January 7th, 2015 10:16 am ET - Blog Administrator
Making the decision to volunteer in an Ebola Treatment Unit (ETU) in West Africa shows a lot of courage and takes support from friends, loved ones, and other healthcare workers. It also requires the knowledge and skills to safely treat very sick patients in a challenging environment. CDC understands that healthcare workers preparing to deploy to West Africa need to know the infection prevention and control principles necessary for working in an ETU. To help meet this need, CDC offers an introductory training course at the Federal Emergency Management Agency’s (FEMA) Center for Domestic Preparedness in Anniston, Alabama.
CDC’s Preparing Healthcare Workers to Work in Ebola Treatment Units (ETUs) in Africa training course allows students to work in a mock ETU, where they practice putting on and taking off (donning and doffing) personal protective equipment (PPE). They also practice triaging patients, drawing blood, and safely cleaning up body fluid spills. In addition to this hands-on training, participants attend lectures to better understand the disease and how to protect themselves physically and mentally when working in an ETU. For most of the trainees, working in an ETU will be a new experience. This course gives them an opportunity to practice the required skills and prepare themselves psychologically.
A recent graduate of the training, Kwan Kew Lai, is back in the United States after serving as a doctor with the International Medical Corps (IMC) in an ETU in Liberia. Kwan Kew volunteered for the Ebola outbreak response because she understood the critical need for healthcare personnel on the ground to help combat the epidemic. Kwan Kew knew the work was going to be dangerous, but she knew her skills were desperately needed, especially since so many local healthcare workers in West Africa had already lost their lives to Ebola while providing care. Kwan Kew has spent the last nine years volunteering during public health emergencies and natural disasters; however, she described the Ebola outbreak as one of the most difficult and heart-wrenching experiences she has ever faced.
Her journey began with CDC’s 3-day training course, which she completed along with 35 other healthcare workers. Kwan Kew traveled to West Africa in mid-October. When she arrived in Bong, Liberia, she was greeted by a huge sign announcing “Ebola is real and it is here in Liberia.” At a roadblock performing temperature checks, another banner read, “Fight the Ebola virus. Protect yourself. Protect your family. Protect your community.” These signs were a striking reminder of the reality Liberia faces as a country plagued by the largest Ebola outbreak in history.
Her first day at the 52-bed ETU began at 6:45 a.m. with caring for 33 patients, 15 confirmed and 18 suspected to have Ebola. Each day, Kwan Kew had to use her training, meticulously donning and doffing her PPE, a process which took 15 to 20 minutes each time. Even with temperatures reaching 89 degrees Fahrenheit during training in Alabama, those conditions were nothing like the humid weather the trainees would face in West Africa.
Kwan Kew, an avid runner, compared wearing layers of PPE and treating patients in the sweltering heat of Liberia to running a marathon on a very hot day.
“At mile 17, I began to hit the wall, but somehow pushed myself to mile 20, at which point I invariably asked myself why I was running this marathon or any marathon at all. But at the stretch to the finish line and at the end, the emotional boost to have finished running 26.2 miles was just indescribable.”
The physical demands, weather, and hot gear worn in the ETU were not the only challenge Kwan Kew faced. She also wrote about how hard it was to care for patients and encourage them to be hopeful while being encumbered by PPE.
“What makes it even more poignant is that when the patients need close human contact the most, in times of extreme suffering, pain, and fear, there is none to offer except with a barrier of protective covering. In the beginning, it hit home to me that there was a real possibility of a true exposure; however, as time went on, inspired by the persistence, dedication, and selfless caring of my colleagues, that fear was pushed to the back of my mind and the goal of getting the patients better overwhelmingly became my main concern.”
Now back in the United States, Kwan Kew’s 21-days of self-monitoring are over. While she is ready to return to her normal job as an infectious disease doctor in Boston, Massachusetts, she can’t help thinking about the uncertainty facing people in West Africa as Ebola continues to spread.