Fighting a world crisis from Atlanta

The epicenter of the Ebola epidemic may be around 5,241 miles away, but the virus is no stranger to the City of Decatur. The fight against the largest outbreak of Ebola in history is inspiring Decatur efforts abroad and at home.

Efforts in Liberia

Henry Walke, father of seniors Lucy and Vega Walke and sophomore Homer Walke, traveled to Liberia to facilitate the Center for Disease Control (CDC) efforts in fighting Ebola.

Walke’s trip to Liberia didn’t frighten him because he is used to traveling to different countries under similar situations. He tried his best to emphasize his lack of concern to his family.

“I reassured them that I wasn’t going to take direct patient care,” Walke said. “We talked some about how the virus was transmitted, and I think they were reasonably reassured.”

Although Walke’s family understood his low risk of contracting Ebola, Walke finds that many still do not understand.

Anne Purfield of the Division of Tuberculosis Elimination stands outside of a high risk zone at the hospital where she worked in Sierra Leone.

“The reason I wasn’t as concerned was because I know good science about how the virus is transmitted,” Walke said. “[…] getting off the airplane in Monrovia and breathing the air in Liberia, you’re not going to get Ebola,” Walke said.

Walke also noticed the fear regarding Ebola crippled the CDC’s ability to combat the virus in the field. Communities often resisted reporting cases of the virus, and Walke believes the fear of stigmatization contributed to this resistance.

“They [villages] are in the denial phase until enough people die,” Walke said.

Anne Purfield, a Clinical and laboratory research coordinator for the Division of Tuberculosis Elimination, was a part of the CDC’s Emergency Response Team and traveled to Sierra Leone to fight the crisis.

According to Purfield, adults primarily tend to the sick, making them more susceptible to contracting the virus. The death of the adults leaves behind a “whole cohort of orphans.”

The orphans, Walke says, are then ostracized, sometimes even by their extended families because of their association with Ebola.

The perseverance of the orphans left Purfield in amazement.

“You see that they have nothing and yet they are so brave,” Purfield said.

Purfield was disturbed by the struggle she saw the orphans endure.

“There is no one to touch them and no one to comfort them. Here you [the children] are and there are corpses all around you and you are all alone,” Purfield said. “There are people screaming. How scared you must be, and there is no one to take care of you and no one to comfort you. There is nothing.”

The disease doesn’t only attack the body, but also leaves an emotional mark on patients because of stigmatization. As the families take care of relatives with Ebola, the virus spreads and families start to blame each other for the death of their loved ones.

“You can see how the family can just be broken up where it used to be close knit. Now there’s is this sort of anger,” Walke said.

Christopher Braden, Deputy Incident commander in the Emergency Operations Center at the CDC, also sees the stigmatization. He believes there’s more to the problem than simply the virus. He believes the bias demonstrated toward these Ebola patients, and people associated with Ebola, will separate our society more than the deaths and losses of entire villages.

“The impact of discrimination is going to be greater than any impact of the illness,” Braden said. “Those types of situations are where we actually manufacture a stigma associated with this [Ebola].”

Despite the challenges with stigmatization and lack of knowledge about the virus, Walke finds empowerment in contributing to finding a potential solution.

“Even if you know how the disease is transmitted, the real passion is how to prevent these diseases and how to prevent burden of disease in humans,” Walke said.

“I felt appreciated, and it’s one of those experiences where you don’t have very often,” Walke said. “I thought it was very kind of him to reach out to folks in country.”

Efforts in Sierra Leone

Wendy Holmes, Junior Jude Holmes’s mother, recently traveled to Sierra Leone. While in Decatur, she wanted to help with the Ebola outbreak, and when given the chance to go overseas, she took it.

“I saw many people going and coming back, and in coming back they had so many more insights about what was happening and what we needed to do to support the efforts that I felt like I needed to know that to,” Holmes said. “I needed to be part of that to be more effective.”

While she stayed in Sierra Leone, she supported the government’s and local NGO’s efforts in outbreak responses. It was her first international tour of duty.

During her time working in Sierra Leone, she learned more about how Ebola is contracted.

Deceased Ebola victims contain high viral loads, making them extremely contagious. Sierra Leone’s traditional practices of  preparing dead bodies by washing and touching them causes these rituals to become centers of contagion.

“The spread is not random,” Holmes said. “You see it in family groups or people that have been to funerals together.”

Holmes worked with a team of journalists to create radio announcements about the danger of the burial rituals. 70 percent of Sierra Leone’s population is illiterate, so the use of the radio to communicate the message was vital.

Purfield also traveled to Sierra Leone where she worked at a government hospital. While there she obtained data on case outcomes – whether a patient died or lived. She gave the data to the Ministry of Health and the World Health Organization (WHO) to analyze the Ebola situation in Sierra Leone.

Purfield did experience concerns about her safety while traveling, but she kept reminding herself and her family of her works impact.

“My mom was worried, but I had to remind her that it’s not about her,” Purfield said. “It’s not about me. It’s about an entire country and a civilization that is just at their knees, and they need help.”

She did experience challenges, though.

“I really had no idea what I was getting into,” Purfield said.

Her first day on the job, she met with the nurses because she needed their logbooks to record who died and who lived.

“The first thing you notice is this look of shell shock on their face,” Purfield said.

Purfield believes the nurses’ shell shock comes from the emotionally and physically tiring work they do. Many of their co workers die, and they work seven days a week in a hot climate with an uneven nurse to patient ratio.

Purfield wanted to support the nurses, but she found this difficult because of the hospitals no touch policy.

“All you can do is put your hand over your heart and give them the most sincere look you can, and then maybe go out and buy some cold sodas, put the cold sodas on their desk and walk away,” Purfield said. “You can’t touch them, and you can’t do anything.”

Purfield tried to make up for the lack of physical contact by supporting those around her with words.

“You can help by simply asking them how they are doing and just acknowledging that this just sucks, and there is no way around this situation,” Purfield said.

Purfield was disheartened by the lack of concern she noticed upon returning to the States.

“You find yourself in this world [the United States] that is smiling and happy and drinking lattes and has no idea what is happening in the small part of the world. It’s like war but only in war the enemy is violence and hate, and this is a virus that completely feeds off love and affections and humanity.”

Emory’s Effort

July 30th marked the first call informing Emory Hospital that they would receive Ebola patients. The next 72 hours consisted of long hours of coordinating to prepare for the first patients.

Doctor Jay Varkey, Assistant Professor of Medicine at Emory University School of Medicine and Epidemiologist at Emory University Hospital, described those 72 hours as being a “mixture of excitement and tension.”

“I would argue that those first 72 hours of getting ready were actually more stressful than caring for the first patient,” Varkey said.

Ambulance sirens and the whirr of helicopters notified the Emory Ebola team of the coming patient, but other modes of communication filled them in as well.

“We were getting minute by minute updates from our staff that were in the ambulance, but it really wasn’t necessary because CNN was showing it,” Varkey said. We could just watch from patients rooms as they [the Ebola patients] were walking in. It was a little surreal.”

Varkey remembers staring at the screen in awe while thinking about how he was going to be a part of the team that would work with the patients over the course of three months.

“It was an incredible privilege,” he said.

The Emory team consisted of five physicians as well as 22 nurses. To Varkey, the nurses were “really outstanding.”

Varkey remained in charge of receiving the fourth patient admitted to Emory Hospital.

“I remember turning to my nurses that I was working with and they both said the same thing. They said, ‘lets do this.’”

Besides the play by play updates Varkey watched when the Ebola patients were in transition to the hospital, he notices some downsides to the media’s coverage of the event. He felt the media miscommunicated information about the Ebola treatment process causing confusion on the methods actually used.

The leading way to cure patients is through a medical practice called supportive care, and this is the process Varkey used on the Ebola patients.

“What supportive care really means is keeping someone alive long enough to allow them to develop the antibodies necessary to fully recover from the infection,” Varkey said.

Treating Ebola is not that simple, though. Other medical procedures, including transfusions and antibiotics, are still needed in order to fully alleviate Ebola. Successful outcomes, though, did result from the supportive care treatments.

“To see all four patients walk out of the hospital was extraordinarily gratifying,” Varkey said.

Varkey’s team did experience unexpected problems during the process.

“The sheer amount of waste was pretty amazing, Varkey said. “In those 33 days, our team generated of 3000 pounds of waste.”

The Emory team tackled the surprise.

“Thankfully we had a plan for it, and we developed a way to do that safely,” Varkey said.

CDC’s website directs to put textile products used around Ebola patients or infected areas in specially designed waste bags.

Like Walke, Varkey found inspiration in getting to aid in the effort to combat the virus.

“It sort of reinvigorated what I love about what I do, that is, being a specialist in infectious diseases,” Varkey said.

Varkey’s experience with the Decatur community while working with the Ebola victims at Emory remained positive. He hasn’t experienced stigmatization because of it.

Varkey recognizes, though, that Decatur residents express mixed feelings about how close the Ebola patients were to home. He admits that his lack of experience with stigmatization could be because the people with concerns were “keeping their distance.”

Junior Sarahn Nazaret had concerns when Emory received the Ebola patients.

“It was a bit unsettling that they were so close to us, but I think that it was controlled enough that we shouldn’t have too much to worry about,” Nazaret said.

English teacher Christopher Simony was not nervous.

“From what I understand more people die of pneumonia and other common illnesses than Ebola in Africa.”

While the Ebola victims have left Emory, the threat of Ebola is still prevalent in Africa, but Varkey remains hopeful that the virus can be tackled.

“The Ebola virus does not have to be a death sentence,” Varkey said.