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Sierra Leone now has the highest number of reported Ebola cases on record. Sierra Leone now has the highest number of reported Ebola cases on record.
 


The Year of Living Dangerously

Aztec Angela Dunn fought local superstition and her own fears while working to contain the Ebola outbreak in Sierra Leone.
By Coleen L. Geraghty
 

Under ordinary circumstances, Angela Dunn lives a relatively uneventful life employed as an epidemiological intelligence service (EIS) officer hunting for long-term solutions to chronic diseases.

But these are not ordinary circumstances. The San Diego State University alumna recently spent a month in West Africa battling the region's Ebola outbreak. Her efforts and those of other health workers earned them recognition as Time magazine's persons of the year for 2014.

Dunn, a medical doctor, completed her residency in preventive medicine at the University of California, San Diego while earning a master’s in public health from SDSU in 2013.

After graduating, she took a position with the Centers for Disease Control (CDC) working at the Utah Department of Public Health. Because the CDC also responds to international outbreaks of infectious diseases, its staff members have been deployed to help West Africam countries contain the Ebola epidemic.

On Oct. 4, Dunn boarded a plane to Sierra Leone, leaving her husband and 2 ½ year-old son at home in Salt Lake City.

Moving to high alert 

Her team was the first to be assigned to the Tonkolili district in central Sierra Leone. Health officials there had already diagnosed and isolated dozens of Ebola patients, but shortly before Dunn arrived, a woman in a non-Ebola hospital died after delivering her baby by Caesarean section. She was found to have the deadly disease.

“The entire maternity ward was shut down, and the hospital staff and patients were quarantined,” Dunn said. “This happened because health care workers in non-Ebola facilities weren’t on high alert. A few did end up contracting Ebola and one of them passed away.”

Dunn’s team immediately established procedures to prevent another such incident. They inspected hospitals and holding facilities. They trained local health care workers to investigate each new case by identifying the victim’s contacts and monitoring the health of those contacts for 21 days—the typical incubation period for Ebola.

"No one would touch him"

Setting up infrastructure was the easy part; Working with the affected villages—not so straightforward. In most of Africa, Ebola carries a fierce social stigma. Dunn recalled traveling with health officials to a village where a suspected Ebola death had occurred.

“The entire village crowded around the chief as he told us that the dead man was a recluse with only one relation, a 10-year-old son. Then the boy came out to talk to us. He looked so scared. Clearly he had been coached to say that his father had no contact with other villagers. Finally, we gave up on identifying contacts and talked about how Ebola spreads. The 10-year-old began to cry. He realized that he probably had Ebola and no one would touch him.

“We also worked with a boy who survived Ebola. When he returned home, the villagers threw stones at him. Finally, he went to live in an orphanage in Freetown. There are a lot of orphans now whose parents passed away from Ebola.”

Unintended victims

Dunn said the Africans on the front lines become victims, even if they never contract Ebola. Fear of the disease drives villages to excommunicate local residents who serve as nurses, ambulance drivers and burial teams for Ebola patients.

Dunn herself experienced a twinge of that fear when, during a village visit, a young boy touched her calf.

“It was a benign incident, but I felt afraid, and that made me angry,” she said. “For a few minutes, I was sick to my stomach realizing how frightening a simple human touch can be.”

To relieve the pressure of 12-hour work days, Dunn did yoga and kept a journal. She had dinner most evenings with fellow health care professionals from Uganda, India, Switzerland and the United States.

The real heroes

Dunn returned home last month, grateful for the experience.  

“It’s an exciting time to be an EIS officer, to play a part in history,” she said. “But it was also stressful. It took me 10 days after coming home to feel like myself again."

Back with her family, Dunn watches from afar as Sierra Leone’s Ebola crisis worsens. According to a Dec. 11 World Health Organization (WHO) Situation Report, the country has the dubious distinction of having the highest number of reported Ebola cases in the world, a total of nearly 7,900.

“I think it’s wonderful that Time chose the Ebola fighters as persons of the year,” Dunn said. “The real heroes of this story are the local physicians, nurses, community workers, ambulance drivers, and burial teams shunned by the very communities they are seeking to protect.

“They forgo paychecks, never get a day off and have to watch as more and more of their family members and friends succumb to the virus. But each local Ebola fighter I spoke with said they are doing their job to help their country.”