Suspect Ebola Case Tests Heart to Heart ETU Staff

The call came over the radio.  A new mother was showing signs of EVD – Ebola Virus Disease – and was now considered a “suspect case”.  She had just given birth 5 days prior in the large hospital next door to the Ebola Treatment Unit (ETU) in Tappita, Liberia that Heart to Heart International (HHI) is operating.  This young mother had a fever, she was weak, lethargic.  And so the voice on the radio said the ambulance crew was on the way to retrieve her and the newborn baby, and deliver them to the ETU.

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In this tropical country, so close to the equator, an illness could be one of many things – dengue fever, yellow fever, lassa fever, malaria, among others.  But in this time of Ebola, no chances are taken.  So the hospital staff alerted the ETU staff.  And the ambulance crew that had been training for several days in a row on procedures and building teamwork, responded.  This was no training drill.  This was real.

Fortunately, the Ebola epidemic in Liberia has dropped significantly through a combination of a public awareness and education campaign by the Liberian government, the response of the US military, USAID, NGOs like HHI, International Medical Corps and others, and by the Liberian people themselves, as they embrace the changes to their culture in order to kick Ebola out of Liberia.  But still… the spectre of Ebola lurks.

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Outside the back entrance to the hospital, the ambulance crew began to don their PPE – Personal Protective Equipment.  These are the ‘space suits’ you see so many healthcare workers wearing – goggles, a body suit, triple gloves, mask.  Hotter than blazes inside it under the broiling African sun.  Because this was the real deal, as they pulled on the protective gear a few members of the crew began to sing a little Bob Marley tune – “don’t worry about a thing, cuz every little thing gonna be alright.”  I sang along as we all could feel the “what if” hanging in the humid air.

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Having one patient is one thing.  Having two, and one is a baby, is something more.  The newborn would have to go with the mother.  It took a little more coordination and thinking through the process, as you don’t move quickly or rashly when in PPE for fear of possible exposure.  But in the end, the training the crew has been doing paid off – the woman was loaded by stretcher onto the ambulance and the swaddled newborn was handed to a PPE-clad nurse to carry to the ETU.

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At the ETU, the donning tent was busy with staff dressing in PPE to take their positions as the mother and child were brought in through the patient gate of the ETU and directly into the Suspect Tent, where patients wait for test results before leaving or going to the Confirmed Tent.  Behind them trailed a sprayer, dousing the ground where they had walked carrying the patient, turning the path dark and wet with chlorine.

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A nurse drew a blood sample from both mother and child which was then hand-carried a couple of hundred yards to the US Army lab set up inside a wing of the hospital and placed inside a box outside the door.  Then, US Army Captain Jerod Brammer wearing his own PPE suit came to collect, spraying the outside of the box with chlorine before bringing the box inside to test the contents.

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The woman and child’s tests came back negative.  No EVD.  No Ebola.  And the woman and baby were taken back to the hospital, a better place for both than the sweltering suspect tent.  But this story doesn’t have a happy ending.  The woman died a day later.  Doctors shared that another medical condition likely caused her death.  The news tempered the joy of the job well done by the ETU staff and the negative test results.

Now our psychosocial team plans to help take the baby to the mother’s village. To family.  But also to a world that was already difficult and hard for babies, even before Ebola came to Liberia.

UPDATE 12Feb15: The worst news.  A few days after the mother died, her baby passed away too.  According to our Chief Medical Officer, the cause of the newborn’s death was not determined.

 

 

 

Heart to Heart’s Ebola Treatment Unit Opens

While members of our Ebola Response Team have been treating Ebola patients and working in facilities across Liberia for many weeks, Heart to Heart’s own Ebola Treatment Unit has been coming together.
The 50-bed unit has been under construction in the town of Tappita.  And now, just about 90 days from when Heart to Heart declared it would go to Liberia to fight Ebola – the ETU is up and running.

The Ebola Treatment Unit is in Tappita, a town about an 8 hour drive from Liberia’s capital of Monrovia, in Nimba County.  The unit was built here as the town serves as a crossroads in this remote corner of Liberia. HHI took on the responsibility of running an ETU there as part of the coordinated international response to combat the spread of Ebola.  This is just one of several ETUs that are already in operation, or will soon be, across Liberia. The goal was to rapidly expand the capacity to combat the virus.  While the epidemic is still raging in West Africa, the efforts of our team and the greater response is having a positive impact in Liberia.

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The ‘suspect’ ward, where patients will await test results to determine whether they have contracted Ebola or another illness.

 

The construction of this Ebola Treatment Unit was managed by the US Army Corps of Engineers and the 36th Engineering Brigade based in Ft. Hood, Texas. The 50-bed ETU is a large compound, akin to a mobile hospital, with areas for patient triage and large tents for suspect cases and for patient treatment.  It also has ‘back’ areas for staff and for the supplies needed to operate the unit and to treat people with Ebola.  The facility also generates it’s own power thanks to two large diesel generators that allow the ETU to operate 24/7.  

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Members of our Ebola Response Team take some downtime in the ETU’s supply area.

 

Major funding for the ETU in Tappita comes from the United States Agency for International Development (USAID) and Office for Foreign Disaster Assistance (OFDA), as well as from generous donations from individuals who continue to help support HHI’s overall operations in Liberia to combat Ebola.

Our team members remain hard at work.  The Ebola Treatment Unit is open.  Progress is being made in the fight against Ebola.  Please continue to support this critical effort.

Donate Now & Help stop Ebola

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NC Doctor Gives Radio Interview on Ebola Fight in Liberia

One of our Ebola Response Team members has returned from Liberia working with Heart to Heart International to combat the Ebola epidemic.
Dr. George Poehlman is a retired family physician living in North Carolina.  He spoke recently to WUNC 91.5, the public radio station in Chapel Hill, NC, about his time on the front lines of the Ebola fight.

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Dr. George Poehlman (r) with other Ebola Response Team members

 

HHI had contacted Dr. Poehlman to assist in our work in Liberia due to his medical experience and background working overseas.  As he told reporters with WUNC 91.5 he has “experience living and working in Africa, some experience with tropical medicine, and an understanding (of) the culture and the people is critical in the work against Ebola”.

Listen to Dr. Poehlman’s radio interview:

 

In the interview, “Dr. P” discusses some key actions that he sees as making a positive impact in slowing down the epidemic in Liberia.   He talks about the reasons he’s in a voluntary quarantine after returning, even though he’s considered low-risk and the seclusion is not necessary under CDC guidelines.  And he adds that it’s a good way to protect himself from the flu outbreak in the US!  It’s a great interview given by one of our outstanding Ebola Response Team members.  Give a listen.

 

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Dr. Poehlman was also interviewed by WRAL-TV and said this about his time with Heart to Heart International: “I was trained to take care of people and look out for people and that’s what I did, and I’m pleased to have been there. I was honored. I was humbled.”

 

US Senator Visits HHI’s Ebola Treatment Center

U.S. Senator Chris Coons is the first member of Congress to travel to Liberia since the start of the Ebola outbreak.  During his four day trip, he visited with deployed American troops, met with Liberian political leaders and explored Heart to Heart International’s new Ebola Treatment Unit in the town of Tappita.

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HHI’s Chief Medical Officer Dr. Rene Vega (center, in blue) escorts Senator Coons and Ambassador Deborah Malec, along with Liberian health and government officials, on a tour of the Tappita ETU.

 

Senator Coons of Delaware currently chairs the Senate Foreign Relations Subcommittee on African Affairs.  He said his trip to Liberia was partly to remind Americans that the Ebola epidemic is far from over, to make a holiday visit with the troops and to provide some oversight of the funds committed to fighting Ebola.

Coons: “There are more than 2,000 U.S. troops currently serving on the front lines of our fight against Ebola, building hospitals and field clinics, but no Member of Congress has visited them yet. I think it’s important to show them our support, especially during the holiday season while they’re away from their loved ones. Congress also just approved more than $2.5 billion in emergency funding to fight the spread of Ebola in West Africa, and to ensure the virus does not overrun the region again. It’s Congress’ job to perform responsible oversight of that investment.”

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Accompanying the senator on the tour of HHI’s Ebola Treatment Unit was US Ambassador to Liberia Deborah Malac and Major General Gary Volesky, commander of the 101st Airborne and overall commander of US troops in Liberia.  Maj. Gen. Volesky had been to the Tappita site previously, as construction for the ETU was managed by the 36th Engineer Brigade, from Fort Hood, Texas.

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As the Huffington Post reported, Coons said he took plenty of precautions to avoid contracting the disease. “Every place I’ve gone I’m washing my hands with chlorine. Instead of handshakes we’re doing the ‘elboa,'” he said, referring to bumping elbows.  Though the trip was considered a ‘low-risk’ visit the senator will follow protocols established by the Centers for Disease Control, his health will be monitored and his temperature taken every day for three weeks as a precaution.

Coons also told the Washington Post he had seen first-hand how international groups, like Heart to Heart International, along with local Liberian efforts had changed the trajectory of the epidemic in the country.

 

 

 

 

Our People of the Year

They’ve come from many backgrounds, all walks of life, from the US, Liberia and other countries – all sharing the same goals of saving lives and halting the spread of the Ebola virus.

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These are our People of the Year, these are our heroes.  These doctors and nurses, logistics specialists, humanitarian aid workers, cooks, security, ambulance drivers and chlorine sprayers  – all who have given their time and talents to step into the hot zone of the Ebola epidemic with Heart to Heart International.  We couldn’t be prouder of their service with us and for humankind.

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Recently, TIME magazine chose to recognize the heroic efforts of those on the front lines of the Ebola fight, choosing the Ebola Fighters as their “Person of the Year 2014”.  They saw that the people who have chosen to fight the epidemic, that put their lives on the line each and every day to help people and to help stop this terrible disease, are truly heroic in every sense of the word.

We at Heart to Heart recognize the actions of our own Ebola Response Team members – their courageous, valiant efforts.  We know it’s difficult work.  Several have already come face to face with the terrors of the virus.  And we know that we couldn’t tackle this without them.

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Our team members are hard at work.  Our Ebola Treatment Unit nears completion.  Progress is being made.  Please continue to support this critical effort.

Donate Now & Help stop Ebola

 

VIDEO: Working Together to Fight Ebola

A new video gives a glimpse into the early days of Heart to Heart International’s Operation Ebola in Liberia and showcases the importance of partnership to combat the Ebola epidemic.

For many weeks, Heart to Heart International CEO Jim Mitchum has been in Liberia overseeing the building of the organizational infrastructure needed to support the opening of an Ebola Treatment Unit (ETU).   Along with Country Director Julie Hefner and Chief Medical Officer Dr. Rene Vega, our team in Liberia has been putting all the pieces into place, hiring staff, and coordinating with multiple aid agencies as part of the global response to the epidemic.

Watch the video to learn the reasons why HHI has taken on the responsibility of running an ETU.  Hear from our new Liberian staff members about their desire to bring healthcare to their people and why it’s so important that HHI has come to help.  And learn how we’re working in partnership with other NGOs, like the International Medical Corps, to tackle this continuing humanitarian crisis.

 

Video by: Blake Nelson

 

Dispatch from Liberia: Waking up in Ebola Land

Morning breaks muggy and warm with broken clouds signaling that the rainy season is slowly giving way to its dry season doppelgänger. Roosters crow incessantly below my second-story apartment bedroom window, ridiculing anyone who wants a few minutes of extra sleep on a Saturday morning. Life in Monrovia, Liberia is waking up to a new day in Ebola Land.

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HHI Chief Medical Officer Dr. Rene Vega visiting the IMC Ebola Treatment Unit in Bong County, Liberia.

 

It’s an important day for us as Dr. Rene Vega, our chief medical officer, has returned from a week of Ebola Treatment Unit (ETU) training with one of our NGO partners, the International Medical Corps, at their Bong county site.  Dr. Vega will be taking a week break from the ETU and working with us in our Monrovia office. He will then return to Bong to gain even more experience in preparation of the opening of our own ETU in a few short weeks in Nimba county, eight hours of rough road from here.

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International Medical Corps workers help a colleague suit up in PPE, personal protective equipment, inside the ETU in Bong County, Liberia.

 

We are looking forward to getting Rene’s input on the design of the ETU we will be operating. Nothing beats experience when it comes to improving the way the unit will be designed and built. Little details like how patients are brought into the ETU or even the width of a patient shower stall can be helpful in preventing unnecessary exposures and risks. Doctors with many years of training in human anatomy are suddenly being asked to become experts in Ebola treatment unit layouts.

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HHI Chief Medical Officer Dr. Rene Vega (left), meets with IMC program director at ETU in Bong County, Liberia.

 

Reports of the number of patients coming to existing ETU’s in Liberia are down suggesting to some that the epidemic may be waning. That is not what the experts believe, nor even the man-on-the-street in Monrovia.  Instead, it is widely thought that people have remained in their homes when showing signs of Ebola rather than heading for an ETU. They naturally fear isolation from their loved ones and the seemingly inhuman nature of being treated by people in body suits where only the medical worker’s eyes are visible, and that through goggles. Fear is palpable.

Staying at home has terrible implications for this disease since home caregivers, almost always members of the patients’ family, usually become the next victims. And so the disease continues, as yet unconfined.  More ETU’s will be built in both the cities and the countryside as this impoverished country seeks to eradicate a virus that is causing panic and fear to spread around the world.

-Jim

 

A White House Invitation

Due to our involvement in the fight against Ebola in West Africa, HHI was invited to attend an event at the White House with the President of the United States on Wednesday, October 29th.

After meeting with advisors and healthcare workers involved in the Ebola fight, President Barack Obama delivered remarks in the East Room of the White House praising those Americans who are risking their lives by going to the Ebola affected areas in West Africa to stop the spread of the virus.

“We need to call them what they are, which is American heroes,” Obama said. “They deserve our gratitude and they deserve to be treated with dignity and respect.”

Watch the President’s remarks:

 

Following the event, HHI joined with a handful of other NGOs to discuss the coordinated Ebola operations on the ground in Liberia, meeting with senior administration officials including HHS Secretary Sylvia Burwell, USAID Administrator Rajiv Shah, Ebola Response Coordinator Ron Klain, and Gayle Smith, Senior Director National Security Council.

Learn more about our Operation Ebola.

 

 

From a Conversation on Ebola in Liberia: “They Are Not Anxious to Die…”

The other night I had a good conversation with a couple of my Heart to Heart International colleagues here in Liberia.  The question I asked them was, “Why are you accepting the risk of contracting a deadly disease by volunteering to come and work in Liberia on Operation Ebola?”

While there was not one simple answer, I thought you might be interested in their responses.

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Nurses in full protective gear carry an Ebola victim on the way to burial. Image courtesy: NBCNews

 

First of all, these are people who are drawn to work that involves medical crisis, wherever it occurs in the world. They are experienced. They’ve worked in many other countries… most of which are developing countries with limited resources and infrastructure. They knew what it would be like to work here, and they did not come with false expectations either about the challenging environment or the personal risks.

I also have to say – they are amazing people. They have a heart for the needs of others and are drawn to help when people are suffering. Their willingness to do whatever it takes to be a part of the solution never ceases to amaze me.

But this is no “normal” crisis. This is an epidemic involving a deadly and virtually untreatable virus that kills indiscriminately and in a horrific manner.  Every effort to protect yourself from contracting Ebola may not be enough.  Doesn’t that make this crisis different?

Their answers were clear. No, it only makes it more important to be here and stop this thing while we still can. Both of our team members told me they were prepared to die if that is what it takes. Don’t get me wrong. They are not anxious to die! They simply acknowledged that before coming, they assessed the personal risk of dying and decided that if it cost their life, it was a price they were willing to pay.

I can’t even comment on that level of commitment other than to compare it to what I have heard quoted by many of our troops when they go to war. And that comparison is apt since this is a combat zone of sorts. It is a region that is fighting for its entire existence and needs all the medical soldiers it can assemble.  Unfortunately there are not enough soldiers here (yet) to turn the tide, but I hope there soon will be.

-Jim

HHI’s Ebola Treatment Unit Under Construction in Liberia

The first photos are coming in from the work site in Kakata, Liberia.  The photos are somewhat small thanks to a slow and intermittent internet connection.  But, you can see that work is progressing on our 70-bed Ebola Treatment Unit!  We expect to have it up and running in November.

Workers are busy constructing the visitor area of the new HHI Ebola Treatment Unit in Kakata, Liberia.

 

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Digging the latrine pits at the new Ebola Treatment Unit in Kakata, Liberia.

 

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The triage area of the Ebola Treatment Unit, where patients will be first checked in.