Life in the hot zone

Within the first few hours of my first day in Monrovia I learned the expectations I had for Liberia were no longer the reality.  By the end of October the number of ebola cases were declining, there was room in the ebola treatment units (ETUs), and there were no longer dead bodies in the streets.  The president of Liberia had declared a state of emergency, schools were closed, but life did go on...

Only sign of ebola in this photo is the hand wash station

The hotel I was staying at, Mamba Point Hotel, was very nice and had one of the best restaurants in town.  They even had a sushi bar, which I ate at multiple times during my stay and lived to tell about.

The sushi was really good!

There were some beautiful views and lovely beaches.

View from the hotel balcony

Kendeja Resort Beach (owned by founder of BET)

Anglers Bar and Grill

On the drive from the airport to Monrovia

Beyond the local beauty, the most obvious reminder that I was in the middle of the largest outbreak of ebola in history was the many signs and posters everywhere I looked.

There were even commercials about ebola that were being broadcast.

Another reminder of the outbreak was the dilute bleach hand wash stations and temperature checks at the entrance to most buildings.

My hands have never been so clean

We tried to guess our temperatures

Despite my fears before getting to Liberia, I did not need to worry constantly about getting ebola.  Ebola was not going to chase after me and infect me like a zombie from the Walking Dead.  The chances are very slim that you will come into contact with infected bodily fluids unless you work in a healthcare setting and not using appropriate protective gear or are caring for an infected family member.  In fact, I think I worried less about getting ebola while in Liberia than some people in the United States worried about getting it in a country with fewer than ten cases of ebola.  That being said, I still had to be vigilant about washing my hands and using hand sanitizer when I could not wash my hands.  Ebola is very easy to kill so those two methods were my strongest safeguard against getting infected.  My biggest concern when I was out in public was using public bathrooms, but I would make sure to wash my hands if possible and then once out of the bathroom I would also use hand sanitizer.

My temperature log while in Liberia

One thing that was very different about being in the middle of an ebola outbreak was having to pay close attention to any changes in my temperature, energy level, gastrointestinal system, or other health parameters.  Although not required, I took my temperature twice a day and would sometimes check at other times of the day if I had any concerns about my health.  On one of the days my temperature was 99.5 F so I reported it to my team lead and remained in my hotel room until it was back to normal the next morning.  Although I did not have any potential exposure risks and any other symptoms compatible with ebola, I still had some concern that somehow I had been infected even though it was not logical.  After a few hours I was feeling better, my temperature was coming down and I realized my fear was irrational.  There were a few others times where I had some diarrhea, which would be normal when traveling to this part of the world, but it still had to be reported to the team lead and monitored.

President Ellen Johnson Sirleaf and U.S. ambassadorm to the
 UN Samantha Power demonstrating the "ebola handshake"

The last bit of prevention was adhering to the no touching anyone rule.  Until you are not allowed to have any physical contact with others you do not realize how often you touch other people.  Not shaking someone's hand when you meet them in a business setting is a very strange feeling.  It is even worse when you in stressful conditions, working long hours, and dealing with some very emotional situations and you cannot physically comfort someone.  There were many times I really could have used a hug or wanted to hug someone else that needed one but could not.  

I could always tell when someone new had arrived because they often tried to shake my hand or casually touched my arm.  I quickly developed a response of back up and becoming very protective of my personal space.  When handing something to another person I became very careful to make sure my hand did not touch the hand of the other person.  I could not wait for the day that I was able to hug the people that I had become close to and developed lasting friendships while in Liberia.

Although my day to day life was not bad, I often felt guilty because I was staying in a nice hotel with potable water, reliable electricity, internet, and food in a country ravaged by civil war for years, a gross national income of only $410, and fewer than 2 doctors per 100,000 people before the ebola outbreak occurred (compared to 245 doctors per 100,000 people in the United States).  Almost 200 healthcare workers have died in Liberia and the healthcare system has completely shutdown because of the outbreak.  The people that go to ETUs for treatment but are negative for ebola are sent away with nowhere to go for help.  It was hard to to think about all of the things I could not do, but I needed to stay focused on what I could do to help while I was in Liberia.