4 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 We had been running the system up to now, and it's really working well, and now we have also--so after the Ebola crisis was declared over, the country now started moving to a more or less normal health delivery system. Some of the facilities which were closed, they began opening up. It also meant that Riders had more work to do carrying samples from those areas which were once closed and now they're opening up. And also the ETUs and the triple Cs were decommissioned once there was no more Ebola. When one is put in an ETU, there's that sense of fear that Ebola still exists, so they needed to decommission those ETUs and now the other health facilities were opening up. Now, one challenge that faced Riders for Health is that since it was the only organization transporting specimens, the initial plan was that Riders would pick up specimens from a specific number of facilities, which was 302, in our case. But with the opening up of the other facilities, there was an overwhelming number that would balloon up to about five hundred and so, over five hundred facilities Riders had been picking up samples from. That had a lot of pressure on the resources in terms of the fuel, in terms of the motorcycle maintenance, and also in terms of the courier time that he spends on the motorcycle, that relative fatigue that is associated with riding a motorcycle for a long period of time. Of course, fatigue, you end up having more accidents, and that means that we also had more breakdowns. Of course, our budget was really not matching up, all the time, with this sudden change of operations. This is how it became a challenge. What was necessary was now to go back and discuss with the health facilities, discuss with CDC, discuss with the health facilities, tell them Riders is only picking from these 302 facilities. The Ministry needs to find other means to transport samples to bring them to Riders for Health pickup points, and then Riders for Health will pick them from there and then take them to the laboratory. This has been the discussion of, I think, six months, and now we're getting there. The ministries and other partners, actually, are beginning to--they've actually accepted that Riders cannot pick samples from each and every other corner of the country, but stick to the 302 facilities, given the amount of resources that are planned under the current project. So it's really now working, we will continue to push to make sure that everybody keeps on understanding the fact. 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 Grison Pressure 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 My role in the Ebola response is basically I came here under Riders for Health. The main role that I played as an individual under the organization was to set up the sample transport system, which was meant to respond to Ebola samples from wherever they were going to be generated. By that time, generally most of the health facilities were closed. Only the major places, only the major referral hospitals, which were at the county level and some of the district-level hospitals, were operational. There were also ETUs [Ebola treatment units] and the CCCs, which were what they used to call the triple Cs, the community care centers where they would actually put in people who were suspected to be having Ebola or those who are already known to be having Ebola, where they would keep them and then transfer them to the ETUs for the treatment of Ebola. My main role, when I came here, was first to have an assessment of where can we actually start from, in terms of setting up the sample transport system that would take care of all those samples, which needed to be referred to the laboratories for testing. 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 Grison Role 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 RAO: It is not a pleasant job. I felt awful. I felt awful for them, for the people doing the job. They often didn't have the proper training. They didn't have the proper equipment or the proper PPE. They're pretty much despised by the population because one of the reasons that Ebola was being transmitted during funerals is that they have these cultural norms that they must, must do to bury somebody who's died. And there are these people dressed in blue garb, all made up, coming to take away their loved one, and sometimes not doing a great job explaining where this loved one was going, how they could--where this loved one was going to be buried, what they were going to do with the body. It also announced to the rest of the villagers that there was a suspect Ebola--or there was a confirmed, at that time, because they were confirming that there was an Ebola patient in that house. So they would get screamed at. They would get spit on. People would take pictures of them and post them on social media. These people just did not want to have their faces shown. It was bad. And it was hard work because it's not like they could drive the car up the hill. Sometimes it's like a half-hour trek up the hill to where this body is. Shrouding the body, spraying everything down, because they had to carry all their equipment up with them, all of the bleach water to do the spray and the de-conning [decontaminating]. They de-con as they come down, they de-con the path on the way down, too, they're de-conning where the body was, de-conning the way down and-- Q: They're carrying this body? RAO: Carrying the body. I'm dying, and all I'm carrying is my backpack. I'm like sweating buckets. I'm like, I'm not going to make it. [laughs] They're carrying a body in full PPE garb. I don't know how they do it. And they're totally unappreciated. I just felt really--it was a hard job, and it was definitely unappreciated, they were definitely unappreciated. But it was necessary. That was one of the ways that they were able to control the outbreak, was to stop these burial practices and to do safe and medical burials. 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 Rao Burial 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: So you go to Anniston with all of these strangers.<o:p></o:p> BORNEMANN: All these strangers. All these strangers. It's almost surreal as I look back. We recently had our two-year anniversary of returning home earlier this month, and in looking at the pictures and the reminders, in some ways it seems like a million years ago and in some ways it seems like yesterday. Anniston is such a blur in so many ways. I feel like I was a child then. The highlight for me of Anniston was because of my dad's familiarity with the country of Liberia, his passion for the country and its people, his knowledge of the current state there and, of course, his service as a corps officer himself, I asked for him to come and give sort of the cultural awareness piece. He drove down to Anniston and gave us a brief on Liberia, and he got to meet some of my brand-new friends. I felt very lucky to have had that opportunity. I wish other teams were able to hear him, because again, his passion and his knowledge around the country. But for me, I got that extra squeeze before I left.<o:p></o:p> Q: Were there some important messages of cultural sensitivity and understanding what it's like to live in Liberia that you felt were especially important that you brought with you?<o:p></o:p> BORNEMANN: Yes, very important, and ones that I was aware of, but I was worried about others. Not necessarily our group but just in general. I worry that a lot of people tend to think of Africa as a "land of savages," and I think in very narrow viewpoints it's "why do we care about a bunch of savages," if you will. That saddens me to my core because they are human beings just like each and every one of us and they happen to not have the resources that we have, and people were getting very, very sick. What my dad brought to it was certainly the sense of humanity. Even besides the savagery reputation, misinformation, that I think some people have, it also should be noted that Liberia had recently in the past thirty years been through two civil wars. That's pretty scary stuff. There's a lot of security concerns there. Based on those headline-type areas, people could assume one way about Liberia and its people. But the reality is they're actually very warm, they're very loving. For a culture that is like that, and they have a special handshake when they greet each other, to not be able to touch was huge and certainly worth noting, so that when we did enter, we had that awareness of the importance of physical human interaction to the people of Liberia. Of course, that's a generalization, but that's just in terms of the cultural piece. That was something, again, that humanity piece that I'm so grateful my dad certainly brought to me but also to our entire team before we left.<o:p></o:p> Q: Were there other parts of Anniston that you found particularly helpful for preparation? Going in?<o:p></o:p> BORNEMANN: Sure. I think we had the look of having a tremendous training cadre of I think primarily CDC folks. The woman who sticks out the most for me is Captain Holly Williams, who is here at CDC.<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 Bornemann Training 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 The one thing, the thing that I think I would want to--the message I would want to convey most of all about what it was like working in the red zone, is not how impersonal the PPE made it, but actually how personal it made it. Because Ebola is very isolating illness. The moment the Ebola box is opened, you leave your kids. You don't touch your children. You don't touch a dead body. You cannot touch, you cannot go near a sick person. One of the most instinctive things is to care for someone who's really sick. Just to even hold the hand, or to mop their brow, all that, you cannot do. Someone's got Ebola, you cannot go near them. And PPE, the only people in the world who could crouch down and clean up someone who was having profuse, like, ten liters of diarrhea every day, uncontrollable water coming out of them, the only people who could crouch down and clean the sheets and change their clothes and wipe them down and wipe their brow and give them a sip of water were the people wearing the PPE. So actually, it felt really privileged, and it felt really close. It was the most intimate patient care experience I've ever had. It was crouching down with a--this fantastic Sierra Leonean hygienist called Princess who--she did not take any shit. [laughter] If she wanted to spray your shoes, even if someone's like, "Why are you spraying my shoes here, Princess?" She's like, "No, Charles, stop! Shoes!" It's like, okay, whatever, whatever. But because she cared about the people she was in there with, she cared about keeping things clean, she cared about doing things right. We did a ward round together, and we did it efficiently, we did it well, and we were going well. I think the second- or third-last patient we had was a fourteen-year-old girl who was dying, and she had just been cleaned like half an hour earlier, and she was already horrendously soiled. She was lying on her mattress on the floor, that she'd put her mattress onto the floor as many of our patients did. We saw her, we did the kind of clinical bit, and then I wanted to move on. And Princess was like, "Are you leaving her?" I was like, "No, we're going to see our next two, and then we'll come back, because we've got enough time." You're only meant to be in the red zone for an hour, but we had probably been there for forty-five minutes at that point. It's like, we've got two more people--no, it must have been one, because we would have been about the forty-five minute--we had one more person who needed a proper review. Then we had three or four people in the convalescent tent. They were all well. They were getting better, their blood tests were just still positive. I said, "What we're going to do is we're going to see this one more person, we're going to sack it off, convalescent tank can wait for another time, and then we're going to come back and clean this girl up." Princess was very happy about that. We did that, came back, and together, Princess on one side of the mattress, me the other side, we crouched down. You're wearing this big PPE with these heavy aprons and gumboots and the hood, and your goggles are steaming up, you've been there an hour. It's really, really hot. Your clothes, the scrubs you've got on under your PPE is absolutely saturated, like you have jumped in a swimming pool, saturated with water. I have one photo of me, before-and-after photos getting on scales. I'd gotten on scales before I went in, and then when I came out, I didn't drink any water, I just went and changed my scrubs into dry scrubs and got back on the scales before I had water. I'd lost 1.3 kilos [kilograms] in an hour. And you hear stories of people losing more. Anyway, so we were crouching down, sopping wet, and got new bedsheets, got new clothes, cleaned her up, made her comfortable, gave her some water. She would have only been clean until the next people came past, I'm sure, and they would have done the same. But that was the most intimate patient care experience I've ever had in my career. No question about it. 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 Care 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 MCCARTHY: Well mostly, when we went for training, they taught us how to take care of--but first of all, the dressing. How to dress to enter in the unit. How to put on our PPE. That is donning and doffing. How to put on the PPE and how to take off the PPE. You see? Mostly putting on the PPE is difficult, but not as [much as] taking it off because when you are in there and you are exhausted, you are [unclear]. You just want to rush to take off your PPE, and it is during that time, if you are not careful, you will infect yourself. You have to be very careful in doffing, that is, taking care of your PPE. [interruption] Q: Did you find that training sufficient? MCCARTHY: Yes, for the moment. Later, again, we did other training during the course of the Ebola. Other training we carried out. IRC [International Rescue Committee] came, they trained us, gave certificates. We are doing in training. Q: Does that mean that sometimes your procedures changed after you received later training? MCCARTHY: No, the procedures--it's the same procedures. Although at times, procedures changed in donning. But almost the same. Q: Sure. Like what, for example? MCCARTHY: It's just a refreshment training. It's not to go out of the way. It's a refreshment training. Q: Do you remember what specifically might have changed about the donning? MCCARTHY: The donning? Well, at first, like putting on the face shield. At first, the face shield before--after you put on your coverall, before you put up the head, the cover of the coverall, you have to use your face shield. But when you put it on that way, you put the face shield then you put on the coverall, the cap of the coverall. But when you enter, you won't take a long time and it will fog. The place becomes clouded and that [unclear]. So the next, other training, again, other guy said, you put on the coverall, everything, then you put on the face shield. 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 McCarthy Training 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 GASASIRA: [One of the things that came to the fore] as part of the outbreak was infection prevention and control. Suddenly, there were so many partners in this space trying to do infection prevention and control. They had gotten support from different organizations, and yeah, a lot of people got this in place and said okay, we're here to train, we're here to ensure that you're doing the right--again, I must also say that out of this experience, we started trying to put in place much stronger coordination mechanisms, and they worked to different extents. I think it helped, it helped, but there were still areas that were oversubscribed, and then there were some areas which were undersubscribed. Of course, there were big things. There were big, big ticket items like health infrastructure, the health facility infrastructure, which was not something that many partners wanted to go into. That's one, it's quite expensive; two, there's some skills that are required. At some point, the government was a bit frustrated that everybody was going for the softer, easier areas of the recovery, and that was a challenge. Q: Was it one that you were able to resolve in any way, or did it just continue to be a challenge? GASASIRA: I think [there was a lot of progress made]. 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 Gasasira Challenges 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 started something] picked up by both Guinea and [Sierra Leone], was what they were calling ring IPC [infection prevention and control]. Once a case was identified, the IPC colleagues would draw a ring around the case, a geographical ring, and within that ring go to all the health facilities and assist IPC practices and reinforce what needed to be done in terms of IPC. Because initially, if a case has been seen in an area, more often than not, that case had been to a clinic, had been to the hospital, had had contact with the health facility. And maybe if you had had contact with that health facility, another patient at that time would have moved. It became a standard response practice, and it was called ring IPC, and I think a few articles have been written about it. That was something that was started here and that was replicated in other countries after we all shared this information. 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 Gasasira IPC 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 Then I think one of the other areas that I saw that I both heard and then I saw with my own eyes was more infection prevention and control and also teaching healthcare workers that were not at Ebola treatment centers about Ebola. Do they know how to screen for that? Do they know how to triage? Do they even know what the case definition was? So I paired up with a local MSF staff nurse and that was a big passion of hers. What we did was we ended up holding a training actually at the Ebola treatment center. We brought in a lot of different local healthcare workers and had this training session with them and discussed a couple things and then what we also did was we went to some of the hospitals and health centers to give trainings to the people there and also ask, what do you think Ebola is in this? And when we were at some of these hospitals and we'd see Ebola patients in regular wards, but they just didn't recognize it as Ebola. They just thought it was malaria. It really was eye-opening to know that okay, we really need to educate the non-Ebola-treatment-center staff and the hospitals what is Ebola because this is going to spread so much quicker. 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 Narra Education 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 There were a lot of those types of challenges, too, policy-type challenges. Quarantine was a huge, huge issue. When to implement it, how to implement it, who was responsible for implementation, who was responsible for releasing people from quarantine, were military people going to be involved? It was very, very complex, and people had different--there were some wildly varying ideas of what to do about this. I think WHO, CDC, made the same recommendation, but I think for some political reasons the government of Sierra Leone felt like they had to quarantine people. Originally, we were not keen on the quarantine idea because, again, there was no support for it. Basically, they were going to tell people they had to stay in their houses for twenty-one days, and we said, they have no water, they have no food, these people live day-to-day. You can't do this and they won't do this. Eventually, it will all break. And that was a big part of the problem. That's exactly what we saw. So that was an interesting aspect of the deployment. 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 Moffett Quarantine Transcript