Asst. U.S. Surgeon General recalls “noble mission” treating Ebola in Liberia

By Zoë Fisher

In December 2014, Rear Admiral Richard W. Childs, MD, Asst. U.S. Surgeon General, deployed to aid in the Ebola crisis in West Africa. His two-month stay was filled obstacles, prayers, safety concerns, and boot-sweat competitions. He presented his mission to around 60 Loyola University Chicago employees in the Center for Translational Research and Education (CTRE), his decorated uniform hat on the side of the stage.

When Childs first received an e-mail stating, “Congratulations, you’re considered for deployment,” he felt mixed emotions, among them excitement. An Ebola epidemic was declared in Sierra Leone, Guinea, and Liberia in spring 2014. Childs described his trip to Monrovia, Liberia as a “noble mission.”

The 70-person team, was comprised of physicians, nurses, engineers, safety inspectors, and other health care providers. They were stationed at the Monrovia Medical Unit (MMU) which primarily focused on treating Liberian health care workers. Before they got there, around half of all health care workers in Liberia had been infected, and out of those infected, half had died. In December 2014, the Centers for Disease Control cited an 85 percent fatality rate for people who were infected.

Before they got off the plane, Childs remembered his team leader gathered everyone on the team and gave them an encouraging speech: “For God’s sake don’t get infected,” Childs said with a chuckle.

The heat was one of the most difficult problems, he said. The medical team wore personal protective equipment (PPE) that covered every part of exposed skin on their bodies. In 90 to 100 degree weather, the health care providers could only manage to stay in the suits two hours without overheating. Their boots would fill with sweat by the end of their two-hour shift. By the end of the trip, the team would have competitions for who had the least amount of sweat in their boots.

The 30-minute assembly and disassembly often caused a lag in patient care. Sometimes, Childs would have to leave a patient early and by the time another physician got dressed and came to take over, the patient would’ve unfortunately passed away, he said.

Morale was high in the first few weeks. Every time health care providers entered into the area that housed the patients, they would huddle up and say a group prayer after they had put on their PPE. By the end of the mission, Childs said he started leading the prayers himself.

The mental health staff became more involved in assisting the deployment team. After about four weeks in Monrovia, things started to take a toll psychologically and emotionally, he said.

At the end of the mission, the team had treated 42 total patients. Out of 18 with confirmed Ebola, 10 survived. The phases progress from early, with nonspecific symptoms, to the “wet phase,” which consists of extreme diarrhea. The next phase often includes hepatitis and leptomeningeal carcinomas, where diseased cancer cells spread to the brain and spinal cord. Some patients would improve after these phases, but then would suddenly start having hiccups. Childs said it was a Liberian rumor that anyone with hiccups would die. From Childs’ experience, he unfortunately found that to be true.

At the end of his deployment, Childs remembers the reactions and speeches of the patients he treated. Particularly, one woman who survived but her mother and two brothers died from the disease. Once discharged, the survivors were given a paper that said, “I had Ebola, I’m now Ebola free.”

Childs described his mission as successful. The Monrovian Medical Unit had custom IV fluids, an extensive pharmacy, a laboratory and ultrasound equipment, which was much more than what other Ebola medical camps had, he said. The MMU had a 56 percent survival rate when most places in the country had 20 to 25 percent.

Liberia was declared Ebola free in May 2015, about three months after Childs’ team returned to the United States. Recently, similar public health service initiatives have been deployed to Flint, Michigan and South Dakota. Childs continues to work as a senior investigator at Laboratory of Transplantation Immunotherapy at the National Institutes of Health.