2 10 229 Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Ebola - Oral History Transcripts Oral History A resource containing historical information obtained in interviews with persons having firsthand knowledge. Transcription Any written text transcribed from a sound So yeah, they were like alright, you're just going to jump in. They had this case, this guy who had traveled from Guinea, from where the outbreak was biggest, and he crossed the border into Mali and no one had realized that he had Ebola for like weeks. He crossed the border, he got to this private hospital in Bamako, they didn't realize it, had a lot of contact with people, got some other people sick. This is how it happens. By the time they realized it, it was too late and he had gotten other people sick and he died. It was already kind of like this scary thing and I think because it was in Bamako, it was a huge city, they were like, this could be a complete disaster. They were really worried that it would be, and I think we're really lucky that it didn't become a disaster. I mean we responded, but you can't--we only responded as far--you know, after we knew things, which was already too late. People were very on edge and there was this whole theme because Senegal had that one case and it was fine, and Mali had had one case a few weeks before, but it was not a big--you know, it was just one single case. She died, it was sad. Nigeria had those few cases so everyone was like, are we going to become a Senegal or are we going to be a Guinea? Be a Senegal, that was the theme of the whole thing. So we just started. We went in, and they had set up an emergency operations center, the COU [centre d'opération d'urgence ], and we were working with all kinds of--it was like, CDC was there, Doctors Without Borders, all these NGOs [nongovernmental organizations] and stuff had just flooded in. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Moriarty Senegal Transcript Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Ebola - Oral History Transcripts Oral History A resource containing historical information obtained in interviews with persons having firsthand knowledge. Transcription Any written text transcribed from a sound We found it was pretty chaotic. Nigeria was the first time--and Lagos, where it was I guess a great fear was realized. It's a city of twenty-one million people, and they're jammed very tightly. I think that was always one of the great fears about Ebola, is what would happen if it got into a densely populated urban center? Before, you'd go out for Ebola or Marburg and it would be in a very remote area. Uige, Angola, was remote, and it would usually burn out. But the idea of having it in this very [densely populated] city was terrifying. One of the first things we did was there were--I think, at the time--twelve cases, and we had to begin contact tracing. It got up to about two hundred people that we're doing the tracing on. We worked with our partners, we had to come up with a kind of a facility to put the patients. We quickly converted--I think it was an old TB [tuberculosis] hospital--into an isolation ward. We got an isolation ward set up, and we started working. It was amazing, they stood up this kind of ad hoc communications group, and there was, let's see, a UNICEF [United Nations Children's Fund] communicator, there were some college kids, there was a professor from one of the universities. We really went into the ICS, the incident command structure, with communications as part of that. As far as communications, I was working with--we also have a consulate in Lagos. With an outbreak like this, there was intense media interest, so we were working the public affairs aspect with our State Department folks at the consulate in Lagos, as well as Atlanta and everybody. So there was the aspect of the media relations, the public affairs. But there was also--we stood up a kind of social media arm, and the Lagos guys were amazing. Some of these young kids in college putting together social media campaigns, leading Twitter chats. We hooked them up with CDC, and I think one of them--we did a Twitter chat that was one of the largest ever, from Nigeria working with CDC Atlanta. There were some amazing things. There was really a need for it, because we would see these crazy rumors that would just take off. I remember, the day after I got there, looking at the headline of a paper that said something about salt water possibly curing Ebola or preventing it. So initially, go into a campaign, one to help educate, but also to do some rumor-busting. There were rumors about cocoa nuts or a certain kind of nut that would also prevent it. So there was a lot being done very quickly. And then just getting educational materials in place, and a lot of this stuff we were pulling straight from Atlanta and trying to get to our counterparts. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Daigle Lagos Transcript Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Ebola - Oral History Transcripts Oral History A resource containing historical information obtained in interviews with persons having firsthand knowledge. Transcription Any written text transcribed from a sound [T]he huge success was the spread of Ebola into Nigeria that had occurred a month earlier. In Nigeria, we were fortunate that we had several collaborations in place. The introduction into Nigeria was a single person ill on an airplane and introduced it into Lagos, and secondary and tertiary transmission occurred in Lagos and then it also spread to Port Harcourt, a second city. When I joined the International Task Force, besides leading the response in Senegal, my team picked up the Nigerian response although it was well in its--it was quite a mature response. I led the lingering activities that were in Nigeria, and I learned a lot from that Nigeria experience because what Nigeria showed us was how vitally important it is to rapidly identify all of the controls and to monitor them and prevent secondary transmission. But in order to do that, the success story in Nigeria was that there was a Field Epidemiology Training Program, an FETP, that was very robust, in particular because of the polio resources. Polio's resources that were provided to the FETP in Nigeria led to well-trained field epidemiologists that were used to being in the field and finding cases. In some of the polio trace-backs, they found cases, even in the most difficult settings, and knew how to do contact tracing in a very robust way and to monitor the contacts. That EIS-matured program, experienced EIS program, was just phenomenal. They immediately went to the field in the Ebola outbreak and broke the chains of transmission. The second thing was because of the polio effort, there was an emergency operations center concept and program in Nigeria, so that when Ebola was introduced, they immediately set up an emergency operations center to coordinate and make all the decisions rapidly. These decisions, which sound simplistic, but the emergency operations center for example had the ability to immediately allocate resources, small resources. In some of our other countries' responses, paying for the taxis, which was a minimal expense, would take a week to get the necessary signatures to pay for. But here in the EOC in Nigeria, they were able to immediately allocate funds. Although they did get some of the funds from private partners, so in some instances, even going through the government was not quick enough, they got additional resources added. But nonetheless, they had a mechanism to make decisions rapidly to, how do we respond? So the FETP, the EOC, and then they had a robust laboratory program network because of the polio. All those pieces were in place mainly because of our--in large part because of CDC country office partnership with the Ministry of Health, and we had their trusted relationship with the Ministry of Health. All those programs together allowed CDC to contribute to quite a robust response in Nigeria and rapidly contain the introduction. We learned a lot from that in our team as we were starting up this Unaffected Countries Team, we called it, in the third week of August. I remember that we were fortunate that on my first or second day, Frank Mahoney had returned from Nigeria and came to the EOC, and I sat down with him and debriefed him, and he shared all these stories about the success in Nigeria, and we learned from that, that those are the things we needed to focus on for our responses in the other countries. We began to focus our energy on controlling Senegal, but rapid concerns about well okay, if this could happen in Senegal and happened just a month earlier in Nigeria, what about Côte d'Ivoire or any immediately neighboring country? And also, any country. Like Nigeria demonstrated, it doesn't have to be an adjacent country. Any other country that has connections, flight connections, there could be transmission. What can we do to strengthen the neighboring countries so that it does not spread out of these heavily affected countries? Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Angulo Containment Transcript Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Ebola - Oral History Transcripts Oral History A resource containing historical information obtained in interviews with persons having firsthand knowledge. Transcription Any written text transcribed from a sound DELEA: [M]y personal opinion is that's why we had success. People don't really talk about the success in Bissau, but I would say for the Global Health Security high-risk countries, Bissau has probably been the most successful. Our successes, my true personal opinion is our successes are based truly in the fact that we change people's perception of what they were able to do. Placido had some big ideas, but a lot of the staff under him did not think that it was possible. I think, again, this comes back to you don't need to give a country a lot of money. Luckily, because Bissau was small and nobody was paying attention--let me just tell you in general what happened.<o:p></o:p> Q: Sure, sorry. [laughs]<o:p></o:p> DELEA: I came in on a two-month detail. I came in as the support for the first month, for the first three weeks. Then I was a team lead after that. But there were two of us in-country at that point. We had an FETP [Field Epidemiology Training Program] program, the STEP [Surveillance Training for Ebola Preparedness] program, which was the surveillance--oh gosh, I can't even remember these names. It was an Ebola program, basically a very basic field training epi program that was done specifically for Ebola. We had enormous success with that, our STEP program, and we brought in mentors from Portugal, or from Brazil. The Brazilian FETP program sponsored, and one girl was from Argentina, and one girl was from Colombia. Basically, South America's FETP program sponsored Bissau. We worked with TEPHINET [Training Programs in Epidemiology and Public Health Intervention Network], which is a regional co-ag [cooperative agreement] we have in South and Central America. We worked with them to bring these people into country for a ten-week training program. We were able to train sixty people, I think. We had enormous success. These people were trained very well. Our going out into the field, our training exercises, and their projects, what they brought back. We actually identified chikungunya, which they said didn't exist, and we identified that. We actually did have chikungunya in Bissau. And there were a couple other things. We identified some outbreaks that were going on and tried to think about how the country needed to deal with some of those that the country apparently knew were going on, and was ignoring. But it came to light and we're like, how do we deal with these? That was one of the big things.<o:p></o:p> I spent a lot of time, aside from just these, being the technical lead and meeting endlessly in all of these different work group meetings about how we prepare the country, we did this training. And then I did a lot of training. I spent a lot of time with Placido. He was my basic person, so sometimes I would just go sit in his office and be like, what do we need? I did very, very basic training on [Microsoft] Excel. A lot of their surveillance was based on Excel, and they didn't even know what a cell was. A lot of these people were not computer literate at all. They were scared to be computer literate. So I did a lot of training. Then of course, there's people who want to do pivot tables in Excel. It was kind of like, I had to do training for, what is a cell in Excel? And how do you add two cells together, and how do you put a word versus a number? All sorts of stuff like that, all the way to how do you develop pivot tables that we can do some pretty--more advanced analysis than they were able to do before they understood that technology. So, stuff like that.<o:p></o:p> We were trying, and then they wanted some evaluations, so I spent a lot of time working with two of their people. In the time that I was there, Placido actually made an evaluation group. He identified and hired three people that would be in charge of evaluation for the agency as a whole. Which meant we went back and we looked at their strategic plan and some of the plans, and we started selecting evaluation indicators. We went back to IHR, what they had to do with the International Health Regulations, and started looking at, how could the countries start evaluating what they were able to do and not do? And how could we use that data to improve their system? These were the kind of things and the conversations.<o:p></o:p> Because there were only two of us, sometimes only me, in that first kind of sixty-day period, and I actually closed the program. I went in January and I closed it on April 1st. Then I came home, and at that point I was still working at NCEH, and I came home and went back to NCEH. While I was in-country, I was offered a job in global health in the Global Health Security Agenda program, running the Bissau country program. We would, of course, never have a country director, we would never have a program in-country, but it was, how can we work with this country? We've got eight million dollars, seven-point-some million dollars that we can spend. What can we do?<o:p></o:p> Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Delea Prevention Transcript Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Ebola - Oral History Transcripts Oral History A resource containing historical information obtained in interviews with persons having firsthand knowledge. Transcription Any written text transcribed from a sound We were really working hard, and it was frustrating because we hadn't opened. It's just hard when you see the need is so great and you're not getting anywhere. We really needed some good news, and I remember the day they reopened the schools. The schools had been closed for nine months--there were no children on the streets at all. It was weirdly quiet. I remember the day they opened the schools, driving out to Connaught Hospital and seeing all these kids in their school uniforms marching off to school. I just thought, oh my God, we're on the back end of this. Things are going to start to get normal again. It took a really long time for that to happen. We still had cases and clusters, and even after we got to zero, we got another case, but that to me signaled like we're on the back end of this. It's contained, if not controlled entirely. But it's contained, and we're on the back end. This is a country that had lost so much that just seeing the kids walking to school was just this vision of normalcy that there hadn't been any of it for months. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Callis Normalcy Transcript Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Ebola - Oral History Transcripts Oral History A resource containing historical information obtained in interviews with persons having firsthand knowledge. Transcription Any written text transcribed from a sound Q: Were there any moments, keeping that in mind, that the country was in charge, where as an advisor from somewhere else you kind of disagreed with an aspect and you had to work through some disagreements? MARTEL: Yes, and I remember some very funny things, like for example, one day I received a call from Atlanta. People were saying, Lise, you need to tell Dr. Sakoba that it doesn't make sense to put ThermoFlash in all the schools. It's very costly. The kids are not at higher risk. Actually they're safer in the schools because most people being infected are people that are taking care of bodies. You need to advise him to ask the president to reopen the schools and this ThermoFlash thing, forget about that. Instead, just make sure that if a kid is sick, they go back home. Anyway, so I arrive in the meeting, and Dr. Sakoba comes in the meeting, despite having received this feedback from CDC, and he says, "We need ThermoFlash in all the schools." I'm kind of a little puzzled by it, but trusting him a lot, I said, "Dr. Sakoba, can I talk to you for a minute?" And I closed the door and said, "Dr. Sakoba, I want you to explain to me why it's important to have ThermoFlash in schools." He looked at me and he paused, like he was deciding how he was going to say that to me. And then he said, "You know, Lise, when foreigners leave Guinea and come to Guinea at the airport, we have ThermoFlash, right? And we take the temperature of everybody, correct?" I said, "Yes." He said, "Okay, so we see on TV a lot of white people, foreigners, temperatures being taken, people are being monitored for temperature," he said. And then he said, "When you go to your country, you get monitored for temperature, and you have a proper apparatus to do that, right? So what message are we telling parents if we say, we're going to do that here, but in the schools, your children are not quite important enough to have a ThermoFlash?" He said, "The point is not that the kids need to have their temperature taken. The point is perception of the community, and if you want the buy-in of the community to help us to do activities, you need to give them what they want. And right now they're scared. They're scared for their children. Their children is the most precious thing they have, and you have to show them that you're willing to do anything to help them protect their children. If you do that, we're going to buy a lot of goodwill from the community." And I said, "Dr. Sakoba, I totally understand." I was like, "We need ThermoFlash in all the schools." [laughs] So sometimes the decision is not purely scientific. Public health involves a lot of psychology also. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Martel Safety Transcript Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Ebola - Oral History Transcripts Oral History A resource containing historical information obtained in interviews with persons having firsthand knowledge. Transcription Any written text transcribed from a sound ALPREN: The main projects I've been involved in, the main theme of my work over the last year, has been semen. [laughter] Because Ebola was found to persist in bodily fluids, particularly immune privileged sites--the sites that don't get much blood supply, much immune cell supply--for far longer than we initially thought when the outbreak started. When I was discharging men from ETC in Aspen, we would say to them, "Look, Ebola has been found in semen for longer than other bodily fluids, and we think probably about three months, so you should use condoms." That's the kind of advice, that was the basic advice. I could have probably put it in a slightly more articulate, official way, but that's kind of how it was said. It quickly became evident that it was potentially present for a lot longer than three months, but probably the chances of actually causing sexual transmission were low. That's really where we're at now. We've had examples of sexual transmission from survivors well over a year, well over fourteen, fifteen months from the time of their infection, but they are very isolated cases and very rare. However, when you've got three, four thousand, however many survivors we've got in Sierra Leone, forty-odd percent of whom are men, most of them are men of sexually active age. They all need testing, they all need counseling, they all need to change their behavior because you don't know which one person--we don't know for sure if having cleared Ebola RNA [ribonucleic acid] from your semen, it stays away. We don't really know what negative means, what not detecting Ebola RNA in semen means. One of the things that I say when I'm teaching about Ebola is--I don't know, do you know how many people work in this campus of CDC? Q: I have no idea. [laughs] ALPREN: No? I use the example of Melbourne University, where I teach, where there are about forty thousand undergraduate students. It's a big--it's a big-- Q: We have a large college campus next door with Emory [University], too. ALPREN: Exactly. So a big university campus, a few tens of thousands of people. Probably most of them, if not all of them--not all of them, ninety-odd percent have had chicken pox, a very common infectious disease. But everyone kind of knows it. We know a lot about chicken pox, but there's stuff we don't know, and there's problems we have with it still. We can't treat it very well. Shingles comes along. Sorry, this is a bit of a longwinded explanation. However, before this Ebola outbreak, there had been just over two thousand recorded cases of Ebola ever. And there have now been less than thirty thousand cases of Ebola recorded. So less Ebola than there has been chicken pox at Melbourne Uni now. We know nothing about this condition. Our level of understanding is low, but accelerating very fast. And that's been reflected in--so many times, the uncertainty about the counseling, even that the politicians or the public health people should be giving the politicians early in the outbreak, and the confusion that happened, not just in West Africa but also in America, in Australia, in Europe, when there were cases. I do think we've learned a lot about communicating uncertainty. That's one thing I do think we've learned a lot about. The speed at which the information is changing, we've gone from saying to male survivors, three months, to six months, to a year, to [shrugs]. [laughs] To a year? Well, there's no RNA in your semen, and that sounds great. Keep in touch. We're not totally sure what that means, but you've had a couple of negative tests, so whoopee. Which is kind of where we're at, at the moment. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Alpren Persistence Transcript Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Ebola - Oral History Transcripts Oral History A resource containing historical information obtained in interviews with persons having firsthand knowledge. Transcription Any written text transcribed from a sound [I'm facing a lot of stigma and discrimination in the] community that I found myself. But [unclear], we decided to really form the association. We started to form the survivors' association, that we that survived--I came up with the initiative for us to form the association so that people will see us as vulnerable ones. Because some of us have lost all our families. It's not an easy thing. So I'm coming to form the association and trying, fighting hard at least to really know that we too, we are patriotic citizens, we're the survivors. Because the association is a legitimate association. We are sanctioned by His Excellency the President, Dr. Ernest Bai Koroma, using us as--doing community mobilization. Some of the quarantined homes, we go there. Build confidence in some of the lives of people, explain our challenges, explain my challenges to them, my story to them that you have to be patient. I have gone through it. For me, Daddy Hassan, I lost all of my family. So do just be patient when you're sick. Just call 1-1-7. Don't be afraid. They will take you to the treatment center. Then, you will come back. As you can see me, Daddy Hassan. So with this, I think we formed the association to complement the efforts of the government by then in the fight against Ebola, responding [unclear]. We have about 4,052 survivors in Sierra Leone. Then also, we have a lot of orphans, about ten to twelve thousand orphans now. We are now advocating for these people because we are their leaders now because I am the national spokesman for the survivors' association in Sierra Leone now. I think advocacy is the thing we should really focus our attention to the world because since we have the passion for our members, the vulnerable ones, I think for us to really come out here to explain our challenges, what we are facing in terms of the livelihood aspect, capacity building. Then also, we have what we call "aftermath illness" now. The health issues. Just after treatment center, we turned back to our community. We are facing a lot of complications with the survivors in Sierra Leone. A lot of complications. We have twenty-three health complications now that we are facing due to aftermath illness. Some of the hard treatment, because some of the medicine that they poured in our system made some of these complications, started inflaming out. So we have to detail the joint pain, muscle pains, headache, eye problems. We have some survivors that have cataracts in their eyes, uveitis, menstrual problems, visual problems. We have a lot that we are facing in Sierra Leone. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Kamara Sequelae Transcript Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Ebola - Oral History Transcripts Oral History A resource containing historical information obtained in interviews with persons having firsthand knowledge. Transcription Any written text transcribed from a sound Back to the Ebola survivor that I met, she said that even people in their area of town--I'll think of the translation, they're little--in their neighborhood, she said, yeah, there were people that wouldn't walk by them or people still didn't understand that they were actually a survivor. MSF did a lot to put together certificates so they could show people. But there hadn't been an outbreak of this magnitude. People didn't understand. They just knew Ebola as people got sick, they die and it's contagious. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Moorhouse Stigma Transcript Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Ebola - Oral History Transcripts Oral History A resource containing historical information obtained in interviews with persons having firsthand knowledge. Transcription Any written text transcribed from a sound [T]raditions around burial. I wanted to know the nitty-gritty. "I heard that you wash the body. How do you do it? Why? What is it about burial that so many people get it?" My driver was Muslim-born but he became Christian. His name is Abu. Like Abu Bakar, that's very Muslim, but he's Christian. How ironic is that? But that's how it is in Sierra Leone. You're born Christian, you become Muslim. You're born Muslim, you stay Muslim. All kinds, but they all live happily together. It's incredible how they do that. He explained to me about the Muslim burial, and then once I got to Bo and Kenema, which are heavily Muslim, they explained to me how the burial is done. So usually men wash men's bodies, women wash women's bodies. Someone close like your sister. If I die, my sister or aunt or female relative would wash the body starting from the right side and then the left side. You either have the best clothing you've ever owned and then wrapped with white shroud, and there's a whole list of processes: how that body gets transported to the gravesite, who goes into the grave to hold that body right-side-down facing where it's supposed to face. Then, there's a rectangular hole. They put trees vertically and leaves vertically and then put the soil in. I said, "Why do people do that?" They said, "Because, one, they don't want animals getting to the body, but also, how can the body breathe if the soil is right on top of the body?" "Like, breathe? Please explain further." Many people explained to me that the day of burial is the best day of your life because you then will enter the eternal, painless world where all your ancestors are waiting for you. If you're not cleaned, you won't be welcomed. Ancestors will not accept you, so then you end up floating in this gray area. That's why when the burial team takes the body from you, they will find the body, dig it up, wash it, because you want your loved one to be in a painless world. Wouldn't you want that for your loved ones? Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Lee Ritual Transcript