Life after Liberia

Hand wash station at Emergency Operations
Center in Monrovia: Ebola is Real

I have been putting off this last post on Liberia, but am finally forcing myself to write about what life was like after leaving Liberia.  This post is probably the most important for me to discuss because it touches on the emotional toll of the outbreak and stigma associated with ebola.  Articulating my thoughts and feelings is difficult since I don't entirely understand them myself, so my writing may ramble a bit.

I had heard hat folks returning from west Africa were having feelings of survivor's guilt and potentially some PTSD.  I had also heard that it took some time to process things once you return.  The first few days I was back in Atlanta I was glad to be home with my family and I was feeling very happy.  I thought that maybe my return would be easy, but my first day back at work (two days after arriving in the United States) ended up being very difficult.  There was a lot I had to do for the post-deployment process and I also had to transition back into my regular job, but everything seemed to be so trivial after being in Liberia where there was such urgency in stopping the outbreak.  When I was researching information for my blog I came across this interview with some people from CDC and one of them said something that really explained how I felt when I got back.   When asked what it was like returning to the United States one of the women responded:

"...and you're not really here and you're not really there."

This perfectly summed up how I felt when I returned, I just wanted to get back to west Africa to help.

Saniquellie gas station

In the video it also touches on the emotional toll of the outbreak for those involved.  I thought that because I was not hands on with sick people or out investigating deaths that I would be fine.  I was lucky because I did not see any of the real suffering that was happening during the outbreak.  The people out there caring for ebola patients, tracing cases and contacts, and burying bodies, I do not know how they do it.  I think I would just want to cry most of the day if I witnessed the things they had witnessed.   One of my coworkers in Liberia said that some days you just had to have a good cry and then move on to the next task at hand.  

Despite not witnessing these things, after 3 or 4 days of being back, I started to feel really emotional about everything and could not help but cry when I thought about it or talked about things with other people.  I am normally a crier, but it was worse than normal for me.  Sometimes I did not even really know why I was crying.  I guess this is what everyone had meant when they said they needed time to process things once they got back.  While you are there you don't have the time to think and reflect about some of the awful things that are going on because every bit of energy has to be focused on the job you are there to do.   Once you come back you begin to realize the magnitude of things. 

Not happy about bath time

While I was there it was always in the this thing in my subconscious reminding me I had to be cautious so I did not get ebola.  There were times when it seemed like things were "normal" but then something would remind me that they were not normal.  They were far from normal.  One day when we were driving to the Ministry of Health I saw a man laying on the sidewalk, propping himself up and talking to two men that were near him.  He looked lethargic and unable to get up.  I do not know if the two men were trying to help him or if they were harassing him.  Another time, when driving back to the hotel, there was a man laying face down on the sidewalk and he was not moving.  People were walking by him, not doing anything.  I don't know if he was dead, but I could not do anything to help other than call the national hotline to report it.  Another shocking thing that happened was on a drive back to the hotel and traffic was backed up more than usual.  One of the lanes was shutdown because of two ambulances and in between them was a person in full protective gear being sprayed down with bleach.  I have no idea what happened, but it reminded me of the reality of the situation at hand.  You just have to always assume that all of the situations are due to ebola and take the necessary precautions.

There have been more new cases in Sierra Leone in the last week than
total number of cases in most outbreaks of Ebola since it was discovered.

Now that I am back I think about these events and stories I heard from people working in the field.  People were (and still are) dying every day.  Children are left homeless and alone.  Adults are left with nothing because their entire families have died.   People have so little and then even more is taken from them when their family members die.  And even though all of this still continues, ebola is no longer front page news like it was before I left in October.  People have moved on to the next tragedy even though this one is still very much ongoing and it frustrates me.  How can people not seem to care or want to help stop this?  

A week after I got back CDC had some TEDMED style talks from people that had been deployed in Sierra Leone and Liberia.  Many of the speakers broke down in tears discussing their experiences during the ebola response.  Many audience members also cried hearing the speakers and maybe thinking about their own experiences in west Africa.  I notice about 30 minutes into the talks that there were Kleenex boxes placed around the room of the auditorium.  This sort of emotional response is not even close to normal when attending talks at CDC.

After about three weeks of thinking  and talking about ebola everyday and crying when thinking about things, I began to feel better and more connected to my job (although I do think about going back almost everyday).  I feel guilty that I can return to "normal" life in the United States while life will not be normal for those living in west Africa for a very long time.  I also feel guilty about the sadness I have experiences because others have seen so much worse than I have.  Yet, those that have seen worse than I have feel guilty about their feelings because the ebola victims and survivors have it worse.

Life for the the people that have survived ebola or family members that have lost loved ones to ebola must be beyond difficult.  Many also have to deal with the stigma of ebola, whether they had it or a family member died from it.  People have been chased from their villages when they are sick and some end up dying alone in the jungle.  Children with parents that have died from ebola are often left to fend for themselves because no one will take them in.  Survivors return to their villages to find that their house has been looted, boarded up, or burned down and they are no longer welcome.  

If you would like to help the fight against ebola in west Africa and those affected by it, there many organizations you can donate to (or even volunteer for) if you would like to help.

Children of Fish Town