Presence Matters: Navy Medicine’s Emergency Preparedness and Disaster Response in Africa Pt. 2

By Dr. Michael Owens, Emergency Department physician, Naval Medical Center Portsmouth and director, Global Emergency Preparedness & Disaster Response Fellowship

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An Insider’s Perspective – Fighting Ebola Inside the “Hot Zone”

I responded to her by saying, “I worry more about the provider who is not afraid.”

This seemed to calm the nurse who was about to enter the confirmed ward (“hot zone”) and meet Ebola patients for the first time. She stopped talking, looked at me for a moment, and said “thank you.”  She acknowledged that she must have been rambling about various subjects at light speed since she was so nervous. To justify my point I explained that those who acknowledge their fears and act on them accordingly are more careful and situationally aware when working in this austere environment. She quickly understood my point, even though she had been in Liberia for less than a week.

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I was one of the few who responded to an international call for health care providers.

After working in Liberia for two weeks, completing training, and treating 40 or so patients in the Ebola Treatment Unit (ETU) for three straight days, I was considered an expert.

The World Health Organization (WHO) and Doctors without Borders had specified a dire need for clinical experts to prevent this fatal virus from becoming a global pandemic. At the time experts estimated there would be more than 1.2 million patients within a month. I was one of the few who responded to an international call for health care providers. I was also afraid but I realized an even more intense call to care for those in need.

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I spent the usual 10 to 20 minutes waiting in line to complete the protective gear removal procedure – the point when individuals are most prone to virus exposure and infection.

Before I left for West Africa I assisted with protocol development for the Department of Health and Human Services (HHS), studied every presentation given by the Center for Disease Control (CDC) and the National Institute of Health (NIH), and read all the transcripts from experienced West African and the United States providers. But this preparation didn’t compare to actually seeing and treating patients in country.

It was a typical hot day near the equator, made even warmer by the Personal Protective Equipment (PPE) I was wearing. But the mission made anything else about that day far from typical. For starters, I was struggling to breathe in the wet mask that stuck to my face with every breath. I tried to breathe out the side of my mouth or up toward my nose but the process didn’t keep the mask from sticking to my face. Sweat covered my face, mask, and glasses making it almost impossible to see. After my time in the “hot zone” was up, I spent the usual 10 to 20 minutes waiting in line to complete the protective gear removal procedure – the point when individuals are most prone to virus exposure and infection. I repeated this process many times over the following few weeks.

As the days passed by, I feared what Ebola might do to my health, but I was more fearful of what it could do to my friends and family if I didn’t overcome my fear and help stop the spread of this deadly virus disease. Today there are still close to 20,000 plus confirmed cases. It’s certainly not 1.2 million, but my biggest fear now is that we don’t become complacent.