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Alumnus helps fight Ebola in Sierra Leone

Photo courtesy Dan O'Leary
A local official speaks to quarantined villagers. For quarantine to succeed, daily communication between public officials and villagers was essential to monitor for new cases, address concerns, and to coordinate an adequate supply food, water, and non-food items.

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In order to not become contaminated, a family reluctantly stands a safe distance away from the burial of their loved one. They gaze upon Public Health Officials dealing with the body to prevent Ebola from spreading to any more people. Though the family would prefer to prepare and bury the relative themselves, they know the risk of contracting the disease. This is called a “safe burial.”

Dr. Dan O’Leary, an epidemiologist with the US Centers for Disease Control Prevention (CDC), class of ’78, traveled to Sierra Leone on Oct. 25 for 45 days. As part of the CDC, he was sent to help fight Ebola.

“The CDC director volunteered the Centers for Disease Control’s staff to go over and help fight the epidemic to try to control it in Africa so it doesn’t spread widely all over the world,” O’Leary said. “Hundreds of CDC staff, like myself, have volunteered and been sent to West Africa.”

The four countries that the CDC staff is fighting Ebola in are Sierra Leone, Guinea, Liberia, and Mali. According to O’Leary, “this is the largest [single] global outbreak response CDC has ever done.”

O’Leary was one of those deployed to “assist Sierra Leonean public health colleagues to implement processes needed to slow the epidemic.” He has been working for the Wyoming Department of Health for nine years, which runs programs and investigations that detect and prevent diseases, and also involves helping out Tribal Health with its health care.

His task in Sierra Leone was to “support local efforts,” to bring the population back to health, and to eliminate the threat of Ebola, as much as possible. This meant ensuring that “case surveillance,” which is tracking and finding cases of Ebola in villages and isolating those who were sick, and “contact tracing,” which is following up with the families to make sure Ebola isn’t spreading, were done “correctly and consistently.”

The contact tracing involved visiting the homes “every day,” and “if there were other people getting sick, [they] got them out of their homes quickly for testing and treatment.”

The citizens of Sierra Leone sometimes grudgingly accepted the help of the local Ministry of Health and CDC. “Unfortunately, early in the outbreak there were some missteps in coordinating the response and, as a result, [there were] instances where houses were quarantined and food didn’t come right away,” O’Leary said. “Several days passed when houses didn’t have food.”

News of this spread to other villages, making it difficult for ministry officials to find everyone who was sick. “We once visited a small village with local contact tracers and we saw two people who were ill. We [asked] if there were other family members or others in nearby homes who might be ill, [but] the people didn’t trust us, and so they told us nobody else was ill,” O’Leary said.

Since Ebola is spread through body fluids, like saliva and feces, any family members who are taking care of sick patients are at high risk of getting sick themselves.”

— Dan O'Leary

“And then, the next day—it was very eerie because everyone was so quiet and unwilling to talk to us—we returned to the village and eventually were told of approximately 14 people who earlier that day were taken by ambulance and on foot out of the village. Most of them would test positive for Ebola. That clearly told us they were distrustful and had, the previous day, been harboring many sick relatives and neighbors in the houses only several feet away from us.”

At the time O’Leary and his colleagues had arrived in this village to help, the public health system had become more organized, so houses weren’t put under quarantine until food was available to be delivered. However, “this village either did not know—or didn’t believe—that conditions had improved” and didn’t trust the health officials to help their sick until they were extremely unwell and less likely to recover.

According to O’Leary, those who live under the same roof as someone with Ebola often contract the disease themselves. “When someone gets sick they often don’t have access to health care, so the family takes care of them. That means they feed them, clean up after them, and help change [his or her] clothes. Since Ebola is spread through body fluids, like saliva and feces, any family members who are taking care of sick patients are at high risk of getting sick themselves.”

Taking care of a loved one also involves preparing the body, after his or her death, and burying the body. The time when an infected person is most contagious is right when they die, and therefore it is imperative for the family members to allow trained health officials to prepare the body for the “safe burial.”

Keeping a safe distance from the deceased was not the only rule of thumb. “Communities were put on ‘high alert’ to keep away from crowds and avoid any direct physical contact, which was also followed by CDC workers. School and many businesses were closed to limit spread of Ebola.”

In order to enforce the message, health officials tirelessly worked, played radio messages and recordings on vehicle-mounted loudspeakers, posted billboards, visited homes, and enlisted influential individuals among communities to help spread awareness.

“Ebola is one of the most deadly diseases that I’ve ever worked with or around and it requires a great deal of respect and a great deal of awareness so one doesn’t accidentally infect themselves by being careless,” O’Leary said.

He was extremely careful to not get infected, for Ebola “kills 70-90 percent of untreated people it infects and, with early treatment, that percentage can be reduced to about 50 percent.”

As of Jan. 5, Sierra Leone suffered a total of 2,915 deaths due to Ebola, according to Center for Disease Control and Prevention. The next day, 62 more people were added to the list.

Every day, O’Leary and his colleagues would ask each other how they were feeling to make sure it hadn’t spread to any of them. They even took precautions while driving together, seating only two in the back seat in order to maintain distance from each other.

Ebola is one of the most deadly diseases that I’ve ever worked with.”

— Dan O'Leary

“When [O’Leary] said he was thinking about volunteering, I encouraged him to do so. He could use a change of pace, and I knew he would be a big help. He had been to Africa twice before and liked it there,” O’Leary’s wife, Becky, said. “As the time drew closer to his departure I got a little apprehensive, but [O’Leary] assured me the CDC would do everything in their power to keep them safe.”

O’Leary knows firsthand that Ebola is deadly and has yet to be defeated, even if it’s not claiming the attention of those in the United States. “People should know that, even though it’s not in the headlines every day, there are hundreds of health professionals over there fighting this and that it will take several more months to get ahead of it.”

“Right now, we are still in the middle of the war.”

Elizabeth Driver is a Copy Editor for The Patriot and jcpatriot.com.

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Alumnus helps fight Ebola in Sierra Leone