing our programmatic progress for an HIV prevention grant. On my trips, I look forward to the very slight changes that are inevitable here – the change in the brilliant colors of Harare from the beautiful violet Jacaranda or flaming red African Tulip trees blooming, the new construction of roads as the country continues to pull out of economic recession, the change in menu items or services at the hotel as it continues to strive to keep up with an ever-growing global business clientele, or the changes on my own program – meeting new staff members and partners as we continue to scale up our program.  This time, as I walked down to customs, the change was slight but more immediate – my path out was blocked by a small, tired-looking wooden desk. The desk was flanked by two pretty, young, Zimbabwean women.  I approached, glanced back at the long line growing quickly behind me.  “Hello,” she said quietly, almost as if under her breath, as she reached out for my passport, “Have you traveled to West Africa in the last 3 months?” “No,” I responded. “Any fever or chills?”  Again, no.  She thumbs quickly through my passport, hands it back and replies, “Have a nice visit.” I am sent on my way.

This is the extent of the Ebola screening here at one port of entry into Zimbabwe. I walk away wondering.

Ebola has taken hold in four West African countries to date – Sierra Leone, Liberia, Guinea and Nigeria. Ebola is a terrible disease, with the last outbreaks being near fatal to all who contracted it (~90% of patients died.) This outbreak the fatality rate is around 50%, though it is believed there is significant under-reporting of cases. As of today, the US Centers for Disease Control  (CDC) reports there are 6,263 cases with 2,917 dead in this current outbreak. Ebola has a 21-day incubation period, with the average of developing symptoms between 8-10 days.  It is contracted by coming in contact with bodily fluids, including sweat, of someone who is sick and showing symptoms, or even dead.  It’s unknown how long the disease can remain contagious in someone who has died, but believed to potentially be months. The progression of the disease is causing widespread mistrust of governments, health officials, doctors, nurses, even aid workers, neighbors and friends.  The disease is so terrifying it is pitting people against each other. Last week eight health educators were murdered as they were trying to distribute materials about Ebola, and just today, a Red Cross burial team was attacked in Guinea. Economically, the impact is significant, with many flights cancelled to/from the infected countries, and many companies cancelling all non-essential travel.  Here in Harare, 98 people are currently under 21-day quarantine for traveling to Ebola-outbreak countries.

Today, I had the pleasure of sitting with some of whom I consider the greatest, most compassionate minds in the world – our staff and partners here in Zimbabwe working on an HIV/AIDS grant. Many of these individuals have dedicated their careers to public health. Most are Zimbabweans that have weathered colonialism, revolutionary war, independence in 1980, the same government for 34 years, economic crises and hyperinflation, and the ravages of the worst global pandemic of our lifetime to date (at least here!) HIV/AIDs, that has stripped people of many loved ones. My colleagues are doctors and nurses themselves, and come with a lot of expertise. It didn’t take long before the lunchtime conversation turned to Ebola.  This disease is on the minds of everyone here, including me.  We talked about the rapid progression of the disease both in epidemiological terms and rate of spread; we talked about social and economic impacts it must be having on those countries; we talked about how horrific it must be on an individual level.  We talked about the terrible, gut-wrenching stories we had heard about – the moms who hid their children when they were sick, the doctor who contracted the disease from a dead pregnant mother when he surgically removed the dead baby, because culturally you cannot bury a baby in utero. We talked about the sacred burial rituals that are in juxtaposition with the protocols of burying an Ebola victim. We talked about Zimbabwe, and how it could unfold here.  While Zimbabwe has an incredibly dedicated and passionate core of public health officials, and one of the strongest, most responsive Ministries of Health in sub-Saharan Africa, there is no denying Ebola would be an incredible challenge for this resource-taxed country to contain.  The small wooden desk and two young screening ladies at the airport seem woefully inadequate, and yet, how else does a country handle this without creating widespread panic and chaos?  My mind can’t help but move from the small wooden desk to small wooden boxes.  This country has already had to dig too many shallow graves due to AIDs.

CDC released a report two days ago that predicts, with no further investments of resources to contain the current outbreak, Ebola will infect 1.4 million people by January, 2014.  That is in four months.  Four months!  MMWR: Estimating the Future Number of Cases in the Ebola Epidemic – Liberia and Sierra Leone, 2014-2015

Zimbabwe, like much of Africa, does not have the resources, systemically, human or financial, to deal with such a disease.  It has the potential to devastate this beautiful and fragile country.  In really thinking about all of the ports of entry in the United States and the mobility of the global population, I don’t frankly believe we in the U.S. do either should CDC’s predictions be accurate.

Many people ask me what it’s like working in Africa, often with grave misconceptions of the continent, the people, the places, and the diseases.  Working in HIV, in countries that have been completely ravaged by the disease (and highly publicized about it,) and so foreign to many in the United States, one is bound to hit these misconceptions.  “Isn’t it dangerous?”, “What do you do to protect yourself against the disease?”, “Isn’t it really dirty there?”, “Can you catch it from sneezing?” “They must have a lot of sex,”  “They must be stupid,” any my favorite “God must be punishing those people.”

Yes, God must be punishing “those” people. “Those” people are my people.  And your people.  And according to the CDC this week, God must really have it in for all of us. Ebola isn’t a disease that can be blamed on “inappropriate” sexual behavior, or drug abuse.  There are no pious ways out of this pandemic.  There is no discrimination in contracting this disease, only in the care and treatment.

I have gotten the question many times leaving for this trip if I am scared, if I am traveling near to Ebola sites, if I will stay safe. The risk of contracting Ebola this trip is incredibly small – minuscule, really. But, if the CDC modeling is correct, it may not be such a small risk next time, or even to us at home. The risk to our programs here is potentially not so small. And the risk to my friends and colleagues is heart-wrenching.

Those that know me, know I am not a fatalist. I come with a can-do attitude and a true belief in the triumphant human spirit, and the core foundation to help others.  There have to be solutions to the issues at hand. There has been surprisingly little written in the global media about ways people can help – so here are two ways that don’t require you to put your own life at risk to care for others, but together, I believe we can have a significant impact on the populations that need us the most right now.  I’m hoping you will 1) consider contributing financially, and 2) reach out to your public officials to impress upon them to act swiftly.  Together, we can do this.  If we can raise millions for ALS by sending a viral ice bucket challenge over a period of months, we can do the same, or better, for something with the potential to be much more globally devastating.

Here is a link to a great article by One on where to donate:

http://www.one.org/international/blog/ebola-support-the-humanitarian-response/

One of my very wise, seasoned physician colleagues doesn’t believe that we can “small change” our way out of this one, that donations to individual humanitarian organizations won’t curtail the coming pandemic, but rather that it requires a massive multilateral response from foreign governments, including mobilization of top public health officials along with military backing.  Perhaps he is right.  I think we can do both, so please reach out to your public officials also, and urge them to help.    We need every one.

http://www.usa.gov/Agencies.shtml#Elected_Officials

The Jacarandas are beginning to bloom here. Brilliant violet foliage makes the city look like it’s been dustily airbrushed into a painting with a purple backdrop.  It reminds me how gorgeous the world can be, even with such deep suffering.

Marrianne works for the International Training and Education Center for Health, based in the Department of Global Health at the University of Washington.  

Liberian official speculates on how to fight ebola

An unfiltered, direct comment on how to control Ebola, from a person currently working in Sierra Leone

This comment was posted in the Financial Times this morning by John Galani. Source: steamguy


As a person working in Sierra Leone and directly impacted by it, I can say first hand the issues are both complex and varied.

First, the issue of leadership: the problem is that you are dealing with governments in West Africa that are months behind salary payments, not staffed with knowledgeable public servants in the Western sense of the way, but “bureaucratic employees” and a merry-go-round of politicians, who are untrained in the field of public services to say the least.

It does not mean there is no goodwill, just that the machinery of government is dysfunctional at the best of times; let alone in such a major crisis.  Imagine a horror movie where the actors were oblivious to the mounting threat and then belatedly the government driver is now desperately trying to start the car when the epidemic is surrounding the broken down vehicle… and you get the picture.  Giving money to such institutions, although required, will not achieve immediate results, and even less the required one, hence why so much current funding is indirect.

The second issue revolves around the wider implications of Ebola, akin to firefighters destroying a building by dosing it with water trying to put out the fire on the top floor: medical facilities where doctors and nurses are neither trained for, nor equipped to combat Ebola, and have even collapsed as some of them were infected.

The medical map is now of major hospitals with Ebola wards and minor ones closing.  The population at large does not wish to use hospitals with Ebola screening and treatment wards for obvious reasons; therefore multiple health problems go untreated.  Food in locked-down areas is hard to come by and certainly more expensive, and this in a subsidence economy which cannot afford such price rises.

Seasonal planting, schools, jobs related to all these sectors and the wider public sector whose meagre funding is now being shifted to Ebola fighting, all these conspire to a breakdown of central governance.  It is also rather unfortunate, but true, that the local population has lived through such times in the past, and can bear it better than we in Europe could, but still.

Now what does one do about all this?

The solution is actually quite simple, as it is in most major cases: you use a hammer:

The base case scenario is for Western armies to step in with the chemical and biological units. A form of martial law needs to be imposed with quarantine areas, and large scale assistance to the local population which will neither be able to feed itself nor continue normal life until this is over.  If we were to do this it would all be over in 3 to 4 months, with certain areas taking less time, and others going to the buffers, and potentially longer but only a regional basis.

Any other way, which would impeded less on the local democratic institutions and would take into account the human rights of the population, would take longer.  How much longer would be linked to the loss of efficiency versus the method described above.

It is for the local governments to decide their fate, but I would urge them to understand they are not equipped, nor could they ever be anywhere quick enough with whatever money could be thrown at them, to deal with the outbreak.  If they do not take such courageous decisions, the world will likely contain their countries rather than Ebola, as is happening now.  This should be linked to long term funding of their depleted reserves and infrastructure once this is over.

I remember conversing with a trauma surgeon who told me when they got an emergency case in their job was to save the live of the patient, nothing else, and if that meant scaring, amputating or any form of “butchering” in order to save a life, so be it…

Why the ebola drama remains compelling

Ebola-victims

Originally posted July 26, 2014 and edited by me.

Ebola – My Experience, Understandings and Recommended Next Steps

By Siera Vercillo

I am raising money to conduct awareness discussions in Pujehun, Southern, Sierra Leone and buying sanitation materials like chlorine that will be implemented by trusted religious, youth and community partners to fight the battle. Check out the fundraising campaign I started to donate here and help me with this. I am also in discussions with international and local NGOs to inform their health and safety policy & project activities.

What You Should Know In Summary

  • Ebola is out of control not just because of the ignorance of local people. Simply put, it is because of poor health infrastructure, trust and denial from local governments and the international community.
  • Solving the Ebola emergency requires drastic measures: quarantined areas, health screening, more training, more resources and materials, but also ‘sensitization’ or education using trusted sources: local religious and youth leaders.
  • This crisis reveals people’s mistrust of the state, that’s why they do not listen to health professionals. People believe that Big Men are using the state to enrich themselves at the expense of ordinary people.
  • For Canadians and others abroad a bigger concern closer to home is that some equally as infectious diseases which we once vanquished, like measles, rubella and pertussis, are now making a comeback.

Map of Ebola Outbreak

My Story

When I was in Pujehun back in March I got a call at midnight by my mother anxiously yelling on the phone: Ebola is in West Africa, a country called Guinea and might have travelled to Canada. Annoyed because I needed to wake up in a few hours for farm visits, I told her that it is ok, Guinea is not Sierra Leone. But she explained and questioned: it has been around since February why isn’t anybody talking about it? Why only now when there is a suspected case in Calgary (which turned out to a bad case of malaria -god, rest the man’s soul). I searched online, I spoke to a few people from Guinea and there was very little information. I was not worried.

In April I was in a community enjoying a homemade lunch of bushmeat stew with rice after a long, typically hot morning in the garden trying to assess the potential value of peppers, eggplant and other vegetables. I then travelled back to the office where the Project Coordinator mentioned Ebola. I soon realized that no one at the office knew anything about Ebola. I quickly searched on the internet and saw the Ebola incidents were reaching historical records in Guinea with possible cases in Liberia. I had an informal staff meeting and naively announced: Ebola is coming here, we should stop eating all meat and we should be afraid. I did this because I was taught that Ebola is the type of virus that is our worst nightmare. Back home it is described as the modern day plague that has no cure, no vaccine and kills almost everyone in the most horrible kind of way- by bleeding to death. The staff I spoke to laughed at me. I realize now it was not because they thought I was being dramatic, but because they have been through this before with Lassa fever and were afraid.

Lunch

Over the next few weeks I had received all sorts of information from across the continent: there was a vaccine, there was no vaccine; Ebola is air born, it is only through body contact; you can only get it from people who are dying, but also through sweat and animals. Email chains, text messages were passed around with a lot of contradictory information. Senegal and Mali closed their borders with Guinea – Sierra Leone did nothing. I contacted the Canadian Embassy that sent me the same information that was in the email chains I previously received. It was not until I heard that there were incidents on the Liberian border an hour away from where I was did I contact my Manager in Canada to inquire. I was calm, not afraid and a bit annoyed with the miss information. So I was shocked that night when I was called at 9pm from a conference call from Canada. I was trying to find a quiet enough place to speak, maneuvering in the dark as the EPL soccer game got out. I was told that the next day I was to go to Freetown and then taking the next flight home.

All I kept thinking is what do I tell the staff I am working with and friends I have made. How do I not panic them? How do I advise them? Because I have very little knowledge and information about what to do if I was in their shoes. My own family in Canada was glad I was leaving, my partner in the UK did not believe me and the family I was with was worried and confused. My coach calmed me, making me realize how stressful the situation would be if I stayed and got sick. Even something as easily curable as malaria would cause panic, as well as if the borders closed who knows what quarantine would happen if I was stuck. The next morning, I packed my things with the help of friends and explained to some staff who thought the decision to leave was drastic. But I knew (and they did to) there was information that we were not privy to because the news, government, NGOs were talking about it.

Cooking as a family - missing them!

I got back to the United Kingdom in April and learnt that I was not the only one pulled out or prevented from going back to Sierra Leone. Other foreign staff from international NGOs were not sending consultants, PhD students were delaying their flights for research, local community organizations were not accepting volunteers. I knew within a week of being back home that this was the right decision. All I kept thinking is, why is this information only available once I am out of the situation? Why am I (the foreigner) the only one where precautions are made?

The outrageous thing is that in May I travelled to Canada for meetings where I am now, and was preparing to go back to Sierra Leone because the WHO deemed it all under control. Despite Doctors Without Borders calling it an outbreak. Now the WHO is calling it an international health emergency. Borders are closed, people are quarantined at airports having to go through tests, airlines have stopped flying, whole communities are locked up, project activities put on hold, even public meetings are banned. Ebola is plaguing three of the countries least equipped to cope with it. There aren’t enough clinics with resources, knowledge where tests are false positive, and rumours are going around. West African countries are watching it closely as Nigeria now has cases and I get emails about potential cases from Ghana on a weekly basis.

The outbreak started in February. It is now August. What has gone on in the past 6 months?

Hearty meals from the farm

Power and Politics – Outbreak Could Have Been Prevented

I agree with this article: Ebola cannot be cured, but it could have been prevented. I am outraged, as should you be. This is not the result of war over land or resources – Big men fighting for power with man-made weapons. This is a virus that is killing innocent people. People like you and I with families and no idea about what to do or who to trust.

But this needs to be said: the virus has gotten out of control because of power and politics: denial from the international community and local governments. This has also led to denial from ordinary people as well. Evidence of when politics gets in the way is regarding the all of a sudden Hail Mary of a cure coming from the USA. As a Nigerian-Canadian friend on facebook rightfully stated: “So this experimental serum helped the American doctor. Great! BUT HOW COME NO ONE MENTIONED THE SERUM WHEN AFRICANS WERE DYING? Sigh”. Me also insisting with organizations that there are cases in Pujehun and that it would be naive to think otherwise when there are cases an hour away. But until there is ‘proof’ there are no actions taken, which is why the outbreak has turned into an emergency. Thankfully I did what I could and stopped all the activities I am responsible for. But it is not good enough.

As said here, although we should not just blame government or international communities because curbing the spread of Ebola does not happen overnight, what has been done has not been working and public services are still poorly equipped. This is because of the many actors involved in the Ebola response has complicated the response, especially since it’s unclear who is in charge.

Home garden

Unfair Cause of the Outbreak – It’s not just the ignorance of people

Fear and ignorance are increasingly said to be playing a role in the spreading of the virus, which is unfair. The news coverage I have heard on the BBC, CNN etc. focuses on how dangerous it is for local people not to comply.  Local practices such as the consumption of bushmeat (like the meal I was eating earlier) and traditional funeral practices are the go-to explanations for Ebola’s outbreak. However, decades of anthropological research indicates: “not only that this picture is an over-simplification, but that disease control policies based on these ideas may be unhelpful”. Yes, part of the problem is that heath officials have been attacked, rumors that the disease does not exist, belief that people who go to the hospital will not come out alive is resulting in more and more Ebola cases. People are going ‘missing’ or families are taking them out of hospital is not helping.

This is explained better here by Susan Shepler “When someone has the symptoms—fever, vomiting, diarrhea—they are supposed to report to the health center, where they will be taken away from family, and if they die, be buried by men in protective gear with no family present.  You can see why people might be loath to turn over their loved ones. Really who among us would want to turn a sick loved one over to a hospital staffed with foreigners, knowing we might never see them again?  … People’s apprehensions about the failings of the healthcare system come from experience, not from ignorance.” This crisis reveals people’s mistrust of the state. That is why communities are taking sick people out of hospitals and keeping them at home. This is understandable in the aftermath of war, but also people believe that the state is actually out to get them or that Big Men are using this to enrich themselves at the expense of ordinary people.

We need to understand history from an anthropological perspective and use local knowledge to tackle the problem. For example, Lassa fever, another viral haemorrhagic disease is relevant, with longstanding rumours about medical staff administering lethal injections and people avoiding the hospital in Kenema, Sierra Leone where Ebola is treated is something that should have be recognized.

In Kenema doing a role playing exercise

In Mende areas where I was living, there are general categories of big and small fever, and ordinary and hospital sick. Diseases can be understood as caused by multiple things, including ‘witchcraft’. The importance of burial practices cannot be underestimated as they are strictly controlled by the male and female societies. Key to understanding health provision is to “understand how disease categories shift as the illness progresses.”

Swamp Valley Rice

Our Perspective from Abroad

We also need to remember that Ebola is not the exception as outlined here, but one example of the terrible norm – where thousands of men, women and children are dying from a range of horrible diseases every day. Dengue, measles (spread through air-droplets) and hepatitis B (spread like HIV but 50 times more infectious). There is no cure for rabies either with an equally as slow and painful death as Ebola.

In reality, the news likes to create a stir of fear for gaining more viewers, which results in unwarranted panic. A bigger concern closer to home is that some diseases which we once vanquished, like measles, rubella and pertussis, are now making a comeback.

Community meeting

More Reading

  • Most heartfelt story from the front lines here – Trigger Warning- it is a bit gross but reflective of how strong ordinary people can be.
  • Voices from the heroic people – health care professionals working on the front line here.
  • How Ebola spread outlined here

Ebola: a survivor’s story from Guinea

UNICEF EbolaShortly after the outbreak of Ebola in Guinea, when it seemed like bad news was the only news, UNICEF’s office in Guinea started to receive reports of something that seemed almost impossible given the climate. Ebola victims were being released from the hospital, completely recovered. They were healthy and even given certificates signed by health authorities stating that they could safely return to normal life.

We knew that there would be a few survivors, but the initial days of the outbreak were grim enough to turn most optimists into cynics. Talk of very high mortality rates; a rapid spread of the virus to the capital and beyond the borders in neighboring countries; and a palpable fear on the streets zapped the psychic energy of us who live and work here.

But there they were: people, weak and squinting in the bright sunlight but healthy, emerging from isolation wards. And not just the lucky few we expected, but more than 30 per cent of those infected were surviving.

The story in the media quickly turned to the stigmatization of these people. Journalists talked about how they were not welcome at work, school, even at home, but for many the stigma passed quickly and still others were welcomed back, almost immediately, into their old lives.

UNICEF sat down with an Ebola survivor, one of the earlier cases in the country – Kadiatou*. She met us on a main street in Conakry and walked us back to her home, through scores of children playing football on muddy roads. We sat on plastic chairs in a circle while her mother hung the laundry behind us.

“I have no idea where I got Ebola,” she said as she chewed on a sachet of ready-to-use therapeutic food—as part of her post-Ebola treatment. Ready-to-use therapeutic food is normally provided by UNICEF as life-saving emergency nutrition to the thousands of children here who suffer from severe acute malnutrition. Ebola victims lose a lot of nutrients and fluids as a result of vomiting and diarrhea and the ready-to-use therapeutic food help them regain their strength.

“I am a medical student, and in my work, I encounter many sick people.”

Kadiatou’s initial symptoms were pretty typical of many illnesses—a sudden onset, pounding headache and high fever, followed by vomiting and diarrhea. Her knowledge as a medical student probably prevented Kadiatou from spreading Ebola to those caring for her. “When my Aunt would clean up my vomit, I insisted that she wash her hands with bleach.”

As part of our response UNICEF has distributed many of the materials families are using to protect their family members, including over 350,000 bottles of chlorine, almost one million bars of soap, and materials for disinfecting hospital rooms and victims’ homes.

A few days after Kadiatou tested positive for Ebola she was sent directly to the isolation ward in Donka hospital. The isolation center was busy. Families brought food to their sick relatives. And, “there were many journalists.”

“In the beginning we were all in the same room. But as patients improved, they were separated from those who weren’t as fortunate. I first knew I was going to survive when I saw a patient recovering. I thought, ‘maybe it is possible for me too’. For the first few days, I was desperate. I drank a lot of mineral water and had infusions…maybe it helped me to survive.”

Kadiatou holds up the certificate declaring her healthy status.

After what must have seemed like an eternity for her, but in real time was a matter of weeks, Kadiatou was given new clothes, a certificate declaring her healthy, and was sent home.

We asked her about the widely reported stigma that affected survivors. “When I went back to school, some of my friends avoided me, but it’s getting better. People don’t believe that I had Ebola because they can’t believe I survived.”

Of course, Kadiatou is aware that Ebola is real. But UNICEF remains vigilant in keeping the public informed. We have been in the markets, mosques, churches, schools, on the radio and the television providing information on Ebola so health workers and regular people are armed with the knowledge to protect themselves and their children. To date, UNICEF and our partners in Guinea have reached over 3.2 million people.

“Others call me, ‘Kadiatou the new born’—because I was given a second chance.”

BY ON 25 JUL 2014( 6 COMMENTS )
Timothy La Rose is a UNICEF Communication Specialist based in Conakry, Guinea. 
*name changed

This Is What It Feels Like To Survive Ebola

Dr. Kent Brantly hugs his wife Amber after being discharged from Emory University HospitalDavid Morrison—© 2014 Samaritan’s Purse

After two more negative malaria tests, I knew I would be in isolation for at least three more days. Often the blood test for Ebola will remain negative for the first three days of illness, so we had to wait a few days for an accurate result. In the meantime, I grew sicker. My fever hit 104.9. I felt nauseated and began having diarrhea. Eventually the team started an IV in my arm and gave me fluids. We all hoped it could be dengue fever.On the fourth day the team leader came to my bedroom window with news. “Kent, buddy, we have your test results. I am really sorry to tell you that it’s positive for Ebola.” I didn’t know what to think. I just asked, “So what’s our plan?”In the middle of October 2013, I had moved to Monrovia with my wife Amber and two children. We planned to serve as medical missionaries with Samaritan’s Purse for two years. The first time I heard about the Ebola outbreak was at the end of March, at a picnic for expatriates living in the area. Someone asked if I had heard about the Ebola outbreak in Guinea. I had not, but within a couple of months I was one of only two doctors in Monrovia treating Ebola patients.

Samaritan’s PurseDr. Kent Brantly and his wife Amber and their children in Liberia before Dr. Brantly was infected with Ebola

On June 11 our hospital, called ELWA (Eternal Love Winning Africa), received a call from the Ministry of Health. They were bringing two Ebola patients to our isolation unit. In the two hours it took for us to prepare everything, one of the patients died in the ambulance. Over the next month and a half the number of patients grew exponentially. We were overwhelmed.

On July 20, we opened a larger isolation unit and consolidated our smaller facility with the patients from another nearby hospital. That’s the same day I dropped off Amber and the kids at the airport to return to Texas for a family wedding. I was supposed to meet them a week later. But just three days after their departure, I got sick.
Even with the bad news, I felt calm. I never shed a tear when I called my wife and said, “Amber, my test is positive. I have Ebola.” Though the rest of my family wept, I felt strangely at peace. God blessed me with that peace that surpasses understanding. Since we had started treating patients with Ebola in Monrovia, we had only had one survivor. I had watched too many people die from this disease. Amber and I were both at the disadvantage of knowing how this illness ends.
At some point, I was told about an experimental drug. It had worked on monkeys, but had never been tested in humans. I agreed to receive it, but then decided that Nancy Writebol should get it first, since she was sicker. I was not trying to be a hero; I was making a rational decision as a doctor.Over the next couple of days, though, my condition worsened. My body began shaking, my heart was racing. Nothing would bring down my temperature, and I had fluid in my lungs. I felt hot, nauseated, weak–everything was a blur. I had friends and colleagues praying outside my house–and all over the world. The doctor decided to give me the drug, and within an hour my body stabilized a bit. It was enough improvement for me to be safely evacuated to Emory University Hospital in Atlanta.
During my own care, I often thought about the patients I had treated. Ebola is a humiliating disease that strips you of your dignity. You are removed from family and put into isolation where you cannot even see the faces of those caring for you due to the protective suits–you can only see their eyes. You have uncontrollable diarrhea and it is embarrassing. You have to rely on others to clean you up. That is why we tried our best to treat patients like our own family. Through our protective gear we spoke to each patient, calling them by name and touching them. We wanted them to know they were valuable, that they were loved, and that we were there to serve them.
At Emory the doctors were able to see that my potassium level was low and replenish it–something that could not be done in Liberia and could have killed me. I finally cried for the first time when I saw my family members through a window and spoke to them over the intercom. I had not been sure I would ever see them again. When I finally recovered, the nurses excitedly helped me leave the isolation room, and I held my wife in my arms for the first time in a month.Even when I was facing death, I remained full of faith. I did not want to be faithful to God all the way up to serving in Liberia for ten months, only to give up at the end because I was sick. Though we cannot return to Liberia right now, it is clear we have been given a new platform for helping the people of Liberia.
Ebola has changed everything in West Africa. We cannot sit back and say, “Oh, those poor people.” We must think outside the box and find ways to help. People are fearful of isolation units because “that is where you go to die.” They stay home instead and infect their families. Perhaps we need to find a way to provide safe home care that protects the caregivers. The national governments of West Africa are overwhelmed. They are not capable of handling this outbreak with simply a little help from some NGOs. This is a global problem and it requires the action of national governments around the world. We must take action to stop it–now.
Dr. Kent Brantly is a missionary doctor with the organizationSamaritan’s Purse. He recently survived Ebola after treating patients in Liberia.
Sep 5, 2014 by Time