MONROVIA, Liberia — A cluster of American uniformed officers gathered in the sticky heat this week to say a prayer for a dead Liberian nurse, the first loss to Ebola at the only U.S. government-operated clinic in West Africa.
The 34-year-old nurse's death Wednesday hit the American staff hard at the clinic charged with caring for health care workers sickened by Ebola.
"She was one of us. She was a health care provider just like all of us," said Russ Bowman, 53, of Albuquerque, a lead physician here. "This is what this unit is for — to provide care to folks ... providing care for the people of Liberia. We're here to back them up. And we weren't able to save her. And that's a tragedy."
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The nurse — whose name was not made available — was unconscious and already failing when she arrived by ambulance the night before. "It's a shame she wasn't here a lot earlier," said Jennifer Malia, 41, of Laytonsville, Md., a lab medical technician. "I believe we really could have helped and maybe had a different outcome."
Her arrival at such a late stage of the disease raises concerns that the new clinic, which opened Nov. 7, is not being adequately publicized by Liberian health officials. Four Liberian health workers with Ebola are being treated there. All are improving. "I'd like to be able to answer that, definitively, yes (word has spread)," says Paul Reed, the chief medical officer. "But I don't know that."
Chief Medical Officer Paul Reed.(Photo: Gregory H. Stemn for USA TODAY)
When President Obama announced in September he was sending U.S. troops to Liberia, it was with the caveat that none would directly treat patients infected with Ebola, which has killed 3,000 in this country.
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But with health workers among the most threatened by the disease, the responsibility for a clinic devoted to treating doctors and nurses who become ill fell upon the U.S. Public Health Service, a little-known branch of the Department of Health and Human Services. "It's a very noble mission, an honorable mission," says Reed, who left behind a wife and four children to deploy.
The Public Health Service is one of the nation's seven uniformed services with members who carry military ranks and wear uniforms similar to those of the U.S. Coast Guard. They often are sent to domestic and international health disasters.
This is the first time Public Health Service members have operated an Ebola clinic. All 69 workers here are volunteers. "I told my oldest before I left 'This is what God wants us to do. We're here to help people. That's what Mommy does,' " says Malia, a married mother of three. Malia and her colleagues live on pre-packed military Meals Ready-to-Eat. The clinic sits near Liberia's international airport and looks much like a military field hospital with air-conditioned, barrack-like structures assembled neatly into a green zone and a hot zone for Ebola patients.
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Clinicians follow painstaking procedures for donning and taking off protective gear, thoroughly dousing themselves with a chlorine mix to kill the virus as they shed the suits.
With the hoods and masks on in the red zone, they are nearly unrecognizable. So many carry a small photo on their suit allowing patients to see what they look like.
Bowman says he has developed a healthy respect for Ebola. Clinicians are methodical about how they move around patients. One staff member always watches for any safety breach. "It's kind of like a rattlesnake," Bowman says of the disease. "You don't poke it. You know what it can do. You prepare for it. You avoid things that can put you in harm's way."
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The Liberian nurse was in the last stages of the disease, her body teaming with the virus. The U.S. Public Health officers washed her repeatedly with water tinged with chlorine and kept fluids flowing into her veins, hoping that by morning she might improve. But the nurse was too far gone, Bowman says. "She was unresponsive when she came in and clearly very ill. ... We did what we could for her," Bowman says. "It's a very tenacious illness."
Lt. Shane Deckert and CDR David Lau work inside the Monrovia Medical Unit.(Photo: Gregory H. Stemn for USA TODAY)