completely still and silent as Dr. Koroma drew blood. When the patient’s eyelids briefly fluttered—wrinkled, leathered window shades into a soul—I saw it: the whites of her eyes had filled with blood. She had begun to hemorrhage.
Thirty minutes after entering the treatment facility, we volunteers were ushered out, soldiers surrounding us, but keeping their distance. In tropical heat, thirty to forty minutes is all the time workers have fresh air inside their suits. The “machine spirits,” as Akachi referred to us, are humans trapped inside protective suits made of woven plastic fiber coated in laminate. Impervious to fluids, they also block fresh air from entering. Dr. Koroma had dismissed us: “Before you all pass out in those moon suits, you’re going to be escorted to your Disinfecting Station. Be very careful. Follow all the directions given to you. On your first day here, you’ll work thirty minutes on, two hours off. We want you to acclimate to the climate and to the suits. I’ll be here a few more minutes and then I’ll take a break outside as well.”
As I turned on the heels of my rubber boots, I angled my body in such a way that I could move around in my “spirit machine” and catch a parting glimpse of Dr. Koroma. I wanted to see whether or not she was fading, or if she still functioned with energy.
At that exact moment…and it’s burned into my memory like a photograph…I saw her pull back her arm in a lightning flash. She had been drawing blood from an old man. Her voice exploded with anguish and terror: “Shit! Shit! Shit!”
The soldiers pointed their guns at us and told us to get a move on.
My God. Dr. Chibueze Koroma had stuck herself with a hypodermic needle infected with Ebola blood.
My heart pounded. I thought for sure I would faint inside my suit.
The next day, Dr. Koroma was replaced by another intern, Dr. Waahib Ouedraogo. He was tall. Moving around the treatment center like Frankenstein, he had to bend over considerably to administer to patients. His deep black eyes darted around behind his face shield, taking everything in.
I tried to get information on Dr. Koroma. All anybody would tell me is that she was in quarantine. Nobody would tell me where quarantine was located.
That afternoon, I got to work with Akachi again. He was so sweet and cute, I just wanted to sweep him up into my arms, rock him in a rocking chair and sing him a lullaby. “Hush, little baby, don’t say a word…” He seemed to have stabilized. He hadn’t gotten any worse. I was assigned changing his IV bag, to give him more fluids. Dr. Ouedraogo said to me, “Dr. Koroma left notes on her observations of you. She said you’re qualified to draw blood and should be assigned to Akachi for that.” I was glad my first time drawing Ebola-infected blood would be from this child because I was scared to death to do it, especially after seeing what had happened to Dr. Koroma. Reminding myself that Akachi’s life depended upon me getting a grip and doing my job made it significantly easier. I steadied my hands and controlled my breathing. I managed to draw a vial of his blood without incident. I refused to think of all the virus lurking inside that red bodily fluid.
After I had followed through on taking care of Akachi, Dr. Ouedraogo told me I was dismissed for a few hours. He told me that my next assignment for the day would involve traveling to the home of Akachi’s mother.
Sweat trickled down my forehead behind my face shield. I started to lift my hand to wipe it away. I remembered that would be futile, as the plastic would block my hand. Adrenalin surged throughout my body. My fingers trembled. I could not believe I had done that! I had started to touch my face with infected gloves! I berated myself over and over and over again. That’s one of the main ways medical workers get Ebola. In treatment facilities where they don’t have full face shields and a nurse or doctor accidentally touches their own face after treating an Ebola patient, the virus enters their body through a mucous membrane and then begins replicating inside them.
I managed to ask Dr. Ouedraogo, “Why are we doing that? Isn’t it safer to stay here inside the camp?”
Akachi started to cry. “Mama! Mama!”
Dr. Ouedraogo soothed him. He said, “We’re going to find her, sweet one. Don’t worry.”
Then he turned to me. “Let’s talk after we get out of these suits and cleaned up. Just wait for me outside the Disinfecting Station after you’re finished there, OK?”
I waited, as instructed, in front of Disinfecting Station 5. I watched people go into the station, anonymous in their yellow and turquoise plastic suits, and come out looking normal and identifiable as individual human beings with their own tastes and styles.
Finally, Dr. Ouedraogo emerged from the station, dressed in white shorts and a pale blue T-shirt. He looked at me with sad, penetrating eyes. “Come, walk with me.”
After I followed him to a park bench where we sat down, Dr. Ouedraogo said, “In answer to your question that I didn’t want to answer in front of patients: it is definitely safer for us here than going into the home of Akachi’s mother. However, the situation inside their slum is deteriorating. People are staying inside their homes after they develop Ebola symptoms. Family members aren’t removing the deceased bodies for days after they die, sometimes just dragging them outside onto the street or burying them themselves. We’re looking at a potential pandemic here. Among the new responsibilities of our camp’s medical personnel will be outreach into our local communities and educating locals about how to care for their loved ones who get sick with Ebola. We’ve been asked by the World Health Organization to assist both them and the CDC in their efforts inside these communities, including the crowded slum where Akachi’s family lives. We have information that his mother may now have Ebola and another one of his relatives may have recently died of the disease inside their home. Ebola could spread like wildfire through the crowded slums. We need to get on top of this.”
A few hours later, Dr. Steele, Dr. Ouedraogo, Zoe, a couple of other nurses and I were loaded into military vehicles. I was surprised that we were picked up by an armored vehicle, but I supposed it made sense to have as much protection as possible.
It was late afternoon. We rode, jostled back and forth against our seat belts, over rough terrain. With our seats lined up along the sides of the vehicle, we faced each other. The windows were behind our backs, so we couldn’t see much more than daylight flickering outside through the sections of glass visible between the shoulders of the people across from us. Every once in a while, I saw a blur of green outside, as we sped past small trees or bushes.
The driver pumped music through the stereo system, to keep us from going insane, I’m sure.
I napped on and off, but startled awake each time from nightmares. The worst was a horrible dream in which Akachi bit me with teeth as long and sharp as lion’s incisors and then tore away my skin, eating me alive.
Finally, the vehicle pulled to a stop. Dr. Steele said, “We must be there.” She waited until the soldiers gave us directions. Four soldiers were assigned to go along with us to Akachi’s house; two others would remain with the vehicle.
We had stopped in a wooded area at the edge of the slum. Our black armored vehicle was parked in a secluded area hidden by leafy trees. A soldier helped us out, one by one, offering a hand to each of us who needed it.
As we walked into Akachi’s neighborhood, I felt as though we had entered a war zone. Rot infested the settlement through the core. Buildings were barely held together, as though one breath from the heavens would topple it all. The smell was horrible, streams of sewage running down gullies. My heart seized for a moment. The sewage no doubt contained Ebola and a bunch of other serious diseases. I pulled a cloth mask over my nose and mouth, the most protection we could wear for any extended period of time in the heat.
We hiked dirt roads through a maze of ramshackle homes. Many were rectangular turquoise boxes similar in basic style to our residence buildings back at camp. Others were square and blue or green. But the walls were filthy, punctured by holes. Corrugated metal
roofs were ripped off the walls in places, and tattered, as though some huge jungle cat had pierced the juncture of wall and roof with its sharp claws, peeling the tin-can roof back from its supports, looking for food that lurked inside.
Many doors were missing or were nothing but cloth curtains or left ajar. Inside, the floors were dirt.
Mangy dogs, cats and monkeys went in and out the houses. I felt crazed. All those animals could be carrying Ebola, and the people of Liberia ate them. They also hunted bush meat which included bats and monkeys, known carriers of the virus.
When we reached the center of the slum, we encountered a building that looked like something out of a post-apocalyptic movie. Made of concrete and iron, it had, like a dollhouse, no outer walls. It was ten stories high. People moved around each compartment, clearly visible to us, like actors on extra-live TV.
As we moved past the high-rise building, we startled two kids splashing in muddy puddles. The soldier stopped. He smiled at them. He played catch, throwing each one a small package of candy—gummy bears or something. I watched his movements closely. He never touched either of the kids. God…Splashing in puddles. I kept imagining the potential diseases swimming there: Ebola, Typhoid Fever,