I am in the lunchroom in my Cambridge office reading the NY Times front page article from last week, A Hospital From Hell, in a City Swamped by Ebola. Ebola in Liberia, Sierra Leone, Guinea. The Facebook updates, this BBC video, emails from Liberian friends, NPR’s coverage, UNICEF, Oxfam and MSF’s outreach, they all pull me back. They make me remember some of the worst days of the AIDS epidemic. I see the photos of hospitals and the faces of those on the front line of the Ebola fight and I’m pulled back to another hospital from hell.
While there are critical differences between AIDS and Ebola, such as the number of infections, the incubation period, and the time from infection to death; It is the similarities—the lack of adequate treatment, weak and failed African health systems, infections among health workers, the horror and the destruction of an infectious epidemic—they pull me back.
It’s the mid 1990’s.
I’m 23, a Peace Corps volunteer working in Nkhotokota District Hospital in Malawi, Africa. AIDS surrounds me. Death surrounds me. No one knows how many people are infected. I can not breath. My heart stops. My chest is heavy. I know what death smells like. There is death in my office, in the wards, on all sides of my office, around my house, at the schools, in the post office, at the bars.
I try to hold a meeting and I hear people wailing as their beloved takes their final breath. I tremble. I can’t breath. Another coworker–the Chief Medical Officer–has tested positive. Our Head Nurse has tested positive. I walk the halls of the AIDS ward. The skeletal bodies. These are human beings. I am shocked. There is no cure. There are no drugs here. My neighbor is infected. No Mr. Matengere, not you too. Later I sit at his bedside. The life has drained. It will be hours now. His twin baby boys, I hear them laugh. It isn’t clear yet whether they are infected as well.
I am counseling patients. I practice saying the words:
It is hard to tell you this, but your test came back positive. You have HIV. I am sorry. There is no cure.
Something heavy sits on my chest. I am surrounded by men with TB coughing and children made still and motionless by malnutrition, and the opportunistic infections that disgust me. I can not look at that woman. It is harrowing. The world doesn’t care. In the US, people are eating donuts and bowling. A child has died in my arms. A baby. A dead baby child is in my arms. I’m trembling and I can not breath. My blood test came back positive. I have to get out of here. I have to survive. It’s a mistake. But I experience–for moments–what the death sentence feels like.
Each day, they come to my office. They come to my home. They come to me in the street. I look into their eyes. I hold their pain:
Can you help me? My parents have died. My child is sick. My husband…
I can not hold their pain. It is too heavy. It crushes me. I can not breath and I am trembling. Each morning the medical officers describe the condition of the sick. There is nothing for these patients. We wait for each of them to die. I am dying as I listen, at least it feels that way. One morning, there are two patients who have bled out. Ebola? No, we don’t have Ebola here. We have HIV. Ebola would be worse than AIDS. I close my eyes tight. If I didn’t hear it, it doesn’t have to be true. I wait. No more patients bleeding out. Alcoholism and other diseases cause hemorrhagic death too. No Ebola here. We are somehow lucky. I want to survive. I want my coworkers to survive. I want the patients to survive. Death is winning. I am not sick. Still, this feels like death. Death pulls me.
Back to 2014.
I fold the NY Times. This is Ebola, not AIDS. In the past 20 years, we’ve made gigantic strides in treating and caring for people living with HIV because finally, the people who could make a difference, started to give a damn.
The Ebola virus causes an illness which is often fatal if untreated. The current outbreak in west Africa is the largest and most complex Ebola outbreak since the virus was discovered in 1976. There have been more cases and deaths in this outbreak than all others combined. It has spread from Guinea across land borders to Sierra Leone and Liberia… World Health Organization
The outbreak of Ebola in West Africa has become a major regional threat. Approximately 3,865 people have died since March. UNICEF estimates that 8.5 million children and young people live in affected areas. UNICEF
You can help. I can help.
Stand by those on the front Lines. Please donate today.
Stop the Spread of Ebola in West Africa
These organizations need our support to make more beds available, to conduct house-to-house educational programs, to purchase chlorine, gloves, raincoats, plastic mats, blankets, tarpaulins, and syringes for those on the front line.
UNICEF: https://www.unicefusa.org/donate/stop-spread-ebola-west-africa-your-gift-matched/18771 If you donate to UNICEF, your gift will be MATCHED $1-for-$1 by the Paul G. Allen Family Foundation.
THIS IS SIMPLE: Text Ebola to 864233 (UNICEF) for a $10 donation
Medicine Sans Frontiers https://donate.doctorswithoutborders.org/onetime.cfm