In a heavily forested area about 65 miles east of Monrovia, Liberia, statues of stone monkeys keep vigil over a sprawling campus of buildings that has seen better days. The Liberian Institute for Biomedical Research (LIBR) was established in the 1970s as a premier research facility to develop scientific breakthroughs for a variety of viral infections, including hepatitis. The rusted, empty animal cages serve as a reminder of the past research conducted here.
Entrance to the Liberian Institute for Biomedical Research — once a testing facility for Hepatitis B, currently the national lab for diseases like Malaria, Cholera, and now, Ebola.
Anthony, a janitor at the Liberian Institute for Biomedical Research, walks past rusted, empty cages that once housed Chimpanzees used for testing.
Now, the facility finds itself drawn into an epidemiological battle against another outbreak, this time, the Ebola virus. LIBR is one of only a few laboratories in Liberia where Ebola specimens are sent to be tested. Due to the spiralling number of Ebola cases in the region, boosting LIBR’s laboratory testing capacity has been a top priority for a team of medical and disaster experts with the U.S. Centers for Disease Control and Prevention, the U.S. Army Medical Research Institute of Infectious Diseases (USAMRIID), the U.S. National Institutes of Health, and the U.S. Agency for International Development (USAID).
“People are dependent on these test results,” said Gary Wes Carter, an emergency management chief with USAMRIID. “The longer a sample sits here, the longer a doctor in the field goes without an answer needed to make critical decisions about patient care.”
Specimens from across the country are delivered to LIBR daily in these coolers.
Since April, American laboratory and disease control experts have been working at LIBR to process Ebola samples and train local technicians. When the rate of Ebola infections spiked in June, more equipment and personnel were brought in. As a result, LIBR’s lab processing capacity almost doubled from 40 specimens a day to more than 70. The goal is to eventually be able to test approximately 100 specimens a day, with assistance from the USAID-led Ebola Disaster Assistance Response Team (DART) and the USAID Mission in Liberia.
USAID’s disaster response and development experts are working to upgrade the laboratory facility by improving specimen containment, providing improved internet access, renovating hygiene facilities, repairing plumbing, and working with contractors to rewire the building so that it receives a steady source of electricity.
“There are a number of projects underway,” said DART Logistics Officer Sergio Solis. “Working together, we could make LIBR not only more efficient, but more sustainable for the Liberian scientists and laboratory technicians who will be running the facility.”
Laboratory experts with the USAMRIID agree that partnerships are the key to combatting the Ebola outbreak.
“We couldn’t have made the lab sustainable in the long-term without the assistance of USAID,” said Carter. “I have never been to an outbreak response where there has been this much intergovernmental collaboration. This has been amazing.”
Dr. Alec Hail, a Senior Clinical Veterinarian at the U.S. Army Medical Research Institute of Infectious Diseases and his team spend all day from early morning until dark in the lab working on processing samples, documenting results, and sending out reports.
Before technicians enter the lab at LIBR, they must dress in full protective gear, which is essential to protecting them against the virus.
Dr. Anthony Jones works inside the Ebola testing lab: “This is one of the best labs Africa has ever seen,” says Alec Hail, Senior Clinical Veterinarian at the U.S. Army Medical Research Institute of Infectious Diseases (USAMRIID). The lab started off by testing 20 to 30 specimens per day. Just a few weeks later, the it can test up to 80 specimens per day.
Dr. Jason Kindrachuck inserts the DNA from 47 people into the PCR machine to determine if they test positive for Ebola. This machine can test up to 100 samples at a time.
Dr. Jason Kindrachuk (left) and Microbiologist, Dr. Anthony Jones (right) spend four to eight hours of their day in protective space-like suits in a laboratory containment suite preparing samples from potential Ebola patients. As the light fades outside, they face the hardest part of their day. After changing back into normal clothes, one reads the list of names of specimens tested that day as the other records the information into a spreadsheet. Each name read aloud is followed by “positive” or “negative.” “That’s when it gets real,” says Dr. Kindrachuk. Fifty to 60 percent are positive.