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Working collaboratively to support Ebola response efforts in Sierra Leone

Posted on by Bao-Ping Zhu, MD, PhD, MS, CDC Epidemiologist and Uganda FETP Resident Advisor
Dr. Bao-Ping prepares to train Ebola responders in Sierra Leone and is delighted that his tiny battery-powered projector is working.
Dr. Bao-Ping prepares to train Ebola responders in Sierra Leone and is delighted that his tiny battery-powered projector is working.

In late November 2014, during the peak of the Ebola outbreak in West Africa, I was deployed to Sierra Leone to support CDC’s Ebola response efforts. Like many of my colleagues, I wasn’t sure what to expect or where to begin, but I knew that we faced immense challenges, and my skills and expertise in field epidemiology were critically needed to support the global Ebola response effort.

When I arrived in Sierra Leone, in the epicenter of the outbreak there, my first assignment was to assist in assessing contact tracing efforts in the Bo District. During the first couple of days in the Bo District, I visited the villages and towns where Ebola outbreaks were occurring. I observed a number of contact tracing efforts to assess the process, provide feedback, and then advocate for a more systematic approach to contact tracing efforts throughout the district to inform Ebola prevention and control efforts. By engaging in discussions with CDC, WHO, and Médecins Sans Frontières (MSF) colleagues, we were able to quickly develop a plan to systematically train contact tracers and in-country supervisors, and bridge some of the critical gaps by implementing a more systematic approach to contact tracing efforts and improve operations.

Ethiopian public health professionals deployed by the African Union to support the Ebola outbreak response are engaged in contract tracing training session conducted by Dr. Bao-Ping in Sierra Leone.
Ethiopian public health professionals deployed by the African Union to support the Ebola outbreak response are engaged in contract tracing training session conducted by Dr. Bao-Ping in Sierra Leone.

A couple of weeks into my deployment, I received a frantic call from a colleague informing me that in response to Sierra Leone’s Ministry of Health’s request for support, the African Union had sent more than a hundred health workers from Nigeria and Ethiopia into Sierra Leone’s districts. My colleague was concerned because many of these health workers were already in the districts, and they were requesting additional training around personal protective equipment (PPE), contact tracing methods, cross-cultural communication, all of which is critical information required for health workers to be effective and safe in the field. As an epidemiologist with extensive experience in outbreak investigation and response, I knew what I was up against and had to quickly assess the situation and come up with a plan.

Despite the hot weather and lack of air conditioning, Ebola responders suit up and are enthusiastic about learning how to put on their personal protective equipment during training session in Sierra Leone.
Despite the hot weather and lack of air conditioning, Ebola responders suit up and are enthusiastic about learning how to put on their personal protective equipment during training session in Sierra Leone.

Within 24 hours, we miraculously put together a training package that included training on the use of PPE, clinical and infection-control practices in an Ebola treatment unit, case investigation and contact tracing, as well as general occupational safety and health issues specific to working in Sierra Leone. Several partner organizations graciously provided unconditional and unreserved help to make this happen, including the Disaster Assistance Response Team (DART) of USAID, the International Organization for Migration (IOM), WHO, and the African Union’s Representative Office in Sierra Leone, to name just a few. The leadership of Dr. Sara Hersey, the Epidemiology Team Lead, was instrumental in making this happen.

As I reflect on my experience in Sierra Leone, one of the things that became extremely clear to me during the response is that during an outbreak response in a resource poor country, one needs to be flexible, draw on experiences, respect cultural differences without compromising life-saving measures, and work collaboratively to save lives. It was also clear to me that in Sierra Leone, Ebola was a disease of poverty and aided in its spread by a lack of health infrastructure and the absence of a clear process for early response and treatment of suspected cases. Data shows that Ebola was initially confined to a limited geographic area in Sierra Leone before it spread into the surrounding villages and districts. This process can be halted in future outbreaks by building the capacity for epidemiology and laboratory facilities before an outbreak.

Over 100 public health workers in Sierra Leone participate in a demonstration session on how to use personal protective equipment during the E

This is a snapshot of what I and so many other CDC employees are called to do every day. In the face of seemingly insurmountable barriers, we figure out a way to make things work, and make sense out of what initially seems like chaos. Everyone’s contributions to the Ebola response has collectively made a huge difference and has potentially saved many lives.

In recent weeks, the case count in Bo District was reduced to zero. It is this kind of tangible impact that excites and motivates me and my fellow public health professionals here at CDC.

For more information, please contact, Dr. Bao-Ping Zhu, Resident Advisor, Uganda Field Epidemiology Training Program at  (bxz3@cdc.gov).

Posted on by Bao-Ping Zhu, MD, PhD, MS, CDC Epidemiologist and Uganda FETP Resident AdvisorLeave a comment

A Consequence of Conflict: The Spread of Multidrug-Resistant Tuberculosis

Somali pastoralists on their way to Dadaab refugee camp in search of food and care.  (Credit: CDC-Kenya, Ahmed Unhur, KEMRI)

For more than 20 years, Kenya has been providing asylum to people fleeing civil war and conflict from Somalia. Many first reach Dadaab refugee camp, located in Garissa County, Kenya, about 50 miles from the Somali border where the United Nations High Commissioner for Refugees (UNHCR) and partners provide humanitarian relief and protection assistance. In Read More >

Posted on by Nadine SunderlandLeave a comment

An Ounce of Prevention: Why we must strengthen basic TB control to defeat drug-resistant TB

Dr. Sujata Baveja and TB nurses provide patient information at the TB clinic of LTM Hospital in Mumbai, India. (Photo Credit: Susan Maloney, CDC)

To many, the idea of living in a world where there is no effective treatment for tuberculosis (TB) seems unthinkable. After all, we live in a modern era, with hospitals and drugs at our fingertips. TB is considered by some to be a disease of the past. But every year, more than 9 million people Read More >

Posted on by Thomas Kenyon, MD MPH, Director of CDC Center for Global HealthLeave a commentTags

CDC partners with Bloomberg Philanthropies to strengthen public health data collection in developing countries

dataforhealth-infographic

Did you know that each year 35 million deaths go unrecorded worldwide, and that the causes of millions more deaths are never documented? Today, 80% of the world’s population lives in countries that do not collect reliable cause-of-death statistics. According to the World Health Organization, “When deaths go uncounted and the causes of death are Read More >

Posted on by Dr. Samira Asma, Division of Global Health ProtectionLeave a comment

Water is Essential

border between Guinea and Liberia during the 2014 Ebola hemorrhagic fever outbreak across Guinea, northern Liberia, Sierra Leone, and Nigeria

World Water Day is an opportunity to evaluate the importance of improved sanitation and hygiene in the health of the world’s population. Access to basic hygiene and sanitation facilities helps people stay healthy and prevent the spread of disease. Water and Ebola The world is currently battling to stop the largest Ebola outbreak in history. Read More >

Posted on by By Eric Mintz, CDC and Suzie Heitfield, CDCLeave a commentTags

March 3 Marks the First Annual World Birth Defects Day

Mother of child with spina bifida participating on spina bifida awareness day at the Spina Bifida and Hydrocephalus Foundation in Nigeria

This March 3 marks the first annual World Birth Defects Day, launched by a network of 12 leading global health organizations. The purpose of this observance is to raise awareness about the occurrence of birth defects, develop and implement primary prevention programs, and expand referral and care services for all persons with birth defects. Our Read More >

Posted on by Diana Valencia, MS, CDC Division of Birth Defects and Developmental Disabilities1 CommentTags

My journey into Global Health: Dr. Pragna Patel

Dr. Patel at her family’s clinic in India where they provide health services to indigent communities.

Dr. Pragna Patel says “Taking the road less travelled and working for CDC on HIV and NCD has been a worthwhile journey” As a young girl growing up in New York City, I would often help out at my father’s pediatric clinic in an indigent neighborhood of the Bronx.  My father was a caring and Read More >

Posted on by Dr. Pragna Patel, CDCLeave a comment

Working Towards an Achievable Goal: A World without CRS

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When I started focusing on rubella in 1994, it was mainly recognized as a significant public health problem in high-income countries. When the public health community realized that rubella and congenital rubella syndrome (CRS) were actually significant public health issues in the entire region of the Americas, things took a turn and an elimination goal Read More >

Posted on by Susan Reef, MD, Rubella Team Lead, Global Immunization DivisionLeave a comment

Why I Care about Cancer in Developing Countries

Being treated for cancer in a lonely hospital room in Guatemala City.

I’m 30 years old and have already had cancer three times. If I lived in a developing country I likely would have died from my testicular cancer, or from my melanoma, or almost surely from my recurrence of melanoma that spread to the liver and brain. Fortunately for me, I have the opportunity to access Read More >

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2014: A pivotal year for the HIV response in Malawi

barcode scanner and touch screen

How we refined and refocused programs using a data-driven approach The appointment of Dr. Deborah Birx as the new Global AIDS Coordinator in May 2014 heralded an enormous change in the PEPFAR world:  Within the span of a few weeks, the focus changed from the newly-cemented PEPFAR vocabulary around ‘sustainability’ and ‘country ownership’ to language Read More >

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