News from Liberia

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																			November 30, 2014
					

 

Alan-LifsonAlan Lifson, MD, MPH, is a School of Public Health professor and an infectious disease specialist. He’s currently serving as a medical advisor to the American Refugee Committee (ARC) in its work to contain the Ebola virus in Liberia. ARC will soon be opening up a treatment center in Fish Town, a rural community in the southeast of the country. Lifson brings his decades of experience on global public health pandemics to help ARC train incoming health care workers, prepare safety protocols for the treatment facility and advise on staff re-entry policies.

 

December 4, 2014

A few snippets of life here in Monrovia:

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Monrovia’s ever-present hand washing stations
  • No touching: Coming from Ethiopia, where everyone greets with a handshake, a shoulder hug, and (for close friends) cheek to cheek, the rule here is strictly no touching—don’t shake hands, no skin-to skin-contact, period.
  • Wash hands: Every restaurant, every hotel, other public places all have buckets with a spigot to wash your hands with 0.05% chlorine. Also lots of hand sanitizer dispensers. My hands have never been so clean; they vaguely smell like a swimming pool.
  • Fever checks: I’ve had my temperature taken multiple times before entering restaurants, offices, and other public buildings with one of the ubiquitous hand-held noncontact infrared thermometers, pointed at the side of your head.
  • Sticker shock: Prices where the foreign relief workers are located are all high; $3-$4 for a cup of coffee. As one of the locals explained, it is the “Ebola economy”—a bit perverse in that in a poor country whose economy was crippled by war, and dealt a body blow by this epidemic, a major source of current external funding is related to the Ebola relief efforts.
  • Uncertainty: There are many large moving parts that somehow all need to integrate and come together, which were described to me as like trying to move multiple ocean liners through a narrow water channel. For those of us who are used to day-by-day firm schedules and fixed plans, it can all be frustrating, with alternating periods of uncertain waiting punctuated by periodic activity, but more experienced colleagues who have been through similar relief efforts in resource-poor settings tell me that’s the way it is.

Having been here for all of only four days, I realize the more I learn about things here, the less I actually know.

December 2, 2014

Arrived in Monrovia last night, via Frankfurt and Brussels. Airport arrival was crowded and a bit of a scene.  Monrovia weather is high 80’s and humid; it’s supposed to be dry season, but burst of torrential rain tonight.  I can’t imagine what it will be like trying to wear personal protective gear and function in this humidity.

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PPE training in Fish Town, Liberia

This scene is more familiar to others who have worked in large acute disaster/relief projects, but I am struck by all the relief organizations who have converged here, and it seems that everyone in the hotel here and across the street is connected to Ebola. One sees Land Rovers from U.N. organizations, plus large contingents of people from WHO, the U.S. military, and other relief organizations (International Medical Corps, MSF, etc.), all to deal with Ebola. People are here from all over the world, including many Liberians from abroad.

I went to American Refugee Committee office today and met colleagues from Minnesota who are also here to help in the implementation of an Ebola Treatment Unit. The logistics of planning and responding in such a complex and rapidly evolving situation are pretty mind-boggling to me; there are so many aspects to think about: medical/clinical care, purchasing/supplies, finance, personnel/hiring local staff, communications/IT, transportation, and lots more. It is impressive to witness the experience and expertise of this ARC team, and how they are working together to make it all happen.

November 30, 2014

Sitting here in the Addis airport, waiting for the first of three flights up to Europe and back down to Liberia. Ethiopia has become very familiar with me, and I am very comfortable with its wonderful people and culture. I am going into a new and very different situation, with some apprehension and uncertainty about what I will find on the other side.

I have trust in my colleagues with the American Refugee Committee, and comfort in knowing that many of my Minnesota colleagues will be there. It is not the unfamiliarity of new place, and I have no qualms about what I am doing, or that the experiences and background I’ve been fortunate to have now obliges me to contribute to the efforts of so many others battling this epidemic.

At the same time, one would be foolish, I think, if one did not feel some healthy fear of this most deadly of diseases, in which, for example, an unguarded contact on one’s own face with one’s own hands can have the most serious of consequences. The trick, I think is to use that healthy fear and respect to rigorously follow every single one of the strict and detailed precautions that others have laid down, so that I come home safe.

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