An Insider’s Perspective from the Ebola Front Lines in Liberia

Island Clinic Ebola Treatment Unit personnel (L-R) Lt. Robert Gerbasi, Chief Hospital Corpsman (SW) Vilma Bauer, Lt. Cmdr. Matthew Weiner and Hospital Corpsman 3rd Class Eric Cho.

By Lt. Cmdr. Matthew Weiner, officer- in-charge, Naval Medical Research Center Mobile Laboratory Island Clinic

Editor’s Note:  The Navy mobile laboratory at Island Clinic processed its last sample January 26, 2015. Joint Force Command for Operation United Assistance (JTF-OUA) closed the Island Clinic laboratory as a result a reduction in positive results and samples to be tested. In order to properly close the laboratory, the JTF coordinated with the National Institute of Health, Centers for Disease Control, Liberian Ministry of Health, and other U.S. government partners to ensure samples were transported to nearby laboratories. Navy Sailors that were assigned to the Island Clinic lab returned to the U.S. under 21-day controlled monitoring in February. The other Navy mobile laboratory in Bong County will remain open until further notice to continue to provide testing support to the remote locations in Liberia.

During September 2014, the Naval Medical Research Center (NMRC) deployed two mobile laboratories to Liberia in support of Operation United Assistance. Our lab, the Navy Mobile Laboratory Island Clinic, was co-located with the World Health Organization’s Ebola Treatment Unit (ETU) on Bushrod Island, Monrovia, Liberia, and became fully operational under the Joint Force Command for Operation United Assistance October 1, 2014.

The next morning, the first team, comprised of a small cadre of Navy personnel began the difficult task of testing patient samples for the Ebola Virus Disease (EVD). They had an immediate life-saving impact by decreasing result turnaround time from seven days to four hours for nine treatment facilities in Montserrado, Bomi, and Grand Cape Mount counties. Their efforts also made a significant, positive impact in Monrovia, the capital of Liberia.

Expediting Ebola test results to health care providers led to improved patient triage, more efficient ETU operations, safe burial practices, and a significant decrease in the spread of EVD.

Following the initial lab team, a new team arrived on station to support the operation. This team included me, Lt. Robert Gerbasi, HMC Vilma Bauer (already on station) and HM3 Eric Cho. We arrived in late December and conducted a successful turnover.

Expediting Ebola test results to health care providers led to improved patient triage, more efficient ETU operations, safe burial practices, and a significant decrease in the spread of EVD.

January was an intense month as we continued to receive Ebola-positive samples, worked to close the Island Clinic lab, and also planned for our redeployment to CONUS. We looked forward to our trip home, but felt conflicted because this is one of the most important missions the Navy has mounted to combat a disease outbreak.

We were tracking a 17 month old female for several weeks as she battled EVD in the absence of her mother, who recovered and was discharged from the Sinje (ETU) in the north of the country.

Every couple of days, our lab received a blood sample from the girl along with anxious calls from her medical coordinator. We watched over weeks as the viral numbers decreased in the girl’s blood and called the medical coordinator excitedly when she finally tested negative.  You should have heard the celebration on the other end of the phone. Looking past the great news of testing negative for EVD, the girl was finally able to reunite with her mother and restart a life that was almost taken from her.

My team, along with the Sinje ETU, felt deeply connected to the great outcome of this baby girl.  She will never know how many people prayed, hoped, and waited for her recovery, or that the United States Navy stood the watch for her and so many others during this operation.

Our excitement was tempered later when we received a sample from a new Ebola case with a high viral load from within the city, not too far from our lab.

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During the four months that the Island Clinic lab was operational, the teams processed over 2,000 patient samples for EVD.

After Island Clinic Lab closed, samples were effectively transported to other nearby laboratories for testing as result of coordinated communication between the lab, the sample couriers, and the various ETUs.

During the four months that the Island Clinic lab was operational, the teams processed over 2,000 patient samples for EVD. The lab was instrumental in the rapid detection of EVD, but also collaborated with the World Health Organization (WHO), Centers for Disease Control (CDC), and the Liberian Ministry of Health on the collection of data and statistics supporting disease surveillance critical to identifying new Ebola cases, outbreak hot spots, and the multi-national and multi-agency strategic outbreak response.

As the case load drops for the country and the outbreak continues to diminish, the virus remains. In this sense our departure is bittersweet; we have achieved our mission of helping to control the outbreak but we leave knowing that new friends will continue to face danger.

In the face of all of this, I am proud to have served with such an outstanding crew. I have known each member of this team for years and I am honored to have led them in the field. You could not have picked more mission-ready Sailors, and their commitment to their shipmates and United Assistance is unrivaled.