By Lt. James Regeimbal Jr., microbiologist, first mobile laboratory team in Liberia
Stepping off the helicopter onto a dusty field in Bong County, the contrast with Monrovia could not be starker. Monrovia, the capital city of Liberia, located in Montserrado County, is a city of concrete and glass; with all the sounds and smells of any major city.
Monrovia also had several Ebola Virus Disease (EVD) testing labs, as was appropriate given the city’s high population; but, the outer rural counties were a different matter. Central and Southern Liberia were struggling to control EVD just like Monrovia, but there were no EVD testing labs that far out.
The outer counties shipped their samples into Monrovia and if the samples were not lost in transit, they would wait up to seven days for results.
We were in Bong County to help and that dusty field was our first introduction. Bong in the rainy season is very hot, very green and very austere. Instead of a busy city backdrop, we were surrounded by the friendly faces of farmers and a dense jungle.
The lab was set up in 48 hours and immediately the first samples were delivered, because the Ebola Treatment Unit (ETU) in Bong had been eagerly awaiting our arrival. Processing the first sets of samples was sobering. There were faces behind these little tubes of blood, and our work had a direct impact on them.
Our rapid EVD testing shrank the typical turnaround for results from seven days to just four hours. That decrease meant better patient triage, more efficient operations at the ETU and a significant decrease in the spread of the virus in the suspect ward. Our rapid tests also encouraged more folks who were sick to seek help and were used to inform when convalescent patients could be released to return to their families.
You have never seen joy until you have seen it on the face of an Ebola survivor. News of the Bong lab quickly spread to other ETUs, hospitals and safe burial teams. Our location and rapid testing meant that all the outer counties could get same-day results.
The work was very hot, the personal protective equipment (PPE) was at times stifling and dramatically reduced fine motor skills in your hands, and any given sample may have been filled with trillions of copies of Ebola; but, like anything, you find a groove. A typical day in the lab meant chaotic and irregular sample deliveries from numerous sources all over central and southern Liberia. But once inside our lab, it was a monument to monotony.
Every “do on” and “do off” of PPE; every sample; every step in the protocol; every day, was exactly the same. Time seemed to fly and stand still at the same time. The routine was either sweaty meticulous work in PPE with Ebola, or soul crushing boredom waiting for more samples. We absolutely loved it.
There is also a dramatic decline in cases throughout the country and that trend seems to be continuing. And although the work continues, we hope we helped.