A Malibu doctor has flown straight into one of the most dangerous situations in the world.
Dr. Suzanne Donovan is one of a team of volunteers working in Sierra Leone with the World Health Organization (WHO) to help deal with the deadly Ebola outbreak. She arrived in early September and is scheduled to return to the U.S. at the end of the month.
Dr. Donovan, who sat down for an interview the day before leaving, does not believe the U.S. or Europe are at risk for an Ebola epidemic because of the high standards of infection control practices and tertiary care available. But the threat is significant in Africa.
“The first world has a moral and public health responsibility to help Africa deal with this epidemic in any way possible,” she said. “To not help because Ebola is not an immediate threat here is just plain wrong.”
The Ebola virus, which has no vaccine, is not airborne but can be transmitted through human contact and bodily fluids. Ebola’s fever-type symptoms can eventually lead to severe internal and external bleeding. An estimated 2,400 people have died from Ebola since December and nearly 5,000 cases have been reported.
One of the biggest concerns with Ebola is the number of healthcare workers infected and the frighteningly high mortality rate in Africa.
“That’s because basic principles of infection control found in the United States, like hand-washing and protective equipment are not available in many African hospitals. Ebola is very unforgiving of any breakdown in infection control practices,” said Dr. Donovan.
She planned on being suited up at all times and packed medications to protect herself against malaria and diarrheal diseases common in Africa. She has also been immunized against almost everything she could possibly catch.
As a professor of clinical medicine at UCLA’s David Geffen School of Medicine and the Infectious Diseases Department at Olive View-UCLA Medical Center, Dr. Donovan works in an infectious diseases unit that treats the most resistant cases of tuberculosis in the Western United States.
“Part of my job is training people to protect themselves from infection. In Sierra Leone, I will be working in a hospital to improve infection control practices and also acting as an infectious disease consultant,” she said.
Although she understands the communicability and severe outcomes of Ebola infection, Dr. Donovan said, “This is what I have been trained for. It’s like asking a firefighter not to go into a burning house.”
The two main agencies currently handling the Ebola outbreak, providing both clinical and epidemiologic technical support, are MSF (Doctors without Borders) and the WHO. “There is a lack of other international agencies getting involved, which I believe is part of the challenge.,” Dr. Donovan said. “This outbreak is totally under-resourced, not only in clinical care where there aren’t enough healthcare workers, but in the basic epidemiology of doing contact tracing and putting people into isolation. This epidemic has spun out of control because the basic tenets of an outbreak investigation are not being followed. The United States, Great Britain and all major countries need to provide more resources to West Africa.
“It’s not clear to me why there hasn’t been a more dramatic response. We don’t have any idea of the denominator of this outbreak, how many people are infected or the attack rate. We haven’t been able to get out to the villages to see the extent of the outbreak.”
Dr. Donovan’s employer, the L.A. County Department of Health Services, has given her time off to go to Sierra Leone.
“They recognize this is a public health crisis of international proportions,” she said.
If she does get infected, Dr. Donovan will most likely be evacuated to Geneva or Los Angeles.
Not all of her colleagues at UCLA are supportive of her trip.
“Some of them feel the risks to me personally outweigh any public health benefit.”
But her children, Max, 17, and Gabby, 15, are fully on board.
“Gabby has accompanied me on other medical trips to Fiji and Belize. She wanted to come to Sierra Leone as well and was prepared to put on a hazmat suit, but this is not a mission for anyone who is not a healthcare worker or hasn’t had extensive training with highly communicable diseases,” She said. “It would be easy for me to paddle-board my way into the Malibu sunset, which is what I do to relax when I get the chance, but that’s not how I live my life and that’s not how I want my kids to live their lives.”
