We were ready. When the vehicle arrived at the gate of the Monrovia Medical Unit (known as the MMU) in the late hours of the afternoon, we were already gathered in the donning area. A phone call from the Ministry of Health had alerted us to the new patient’s symptoms and background—fever, headache, malaise, nausea, vomiting, and diarrhea in a woman who lived and worked in a neighborhood thought to have a high transmission of the Ebola virus. We had been trained to move slowly, deliberately, and carefully in our preparation, and it took about 20 min before the first pair of nurses was fully dressed in their Personal Protective Equipment, including a gown, boots, two sets of gloves, mask, hood, apron, and face shield that would help protect them from the virus. In the hour before the patient’s arrival, we had moved more quickly, slipping in and out through zippered flaps in the olive-colored tents that make up the 25-bed Ebola Treatment Unit (ETU) staffed by Officers of the U.S. Public Health Service Commissioned Corps in Margibi County, Liberia. The pharmacists gathered the IV fluids and medications that we would likely give. The safety team filled buckets with chlorinated water: 0.05% for skin and 0.5% for everything else. The laboratory team checked that they had the purple tube to collect the blood to test for the virus. When it was time, we lifted the bright orange fencing that separated the donning area from the high-risk area and moved slowly down the short hallway to the Suspect Ward. We washed our gloved hands in chlorinated water from a bucket outside the ward, and then stepped in. She looked sick. She had vomited in the ambulance on the way over. Her face was flushed and sweaty, and the whites of her eyes were injected with red. An Ebola survivor who worked with us had warned us about patients with red eyes—‘‘a bad sign, a bad sign,’’ he had said. The test results came the next morning. She had run a high fever throughout the night, and we were ready for the confirmation of our suspicions. But our Ebola patient did not have Ebola. Instead, she had malaria. In August and September, according to the World Health Organization, at the peak of the epidemic in Liberia, there were over 300 new confirmed Ebola cases per week. Since it began, over 8300 people had been infected, and over 3500 had died (1). Health care workers have been disproportionately affected, with over 800 infections and almost 500 deaths in Liberia, Sierra Leone, and Guinea (1). In response to this crisis, the MMU was set up with the mission of providing hope through care to health care workers and responders in Liberia who may be infected with Ebola Virus Disease. Since it opened on November 7, 2014 until the time of writing in mid-January, it has provided care for 36 health care workers, 17 of whom tested positive for Ebola. The MMU is one part of a large international effort to stop the epidemic. The results of this hard Published online: February 18, 2015
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Feb 27, 2023
Sayyem Akbar 