Ebola update

Two days ago we received an email from the CDC Chief - Tom Frieden stating that we have moved to EOC Level 1. This is the highest level of activation, reserved for the largest-scale responses, which often require substantial agency-wide effort.The Emergency Operations Center (EOC) moving to a Level 1 means that "all hands are on deck" for the Ebola response. Level 1 is the highest on a scale of 1-6 and it means that increased staff and resources will be devoted to the outbreak. It enables CDC to pull resources from across the organization to use in the response efforts. Since I cannot post the email here, I will post a link to the accompanying news article, which you can read here. 

In addition to the announcement about Level 1, Dr. Frieden's email also included a call for volunteers to help the CDC response in the region, particularly French speakers. I don't know how I feel about volunteering at the moment...it is something I have to talk to Michael about. On one hand, having worked and lived there, I know Liberia and its health system like the back of my hand; on the other hand I am not going to put my family at risk and add to their worry. Something to think about...

Regardless of volunteering, I will monitor the situation closely from my post in Dar es Salaam.

Ebola shows no signs of fading away in Liberia

The Ebola scare in Liberia and neighboring Sierra Leone and Guinea is getting worse every day. There are now two Americans that have been infected with the virus. One of the popular doctors in Monrovia - Dr. Brisbane - passed away over the weekend. Another popular doctor in Sierra Leone is currently infected. If you live in that part of the world it feels like perhaps this is the "big one".

Over the weekend I have come to know from my ex-staff in Liberia that Dr. Samuel Brisbane passed away from Ebola. Liberians are grief-stricken by the loss of the Chief Medical Officer of the most famous referral hospital in Liberia - JFK Hospital. I had the privilege of meeting Dr. Brisbane during one of the many meetings at the Ministry of Health and Social Welfare (MOHSW) when I worked in Liberia. I did not know him outside professional interactions, but he always brought a good spirit to the JFK hospital whenever I visited for work. And, most importantly, he was respected as an authority in medicine. I can only imagine the morale of JFK staff at the moment, after their beloved leader passed away. 

There are numerous mainstream media reports on Ebola in West Africa. However, I feel that most of them are not comprehensive. While I have known for a while - through my ex staff in Liberia - that the situation on the ground is not entirely reflective of what is being reported in the media, most of the my friends and family back in the US are not being told the complete story. Only recently are we hearing reports of communities refusing access to Médecins sans Frontières (MSF) in Sierra Leone and Guinea. Some of us have been hearing these reports from almost three months ago. This animosity towards MSF is important to notice because MSF is one of the few organizations that has consistently been at the forefront of the outbreak response. If MSF is denied entry into communities and cannot provide care, the crisis will undoubtedly get worse. My ex staff in Liberia tell a similar story of family members threatening clinic staff with physical violence and taking away their infected family members from the hospitals to care for them at home. The communities do not trust the medical care and believe that quarantine is a way of "controlling" the locals. In fact, the situation in Liberia has gotten so bad with families hiding their infected family members that President Ellen Johnson-Sirleaf had to issue a government order stating that hiding Ebola-infected members from medical care is a punishable offense. 

We are now hearing of a suspected Ebola death in Nigeria that may have come from Liberia. If Ebola has spread from Liberia to Nigeria, I am afraid it has spread to the countries in between - Côte d'Ivoire, Ghana, Benin, and Togo - because of porous borders. As of a few days ago, President Johnson-Sirleaf has restricted movements in and out of Liberia. The land borders are to remain closed but the Roberts International Airport remains open with possible testing for passengers who are entering and leaving the airport. Considering my past experience in Liberia, I do not put much stock in how or if this testing will be conducted. However, it is a important step in disease surveillance. 

So far all my ex staff are safe and sound, in spite of working in the infected areas. I pray for their safety and hope that the outbreak subsides. This is one event we need to closely monitor and take measures to contain the infection. As we used to say during our work meetings at the MOHSW - "God bless Liberia!". Even though I do not live or work there anymore, Liberia will always be in my heart and well wishes. Liberians always believe God will save Liberia and its people...this is one time that God may want to step in and give hope to the Liberians. 

Lone Star Forever!

Nigeria brings back Liberian memories

It has been a hectic past few months, and I realize I have not posted anything since last August, spare for the one entry last week about Ebola in Liberia. Since August 2013 I have been traveling like a mad man. I may have spent 6 weeks at my home base (Nairobi) between August and end of 2013. No wonder I haven't posted anything. Since my last trip to Myanmar, I have been to Washington DC, Cambodia, Myanmar (again), South Africa, Nigeria, Boston, DC again, Chicago, and NYC. All except NYC were work travel. Good times!

I was in Abuja, Nigeria for two weeks back in October. This blog post has been lingering in my drafts since then. What made me go back to my drafts and finish the post is my latest visit to Abuja few weeks ago. If you have ever been to Nigeria you know that it plays a major influence in African affairs, particularly West African affairs. Nigerian music, food, and style is emulated all over Africa. Nigerians are friendly people who are proud to showcase their culture, heritage, and they love welcoming foreigners to their country. The hospitality I encounter every time I am in Abuja is warm and welcoming.

As my friends know, my travels revolve around work and food. I was glad to be back in the land of spicy goat pepper soup, jollof rice, egusi soup, and eba. I was in heaven when I tasted goat pepper soup after a gap of almost one year. I haven't had goat soup since leaving Liberia. Since I pray at the temples of street food, I had to venture out and try Suya, which is meat marinated in a lot of spice and grilled on coal. Let's just say my mouth and insides were on fire after eating a few skewers of beef suya. Delicious!

Suya

The typical West African escargot is a must try if you are adventurous. I used to eat a lot of escargot in Liberia and Coté d'Ivoire, but I haven't found the same ever since I moved to Kenya. East Africans do not appreciate giant snails like the West Africans do. Imagine my joy when I took my first bite of Nigerian escargot after a gap of almost one year.

Escargot

Spicy yam cakes

Egusi soup

Besides eating my way through half of Abuja, work was productive. I trained a lot of people on conducting research in malaria so we can use the information to strengthen access to antimalarial medicines in Nigeria. But enough of that...who wants to read about boring work anyway!

Some of the trainees

In between the training sessions I took a short break to walk around the hotel where we were delivering the training. I went to inspect the pool area and heard some familiar sounds. I turned around and noticed a bird cage with two African Grey Parrots. The sight released a flood of memories. Some of my friends remember Isaiah, the African Grey we had in our Liberian home. He was our child and he lived a good life until the day he passed away. I used to take Isaiah on a walk in our garden....that's right folks, I walked a bird! Watching these two African Greys reminded me of Isaiah and his shenanigans. A teary eyed moment....

Isaiah's family

I also visited the Arts and Crafts Village in Abuja. Wonderful gift ideas and some interesting items. While the beads, leather items, and jewelry were beautiful, there are some items at the market that left me feeling uneasy, sad, and angry. I saw merchants openly selling ivory items, whole elephant tusks, lion teeth, and a variety of endangered animal skins. I almost cried when I saw a group of Chinese tourists bargaining for ivory chopsticks. I wanted to bring an elephant to the market and let it trample all the merchants and buyers. It was quite disturbing! I bought some beads, two pairs of leather sandals, and left the arts and crafts village in anger.

Arts and Crafts Village

I am not sure when I will be back in Nigeria again, but I look forward to eating some good food and experiencing the wonderful Nigerian hospitality.

Ebola in my beloved Liberia

The past few weeks have been very nerve-racking due the Ebola outbreak in Guinea that has now spread to Liberia. As many of you know, there is an outbreak of Ebola in Guinea at the moment that has reached crisis levels with over 60 deaths attributed to the disease. You can read more about the outbreak here and here.

Like most countries with porous borders, Ebola outbreak in Guinea means Liberia and Sierra Leone are next in line. Senegal has already shut its border with Guinea to prevent spread of Ebola. Reports have emerged about deaths in northern Liberia from Ebola, particularly in the Foya and Zorzor districts of Lofa County. I fondly remember the time I spent working in the Foya and Zorzor hospitals when I was working in Liberia. Lofa County was my favorite to visit because I could stay at the United Nations battalion stationed in Voinjama. The battalion was Pakistani and it had the best chicken curry and nan I had in West Africa.

Needless to say I was worried about my ex-team members who work in Lofa county. I called/ emailed them and they are all safe as of today. They are disappointed by the response from international community towards containing the disease. Being health care workers, they are worried about the fact that they still do not have adequate personal protective equipment. However, that does not stop them from providing health care for the needy. No matter where I've been in the world I always encounter health care workers who spring in to action regardless of their safety. It is what makes the clinicians a unique class of people. I am proud to be one of them.

I would like to share one of my favorite pictures from Liberia, which was taken in a clinic in Lofa County...which is now the seat of Ebola scare. I am showing one of the nurses how to enter antenatal care data in to the ledger. I miss my staff...

This Ebola scare has brought back so many fond memories of Liberia and concern towards my staff. I will be closely monitoring the developments and pray that the disease is contained and the Guineans/ Liberians/ Sierra Leoneans do not suffer any further.