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U.S. Opens New Ebola Clinic in Liberia

Liberia is in the midst of a building boom to help control the spread of Ebola. In support of the Liberian Government’s Ebola response strategy, the United States is in the process of constructing 15 Ebola treatment units (ETUs) in this hard-hit nation. Across the country, teams of workers are busy moving dirt, laying concrete, trucking in construction materials, and erecting large white tents.

The first ETU to be built and staffed by the U.S.—in the city of Tubmanburg—started receiving patients on November 18. Now, a second ETU supported by the United States is operational in the city of Kakata, about 45 miles northeast of Monrovia. Built by the organization Save the Children with support from USAID, the ETU is being run by International Medical Corps (IMC), which is also managing another ETU in Bong County, Liberia.

Members of USAID’s Ebola Disaster Assistance Response Team (DART) visited the site on November 22, joining a Liberian delegation that included the Assistant Minister of Health and county health officials. Below is an inside look at the USAID-supported ETU, including those areas that are currently off limits to cameras now that the facility is open to Ebola patients.

11.22.14-Kakata-ETU-sign-photo-credit-Justin-Pendarvis-USAID-OFDA About an hour’s drive northeast of Monrovia, in the heart of Liberia’s rubber cultivation belt, the second Ebola treatment unit (ETU) in Liberia to be constructed and staffed with U.S. Government assistance is now receiving patients. / Justin Pendarvis, USAID/OFDA


The facility was built by Save the Children with USAID providing construction materials, gravel, cots for patients, generators to power the ETU, and other support.  The red fencing separates public areas from Ebola “hot zones.” Photo courtesy: Justin Pendarvis, USAID/OFDA The facility was built by Save the Children with USAID providing construction materials, gravel, cots for patients, generators to power the ETU, and other support. The red fencing separates public areas from Ebola “hot zones.” / Justin Pendarvis, USAID/OFDA


USAID is funding International Medical Corps (IMC) to operate the ETU in Kakata. Here, USAID Disaster Assistance Response Team (DART) Deputy Justin Pendarvis (left) gets a tour from IMC Emergency Response Team Director Sean Casey (right). / Alisha McMichael, USAID/OFDA USAID is funding International Medical Corps (IMC) to operate the ETU in Kakata. Here, USAID Disaster Assistance Response Team (DART) Deputy Justin Pendarvis (left) gets a tour from IMC Emergency Response Team Director Sean Casey (right). / Alisha McMichael, USAID/OFDA


More than 160 people—mostly Liberian national staff—work at the ETU. For the past two weeks, IMC’s medical team received rigorous training on Ebola patient care, safety protocols, and ETU management. Photo courtesy: Alisha McMichael, USAID/OFDA More than 160 people—mostly Liberian national staff—work at the ETU. For the past two weeks, IMC’s medical team received rigorous training on Ebola patient care, safety protocols, and ETU management. / Alisha McMichael, USAID/OFDA


The 88-bed ETU, which opened on November 22, has received a number of patients. Some were discharged after testing negative for Ebola. Photo courtesy: Alisha McMichael, USAID/OFD The 88-bed ETU, which opened on November 22, has received a number of patients. Some were discharged after testing negative for Ebola. / Alisha McMichael, USAID/OFD


NO DETAIL OVERLOOKED: Inside the clinical care areas are electrical outlets where patients can play music or charge their cell phones to keep in touch with their loved ones. USAID provided generators to power the ETU. / IMC NO DETAIL OVERLOOKED: Inside the clinical care areas are electrical outlets where patients can play music or charge their cell phones to keep in touch with their loved ones. USAID provided generators to power the ETU. / IMC

ABOUT THE AUTHOR

The Ebola Disaster Assistance Response Team (DART) is overseeing the U.S. Ebola response efforts in West Africa. The DART includes staff from across the U.S. Government, including USAID’s Office of U.S. Foreign Disaster Assistance (OFDA), the U.S. Centers for Disease Control and Prevention (CDC), and the Departments of Defense and Health and Human Services.

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Key Populations Essential to Realize AIDS-Free Generation

Sex worker working on the Phnom Penh riverside. /  Ian Taylor

Sex worker working on the Phnom Penh riverside. / Ian Taylor

As we commemorate World AIDS Day this year, let’s take a moment to remember how far we’ve come, and where we must go. There are currently 35 million people living with HIV worldwide, and 13.6 million of those people are receiving antiretroviral therapy. New HIV infections continue to decline each year, with 2.1 million in 2013, which was 38 percent lower than in 2001. However, over 4,000 people continue to die from AIDS each and every day.

In accordance with the immense toll that HIV and AIDS have taken on the world, the U.S. Government established the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) in 2003 as the single largest commitment by any nation to combat a single disease. Since then, working closely with many partners, PEPFAR has supported lifesaving antiretroviral therapy for more than 6.7 million men, women and children. As a key implementing agency of PEPFAR, USAID has made significant contributions to this remarkable progress. But, together, we have more work to do to finish the job.

UNAIDS has identified the 90-90-90 targets by 2020. These milestones aim to have 90 percent of people living with HIV know their status, 90 percent of people who know their status receive treatment, and 90 percent of people on HIV treatment having a suppressed viral load so their immune system remains strong and they are no longer infectious. In order to achieve these goals and have a lasting response to this epidemic, we must examine what is required to sustain HIV treatment for decades to come.

India World AIDS Day 2008 / AFP/Narinder Nanu/Getty Images

India World AIDS Day 2008 / AFP/Narinder Nanu/Getty Images

The vision for the next phase of PEPFAR is partnering to deliver an AIDS-free generation with sustainable results.However, a sustainable response to this epidemic requires intensified action to address major ongoing challenges such as health care financing, health systems and new technologies for treatment and prevention. And there is a special need for increased attention to the human rights of key affected populations. These include sex workers, men who have sex with men, transgender persons and persons who inject drugs.

The high vulnerability of key populations to HIV is disturbing. Compared to the general population, sex workers are 14 times more likely to be infected with HIV; men who have sex with men are 19 times more likely to be infected; and the limited data we have on transgender women suggest that they are 49 times more likely to be infected with HIV. Equally unsettling are the global estimates that the number of people living with HIV who inject drugs range from over 1 million to slightly less than 4 million people.

Barriers to essential services prohibit these figures from coming down. Stigma and discrimination, violence, criminalization, bad or ineffective policies, and opposition to civil society engagement present real challenges. One of the most egregious barriers is the lack of acknowledgement by governments and other leaders that key populations even exist and/or are underserved. As I have observed over the years, the most insidious form of oppression is to ignore a people.

Fortunately, that pessimistic view is tempered by the knowledge that these barriers can be overcome. We know from experience that effective programs can reach key populations with high quality, effective services, and that key populations infected with HIV can be linked to the care and treatment services that they desperately need. On Thursday, Dec. 4, we will highlight the importance of key populations in the HIV epidemic at the D.C. launch of USAID’s PEPFAR-funded LINKAGES project.

The U.S. Government’s official theme for World AIDS 2014 is Focus, Partner, Achieve: An AIDS-free Generation. This theme captures the core elements of what is needed to reach this goal, which is outlined in the PEPFAR Blueprint. We must deliver the right thing, in the right place and at the right time. This means focusing on the highest impact interventions, bringing them to scale in key geographic areas and among the most vulnerable populations, including men who have sex with men, sex workers, injecting drug users, and transgender persons.

On this World AIDS Day, nearly 35 years into the epidemic, I am extremely proud of our collective progress. But, while an AIDS-free generation is within our reach, we must not stop until it becomes our reality.

ABOUT THE AUTHOR

David Stanton is the Director of USAID’s Office of HIV/AIDS

Building Ebola Treatment Units to Foster Hope, Healing in Liberia

Liberian Vice President Joseph Boakai, middle, gets a tour of the U.S.-built Tubmanburg Ebola treatment unit from USAID partner International Organization for Migration, which will be running the facility / Carol Han, USAID/OFDA

Liberian Vice President Joseph Boakai, middle, gets a tour of the U.S.-built Tubmanburg Ebola treatment unit from USAID partner International Organization for Migration, which will be running the facility / Carol Han, USAID/OFDA

In the Bomi Hills northwest of Monrovia, in an area that used to be the region’s iron and diamond mining center, it’s hard to miss the new “precious resource” that has become critical to Liberia’s fight against Ebola.

Four stark white tents gleam in the sun, the most prominent part of the new Ebola treatment unit (ETU) in Tubmanburg, which is the first ETU to be built and staffed by the United States in Liberia.

Liberian Army Capt. Glee Dilliard Dada led a team of Liberian soldiers who worked closely with the U.S. military to build the facility. Despite the rain, heat and construction setbacks, the Ebola treatment unit was built in 35 days / Carol Han, USAID/OFDA

Liberian Army Capt. Glee Dilliard Dada led a team of Liberian soldiers who worked closely with the U.S. military to build the facility. Despite the rain, heat and construction setbacks, the Ebola treatment unit was built in 35 days / Carol Han, USAID/OFDA

Construction on the 2-acre site was overseen by the U.S. Defense Department in close partnership with the Armed Forces of Liberia. More than 60 people had to overcome the rain, heat, poor roads and supply shortages to build the site in 35 days, completing the ETU earlier this month.

“Especially in this time of national crisis, it has been rewarding to be out here and assisting,” said Armed Forces of Liberia Capt. Glee Dilliard Dada, who supervised the Liberian military construction crew. “I am very overwhelmed with a lot of pride. In a month’s time we did all of this.”

The Ebola treatment unit (ETU) in Tubmanburg is the first ETU to be built and staffed by the United States in Liberia / Carol Han, USAID/OFDA

The Ebola treatment unit (ETU) in Tubmanburg is the first ETU to be built and staffed by the United States in Liberia / Carol Han, USAID/OFDA

USAID Disaster Assistance Response Team leader Bill Berger called the ETU an extraordinary effort, saying, “It took strong partnership to build this ETU. It will also take strong partnership to provide care to patients.”

USAID partner the International Organization of Migration, or IOM, has stepped forward to manage the ETU under the leadership of the Liberian Ministry of Health and Social Welfare. For the past two weeks, IOM’s medical team—made up of local and international health care workers—received rigorous training on Ebola patient care, safety protocols and ETU management.

Within the 2-acre site is a changing area where local and international staff with the International Organization for Migration will be donning googles and other protective equipment to care for patients. / Carol Han, USAID/OFDA

Within the 2-acre site is a changing area where local and international staff with the International Organization for Migration will be donning goggles and other protective equipment to care for patients. / Carol Han, USAID/OFDA

More than 120 members of IOM’s team are now prepared to care for patients. Tejanie Golafaley, a local resident and Ebola survivor, is especially eager to speak to patients at the ETU about his experience beating the disease.

“When I got Ebola, people didn’t want to come around me. I was stigmatized by Ebola,” Golafaley said. “The best thing I can do is talk to [patients] …. I’m going to tell them I’m a survivor. I want to give them hope.”

Tejanie Golafaley, an Ebola survivor, saw it as his personal mission to work at the USAID-supported Ebola treatment unit in Tubmanburg. “I want to explain my story to patients [so that] they can start to take courage.” / Carol Han, USAID/OFDA

Tejanie Golafaley, an Ebola survivor, saw it as his personal mission to work at the USAID-supported Ebola treatment unit in Tubmanburg. “I want to explain my story to patients [so that] they can start to take courage.” / Carol Han, USAID/OFDA

ABOUT THE AUTHOR

Carol Han is the Press Officer for USAID’s Ebola Disaster Assistance Response Team [DART], which is overseeing the U.S. Ebola response efforts in West Africa. The DART includes staff from across the government, including USAID’s Office of U.S. Foreign Disaster Assistance, the U.S. Centers for Disease Control and Prevention, and the Departments of Defense and Health and Human Services.

The Power of Toilets, Simple Medicines, and Strong Policies to Stop Diarrhea

Children outside of the health center in Kampong Thom province in Cambodia, where oral re-hydration therapy is provided to children who have diarrhea. PATH/Heng Chivoan

Children outside of the health center in Kampong Thom province in Cambodia, where oral re-hydration therapy is provided to children who have diarrhea. / PATH/Heng Chivoan

More than 2.5 billion people still do not have access to a toilet. As we #CelebratetheToilet on this World Toilet Day, we should remember that universal access to toilets is one of the many necessary steps to ending preventable death.

Day in and day out, I’m reminded of the power of innovation to save the lives of women and children. Often,we forget how successful low-cost innovations and solutions—and the policies that support them—have been in advancing health progress. Like the toilet.

It might seem like an odd thing to celebrate, but the invention of the toilet has been a critical contribution to modern-day public health. Access to toilets, safe water, vaccines and simple interventions like oral rehydration solution (ORS) and zinc have the power to stop deadly diarrhea and save lives. But like all health innovations and interventions, toilets need more champions and complementary policies to reach their full lifesaving potential.

 Children and their families attend community health education sessions in Kampong Cham Province. Diarrheal disease is a leading infectious killer of children under 5 years old. PATH/Heng Chivoan

Children and their families attend community health education sessions in Kampong Cham Province. Diarrheal disease is a leading infectious killer of children under 5 years old. / PATH/Heng Chivoan

Around the globe, local leaders and advocates are playing a critical role in bringing innovations, interventions and policy together to accelerate health gains within their countries. It was heartening to see India’s new prime minister, Narendra Modi, embracing innovative thinking and advocacy to solve the health problems caused by open defecation. As a result, he has the country talking about toilets. Diarrheal disease is devastating in India—as well as other parts of Asia and Africa—where it is one of the leading causes of death among children under the age of 5.

India is not the only country making progress in the fight against deadly diarrhea. Another example is in the Mekong Delta, where my organization, PATH, has helped policymakers in Vietnam and Cambodia evaluate and refocus their policy efforts to stop diarrheal disease—a leading killer of children in their region as well.

About 10 years ago, when new formulations of ORS and zinc, the two cornerstone interventions for severe diarrhea, were recommended for widespread use by the World Health Organization (WHO) and UNICEF, it became clear that the diarrheal disease policies needed to be updated in both Vietnam and Cambodia. Unfortunately, making these updates was not a government priority at the time. Local health workers, NGO advocates and scientists knew more needed to be done to prioritize diarrheal disease so that lifesaving medicines could reach the children dying in their local communities.

Latrine in Cambodia. 2.5 billion people-- 1 in 3 worldwide-- lack access to a toilet, and open defecation is a major culprit behind the tragic number of diarrhea –related deaths. PATH/Anne Aumell

Latrine in Cambodia. One in three people worldwide–or 2.5 billion–lack access to a toilet, and open defecation is a major culprit behind the tragic number of diarrhea–related deaths. PATH/Anne Aumell

Using our unique advocacy model, PATH worked with these local champions to help them assemble a compelling case to present to the ministries of health in each country, which included a package of strong evidence based on the WHO’s global policy recommendations, more effective treatments, the high burden of disease, and support among communities and potential partners. This informed the governments’ policies and compelled action to increase access to ORS and zinc, better equipping health workers to deal with the scope of the diarrheal disease problem in both countries.

As the global health community, including USAID, works to end preventable maternal and child deaths in a generation, country leadership and collaboration for stronger advocacy is key. At PATH, we are always gratified to help local communities and technical experts take action to achieve policy improvements that will save lives.

Students learn healthy hygiene habits and help maintain school toilets in the GIZ Regional Fit for School Programme in Cambodia. Photo credit: Ivan Sarenas

Students learn healthy hygiene habits and help maintain school toilets in the GIZ Regional Fit for School Programme in Cambodia. / Ivan Sarenas

I am confident that we can continue to expand toilet use, improve water and sanitation, and advance diarrheal disease policies around the world if we equip and empower more local leaders and experts to be champions of health innovations, interventions and policies. Together, we can bring the basic essentials of our everyday lives to the rest of the world.

ABOUT THE AUTHOR

Steve Davis is President and CEO of PATH, an international NGO working to drive transformative innovation to save lives.

Recapturing Growth in Ebola-Stricken West Africa

With funding and support from USAID, construction crews work quickly to build a new Ebola treatment unit in Monrovia, Liberia, in front of the former Ministry of Defense building, Oct. 1, 2014

With funding and support from USAID, construction crews work quickly to build a new Ebola treatment unit in Monrovia, Liberia, in front of the former Ministry of Defense building, Oct. 1, 2014 / Morgana Wingard

Unlike a civil war or natural disaster, an epidemic does not destroy property. But it sharply increases the cost of doing business, with powerful effects on employment and investment.

This is happening in Guinea, Liberia and Sierra Leone where the secondary impacts of the Ebola crisis have been seen in terms of shuttered businesses and closed schools. But just as economies can stall during an epidemic, we also know what expedites their recovery—a robust business climate that encourages private sector investment.

New Ebola cases continue to be recorded in Guinea, Liberia and Sierra Leone, but as health workers have begun to contain the epidemic, we are already turning our attention, in partnership with host governments, to the task of restoring business activity in these countries. Liberia and Sierra Leone had been growing strongly before the crisis, driven largely by foreign direct investment in the mining sector; Guinea’s growth was weaker but had been expected to increase in 2014. All three economies have contracted sharply in the latter half of 2014, with full-year gross domestic products now expected to be at or below 2013 levels.

A first look at a 25-bed critical care hospital—staffed by U.S. medical professionals—in Harbel, Liberia, that will treat all Ebola health care workers in the country, Oct. 15, 2014

A first look at a 25-bed critical care hospital—staffed by U.S. medical professionals—in Harbel, Liberia, that will treat all Ebola health care workers in the country, Oct. 15, 2014 / Morgana Wingard

Public and private investment plans have been scaled back, suggesting that slow growth will linger through 2015 even if the epidemic is contained early in the year. This is actually not driven primarily by the loss of labor to sickness and health care, but rather by what economic epidemiologists call “social distancing”—when people avoid interacting with each other in order to avoid a perceived risk of viral transmission.

The benefits to workers, firms and farms to restoring normal economic activity can provide a powerful counterbalance to the effects of social distancing, suggesting that capacity utilization, employment and income will rebound as the epidemic is contained.  But tomorrow’s economy depends on today’s investment. The pace of economic recovery will therefore depend crucially on how private-sector firms view the evolving business environment.

Containing the outbreak will do much to restore that environment, but firms across the size spectrum—including potential new entrants—will be wary of their exposure to health-related losses even as the overall health system is strengthened. Reforms that enhance the quality of regulation and reduce the costs of doing business are therefore crucial components of the recovery effort.

Pick-up trucks-turned-ambulances drive hours through dirt roads in Bong County, Liberia, to collect patients, Oct. 9, 2014

Pick-up trucks-turned-ambulances drive hours through dirt roads in Bong County, Liberia, to collect patients, Oct. 9, 2014 / Morgana Wingard

The World Bank’s newly released business-climate survey of 189 economies—Doing Business 2015:Going Beyond Efficiency—highlighted sub-Saharan Africa as home to five of the 10 top reformers, four of which are in West Africa. “Doing business” reforms are changes in the procedure, time or cost of conducting business in a country, such as reducing the time it takes to get a construction permit or the number of approvals required to open a business. USAID has supported the Doing Business project since its inception in 2004.

Several of the highlighted business reforms from this year’s top reformers in West Africa (Benin, Cote d’Ivoire, Senegal and Togo) were the result of coordinated harmonization efforts led by the Council of Ministers of the Organization for Harmonization of Business Law in Africa. These efforts encouraged  business-friendly innovations throughout the region such as one-stop shops for registering a business, easier land registry and transfer processes, and improved credit information systems—including in the countries most affected by the outbreak.

Liberia and Sierra Leone took the impressive step of establishing public credit registries in the past year, making it easier to get credit in these countries. The resolve demonstrated by member governments in setting a regional reform agenda and implementing meaningful changes for business also bodes well for increased regional trade, which USAID supports through its regional Trade Hubs in West, East and Southern Africa.

USAID has been working with many of the reformers highlighted in this year’s report and will continue to partner with governments in the region as they tackle both the immediate challenges and the secondary effects of Ebola. Better regulatory environments, supported by governments taking the right steps to attract both domestic and foreign investment, will help these countries recover and prosper in the future.

ABOUT THE AUTHOR

Stephen O’Connell is the Chief Economist for USAID

You Can’t Save Lives if you Don’t Fight Pneumonia

MCHIP immunization work in India.

MCHIP immunization work in India / JSI

For many problems in global health, we struggle to know the solutions.

Pneumonia is not one of them.

Since passing the 500 day countdown in August, the global public health community has talked a lot about what it will take to meet the ambitious Millennium Development Goals (MDGs). And one thing is clear: achieving MDG 4 – to reduce child mortality by two-thirds by 2015 – will not be realized without better addressing pneumonia, the leading killer in children under 5.

The good news is that pneumonia is preventable—and that safe, effective and affordable tools are helping to avoid and treat the disease.

Nepali village health worker counting the respirations of a sick infant

Nepali village health worker counting the respirations of a sick infant / JSI/Nepal Family Health Initiative

Pneumonia can be prevented by feeding children micronutrient rich foods, ensuring proper hygiene, including frequent hand-washing, and improving indoor air quality through well-ventilated cooking areas.

Most of all, the disease can be prevented by ensuring all children are vaccinated on schedule and treated promptly and appropriately if signs of pneumonia appear.

Devoted to combating the causes of under-5 morbidity and mortality, USAID’s flagship Maternal and Child Survival Program (MCSP) is celebrating this World Pneumonia Day by working to ensure that every infant in the developing world is fully immunized.

Health worker in Mali assessing the respiratory rate of a sick child

Health worker in Mali assessing the respiratory rate of a sick child / JSI

In 2013, MCSP’s predecessor program—the USAID-funded Maternal and Child Health Integrated Program—joined USAID and more than 100 partner organizations, along with national and global experts, to express support for WHO and UNICEF’s first-ever global action plan to simultaneously tackle the two leading killers of children—pneumonia and diarrhea. Implementation of this plan, linked with ownership by national governments and partners’ involvement, will make these goals a reality.

The Global Action Plan for the Prevention and Control of Pneumonia and Diarrhoea (GAPP-D) calls on all parties to coordinate their approach to fighting pneumonia and diarrhea, for which there are complementary interventions to provide protection, prevention and treatment.

Immunizing in Kenya

Immunizing in Kenya / MCHIP

On this day of reflection and action, let us commemorate the brief lives of the children lost to pneumonia—nearly 1 million every year worldwide—by vowing to support and focus on implementing the Global Action Plan and strengthening countries’ routine health systems in partnership with communities.

The fight against this deadly disease can be won. Children are not dying because effective interventions do not exist; they are dying because these interventions are not readily available for all. To dramatically reduce child mortality, we must achieve high and equitable coverage.

Through effective use of pneumococcal (PCV), Haemophilus influenzae type b (Hib), and rotavirus vaccines, vitamin A, zinc, oral rehydration solution, breastfeeding and other interventions, we can address MDG4.

Collectively around the world, we owe it to the future generation to give them the best start in life and protect them from preventable and treatable diseases like pneumonia.

ABOUT THE AUTHORS

Robert Steinglass is the Immunization Team Leader and Katrin DeCamp is the Senior Communications Specialist for USAID’s Maternal and Child Survival Program.

Bill Berger: “There is no book on responding to this Ebola crisis… we’re writing it now.”

Morgana Wingard This is the fifth blog in our Profiles in Courage series in which we’ve teamed up with photojournalist Morgana Wingard, who is on the ground with USAID staff in Liberia documenting the fight against Ebola. This series records the experiences of our Disaster Assistance Response Team staff on the front lines of the Ebola response – from the security officers, to public health experts, to information specialists – and offers their reflections on this historic health crisis.
General Darryl Williams, Bill Berger, and U.S. Ambasador to Liberia Deborah Malac.

General Darryl Williams, DART Team Leader Bill Berger, and U.S. Ambasador to Liberia Deborah Malac. / Natalie Hawwa, USAID

“There is no book on responding to this Ebola crisis… we’re writing it now,” says Bill Berger, Team Leader for the Ebola Disaster Assistance Response Team (DART) in West Africa.

A seasoned disaster expert, Bill has responded to more than 30 large-scale emergencies across the globe and led several DARTs for USAID’s Office of U.S. Foreign Disaster Assistance.

But how exactly are Bill and his team fighting this unprecedented Ebola epidemic?

“Day by day, pushing at a maximum speed on all fronts,” he says, and with every ounce of compassion and disaster knowledge they have.

As the DART Team Leader, Bill strategizes alongside the local governments and U.S. Ambassadors in the affected countries, the United Nations and NGO partners on the ground to mount the most effective aid effort possible. With Ebola, there are many complex technical pieces that need to come together to help save lives.

“We know the basic things that need to happen, such as building treatment centers, training health care workers, providing testing capabilities and coordination — but we also have a real opportunity here to transfer that capacity and boost national health care systems in West Africa.”

The DART is working across the region in Guinea, Liberia and Sierra Leone – each a unique country with its own dynamic for responding to Ebola. While there are challenges of navigating unknown territory for this unprecedented crisis, Bill draws strength from having the opportunity to help those affected by this tragedy. He’s also inspired by his team and the chance they have to contribute to such a critical and historic global issue together.

“Every DART is like living a full lifetime; you have many experiences and feelings in a short period, with so much confronting you daily,” he says. “Working with others during a crisis brings about wonderful and special bonds.”

Bill jokes that the DART will be giving each other the ‘Ebola bump’ — the new West African greeting of hitting elbows, adopted in lieu of a handshake due to the ‘no touch’ atmosphere — for years to come.

“Our DART is a very special group of dedicated people bringing in every piece needed for this Ebola response. It’s a great gift to lead this team.”

ABOUT THE AUTHOR

Morgana Wingard is a photojournalist documenting the many facets of the Ebola crisis in Liberia. Check out her guest posts from USAID’s instagram

First Look at a New Hospital for Ebola Aid Workers: 10 Photos You’ve Never Seen

Morgana Wingard This blog is part of our Daily Dispatches series in which we’ve teamed up with photojournalist Morgana Wingard, who is on the ground with USAID staff in Liberia documenting the fight on Ebola. Her photo series and blogs from the team offer unique angles into the many facets of the Ebola story – from life inside a treatment center, to profiles of the health care workers battling Ebola from the front lines, to the many ways the epidemic is impacting the health, economy and future of the nation.

HARBEL, Liberia—”Where have you done this before?” USAID Administrator Raj Shah asked on October 15, as he stepped through the taupe colored tent flap into the new 25-bed critical care hospital being built to treat all health care and aid workers who fall ill to Ebola. “Nowhere, sir. No one has,” replied an army engineer.

Historically, mobile medical units like this one provide versatile trauma care for military operations. In this case, the Department of Defense (DoD) and the U.S. Public Health Service (USPHS) customized the Monrovia Medical Unit to treat highly contagious Ebola patients.

Once complete, the hospital will be operated and staffed by a team of 65 specialized officers from the USPHS Commissioned Corps – an elite uniformed service with more than 6,800 full-time, highly qualified public health professionals, serving the most underserved and vulnerable populations domestically and abroad.

The Commissioned Corps will deploy clinicians, administrators, and support staff to Liberia to treat health care workers with Ebola, and to continue efforts by USAID, DoD and international partners to build capacity for additional care in Liberia.

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The new 25-bed critical care hospital being built in Harbel, Liberia to treat health care and aid workers who fall ill to Ebola. The new hospital is expected to be online in early November.


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Rear Admiral Scott Giberson (Acting U.S. Deputy Surgeon General and Commander of the USPHS Commissioned Corps Ebola Response) gives USAID Administrator Raj Shah a tour of the new 25-bed critical care hospital for all health workers who fall ill with Ebola while on the frontlines of the epidemic in Liberia on October 15, 2014.  


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Colonel Joann Frye, nurse, Officer in Charge, U.S. Air Force Air Combat Command 633rd IPTS and USAID Administrator Raj Shah inside the new hospital.


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Tents are connected by a covered passageway inside the “Hot Zone.”  Soon the only people inside this area will be health workers either as patients or suited up in personal protective equipment.


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Inside one of the patient wings of a new critical care hospital being built by the U.S. Department of Defense and the U.S. Public Health Service in Harbel, Liberia.


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The new hospital’s supply room.


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CAPT Ed Dieser (Engineer, USPHS Commissioned Corps Safety/Facilities Officer) gives USAID Administrator Raj Shah a tour of the new 25-bed critical care hospital for health workers who fall ill to Ebola while on the front lines of the outbreak in Liberia.

(All photos by Morgana Wingard)

ABOUT THE AUTHOR

Morgana Wingard is a photojournalist documenting the many facets of the Ebola crisis in Liberia. Check out her guest posts from USAID’s instagram

Paloma and Alisha: The Information Gurus Behind the U.S. Ebola Response

Morgana Wingard This is the fourth blog in our Profiles in Courage series in which we’ve teamed up with photojournalist Morgana Wingard, who is on the ground with USAID staff in Liberia documenting the fight against Ebola. This series records the experiences of our Disaster Assistance Response Team staff on the front lines of the Ebola response – from the security officers, to public health experts, to information specialists – and offers their reflections on this historic health crisis.
U.S. Information Officers Paloma Clohossey and Alisha McMichael, left to right.

U.S. Information Officers Paloma Clohossey and Alisha McMichael, left to right.

Though Alisha McMichael and  Paloma Clohossey’s jobs on the Ebola Disaster Assistance Response Team (DART) aren’t as high profile as the health care workers who suit up in protective gear everyday, one could argue that their role is just as vital to the U.S. response.

“Alisha and Paloma bring all the threads of the operation together for reporting and information collection — they know the ins and the outs of the response as a whole,” said Bill Berger, the Ebola Disaster Assistance Response Team Leader.

They are the DART’s Information Officers – also known as ‘IOs.’: the information gurus who compile, collate and verify all the information about the U.S. Government’s Ebola response efforts and the crisis at large. After absorbing every last detail and fact, they distribute them to team members on the ground and back to Washington, D.C. so that everyone is on the same page and has the correct information they need, when they need it.

In a disaster response environment – especially one like the Ebola epidemic, where everyday the international community is navigating new territory – information is critical. Alisha and Paloma constantly take in and filter information to ensure they’re up to date on the latest — no easy feat given the ever-evolving situation as the crisis progresses and the U.S. response gains momentum.

In fact, Alisha has been dubbed the DART’s ‘sync-master,’ responsible for tracking daily the progress of Ebola treatment units, community care centers, trainings for health care workers, burial teams, airlifts of relief supplies, and other response efforts – following the military’s Sync Matrix model. Meanwhile, Paloma writes daily updates about the situation on the ground to inform Washington and communicate key gaps, challenges and successes.

Being a DART IO requires a lot of attention to detail and long days, but working 24/7 doesn’t get them down.

“The best part by far,” says Paloma, “is getting to have the opportunity to do work that feels meaningful. I’ve been given a chance to contribute to something that I believe in.”

Adds Alisha, “This is a great team, and I know everyone gives their best everyday. That feels good.”

(All photos by Morgana Wingard)

ABOUT THE AUTHOR

Morgana Wingard is a photojournalist documenting the many facets of the Ebola crisis in Liberia. Check out her guest posts from USAID’s instagram

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“I’ve Never Had a Job Like This”: Life Inside an Ebola Treatment Unit

Morgana Wingard This blog is part of our Daily Dispatches series in which we’ve teamed up with photojournalist Morgana Wingard, who is on the ground with USAID staff in Liberia documenting the fight on Ebola. Her photo series and blogs from the team offer unique angles into the many facets of the Ebola story – from life inside a treatment center, to profiles of the health care workers battling Ebola from the front lines, to the many ways the epidemic is impacting the health, economy and future of the nation.

SUAKOKO, Liberia—”It becomes day-to-day life. You get into your PPE [personal protective equipment] and you go in every day and you feel safe,” explains Audrey Rangel – a nurse at the Bong County Ebola treatment unit run by International Medical Corps with support and funding from USAID.

Before landing at Roberts International Airport in Monrovia on September 8,  Audrey worked on a maternal, child health and nutrition program in Timor Leste. “I always wanted to do disaster relief work. The crisis started to take off. It was in the news a lot. People were talking about it. So I went online. I saw a position for an Ebola response nurse. To me it was just the right time. The description just kind of fit me. I was speaking with my husband and I was saying I can’t not do this. I can’t not do this…. They need people. There was an actual need for me. And I just kind of felt like the description was made for me. It was just perfect. I had to do it.”

The Bong County Ebola treatment unit where Audrey was stationed is a four hour bumpy journey from Monrovia. Bong has some of the highest rates of infection after Lofa and Montserrado Counties. Their two ambulances drive for hours every day to pick-up patients in remote locations like Bong Mines where they picked-up 18-year-old Cephas after his father carried him on his back for an hour to a location where the ambulance could reach him.

Audrey’s days are spent on the front lines of the Ebola response, suiting up in protective gear and caring for patients like Cephas. Even as she roots for survivors, she admits that it’s easy to get attached to her patients: “For some reason you’re sad to see them go.”

“It’s turned out to be an amazing, amazing experience. I wouldn’t take it back for anything.  I guess you can say it exceeded my non-expectations,” says Audrey.

To learn how qualified medical professionals can join the fight against Ebola, visit: www.usaid.gov/ebola/volunteers.

Watch Audrey’s Story

(All photos by Morgana Wingard)

ABOUT THE AUTHOR

Morgana Wingard is a photojournalist documenting the many facets of the Ebola crisis in Liberia. All this week she will be guest posting from USAID’s instagram

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