I was not sure what I was going to be doing and where I would be stationed when I got to Liberia. Conditions in remote locations of Liberia could be quite austere. The word "austere" was used a lot when describing many locations of west Africa.
There had been some discussions that I would help to link laboratory data with case data, but I got a better idea once I attended the orientation and met with the team lead. I would be acting as a laboratory liaison/coordinator for the CDC epidemiology team and outside partners working on all things laboratory.
It is overwhelming, but necessary, to show up in the middle of a historic outbreak and have to hit the ground running your first day on the job. I attended my first meeting on my first afternoon in Liberia. The subject of the meeting is not something one ever hopes or wants to have to discuss: dead body management. Burial practices in west Africa have contributed to the spread of ebola. The Liberian government began cremating bodies to stop the spread, but many people began secretly burying the bodies of their loved ones so they could continue with the traditions they have known for generations. The government and its partners hope that safe burial practices will replace some of the traditions. These new practices would allow families to pay respect to their loved ones without risk for infection of ebola, decreasing the number of secret burials in west Africa and spread of ebola.
The weekly dead body management meeting was the first of many meetings that I attended. We had team meetings Monday, Wednesday, and Friday evenings. The Liberia Incident Management System Case Management Meetings were twice a week and the Laboratory Subcommittee meetings were once a week. There were other various meetings that tended to fill up most days, including the weekends.
Most of my time was spent in these 8 miles
LIBR
As part of my role of assisting the laboratories I was able to visit the three Monrovia area laboratories in my first week in Liberia. The ebola diagnostic laboratories are important because the faster that a test can be run to confirm a patient has ebola, the quicker they can be released so they are not exposed to other patients that do have ebola. If a patient is positive for ebola, it is important that they are quickly isolated and treated and those that had been in contact with the patient are identified.
First I visited Liberia Biomedical Research Institute (LIBR), a former primate research center. The LIBR ebola testing laboratory is staffed by people from NIH and USAMRIID in the United States. On the way back to Monrovia I visited the CDC/NIH laboratory attached to the Medecins Sans Frontieres (Doctors without Borders) ebola treatment unit ELWA 3.
"ELWA" laboratory next to MSF ETU
ELWA lab glove box used for inactivating samples
The final lab in the Monrovia area that I visited is run by the U.S. Navy. The drive to the NMRC lab took us through West Point, the Monrovia slum that was quarantined several months ago in an attempt to stop the spread of ebola cases.
Crossing over the river into West Point
The NMRC lab is located in a house next to the Island Clinic ETU (and therefore nicknamed Island Clinic lab).
Island Clinic NMRC laboratory
Don't mess with the PCR machines
I was also able to see the clean "green" areas of the Island Clinic ETU.
Island Clinic ETU employee entrance
All non-disposable personal protective gear (PPE) is disinfected and dried before it used again.
Patients are released from the ETU once they have two negative PCR tests. They have to remove clothing (except pants) and leave behind anything from their pockets, including money or cell phones (sad considering how little most people have). They are then sprayed down with dilute bleach and given a new shirt to wear before exiting. All trash/waste is burned in an incinerator.
Looking through multiple fences to treatment building
Overlook into area where patients are held before release
It is overwhelming, but necessary, to show up in the middle of a historic outbreak and have to hit the ground running your first day on the job. I attended my first meeting on my first afternoon in Liberia. The subject of the meeting is not something one ever hopes or wants to have to discuss: dead body management. Burial practices in west Africa have contributed to the spread of ebola. The Liberian government began cremating bodies to stop the spread, but many people began secretly burying the bodies of their loved ones so they could continue with the traditions they have known for generations. The government and its partners hope that safe burial practices will replace some of the traditions. These new practices would allow families to pay respect to their loved ones without risk for infection of ebola, decreasing the number of secret burials in west Africa and spread of ebola.
No comments:
Post a Comment