Fieldset
Ebola: Preventing another outbreak in Liberia

After an Ebola outbreak was declared in Guinea earlier this year, epidemic surveillance was stepped in in neighbouring areas of Liberia. Rita, a nurse and infection prevention specialist, shares her experience of the effort...

I first joined MSF in September 2014, as part of the response to the West African Ebola outbreak that hit Liberia that year.

On the day I applied for the role, I saw everyone wearing their yellow personal protective equipment, known as PPE. I saw people dying in the streets from Ebola, people lying along the fence, people carrying stretchers with bodies on them.

When I saw that, my whole spirit as a nurse left me. I felt physically ill from seeing so many people so sick, and bodies all around.

It's scary as a healthcare worker because you cannot help someone that is dying because you are also afraid to die. At that time, I actually felt lucky to have a job as a data encoder. That is how I started working during the outbreak, and how I was able to have the fear leave me.

Neonatal training

The next year, MSF was opening a hospital to meet non-Ebola health needs in the capital Monrovia, so when I finished my job as a data encoder I successfully applied to work as a nurse in the hospital.

When another Ebola outbreak was declared in Guinea... I felt like we were going back to what happened in 2014

My first position was as an infection prevention and control supervisor, and later I became a nurse in the neonatal ward.

Learning to provide medical care to a newborn baby, with their tiny veins, was like magic for me.  And, now I feel like I am super at it because I underwent the training with MSF.

With the help of my friends in the hospital, I started learning, learning, learning, until today I am who I am.

The return of Ebola?

When another Ebola outbreak was declared in Guinea in February 2021, I felt like we were going back to what happened in 2014.

Guinea is not far from Liberia's Lofa and Nimba counties, and our first case in 2014 came from Lofa County. It has a lot of border points, and people regularly interact with others in Guinea to get food and supplies.

So, I joined an MSF team that travelled to Nimba and Lofa to help health workers boost surveillance for Ebola cases and prepare for a possible outbreak.

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Rita delivering a training session at a clinic in Louguatou, Nimba county
Rita delivering a training session at a clinic in Louguatou, Nimba county

My role is to deliver training sessions for health workers and community health volunteers. Some of them have forgotten a little about Ebola since 2014, so we do a short refresher course about the disease and help them remember what can happen.

Once they are trained up, they can go out to do active case searching – looking for people with symptoms that are in line with Ebola.

We also talk about how Ebola is transmitted and the importance of handwashing to prevent the spread when people go into communities. In some places there is no handwashing station available, so I also show people how they can fill a water bottle with soap and water, put a small hole in the top and use it to clean their hands between visits to each house.

Our logisticians have also set up isolation areas in several clinics, where people with potential Ebola symptoms can be cared for while waiting for test results. That way we can identify an Ebola outbreak before it spreads further, and start treating those affected.

Community action

The community health volunteers (CHVs) are the backbones of this effort.

In Nimba County, a CHV found someone who had a suspected case of Ebola. Then people from the World Health Organization and elsewhere began calling to find out more, and the patient was taken to the hospital and into an isolation room to wait for a test.

Thankfully the test result was negative, and the patient did not have Ebola. But, given the risks of another Ebola outbreak, it was worth every effort to be sure.

The CHVs know how to detect when someone is sick because they have been trained. Some have little education from their school days – some don’t even know how to write that well – but they are out there, putting themselves at risk to go into communities.

Hopeful

So far, the Ebola outbreak has not come to Liberia, and I hope it will soon be completely over in Guinea.

But, there are many other health needs, and we must be on the alert for outbreaks of diseases like Lassa fever, meningitis, and measles as well.

Now, I am interested in studying for a master's degree in epidemiology.

I pray that I will someday have the opportunity and finances to go back to school, broaden my knowledge and help those that are less fortunate. I want to be able to help other people who do not have the knowledge of what to do.

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Read more: Stories about Ebola

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