It was September of 2014, one night during my second week in Freetown, Sierra Leone, I suddenly woke up at around 3am, sweating profusely. My bed was damp. I felt a faint scratchy feeling in my throat that one feels before getting flu. I felt warm. I looked around in dark, fearful and searching. It turned out that the air-conditioner was out. I could hear my heart pounding and I felt shaken. “Did I get IT?” The many things that I had done in the preceding many days, since my arrival, started reeling in front of my eyes. Walking into my room with the same shoes that I had worn and walked around in the community; having held the papers and documents and worked on the computers that were used by the many locals; unsure about the strength of the chlorine hand-wash that I had been using over ten times in a day; having used the office furniture at the district health and medical office that was shared by many at the workplace… every small routine activity of my daily life felt like an irresponsible risky act that may have been a potential source of Ebola transmission, and it could have been anything and everything that I did. It all lay threateningly bare in front of my eyes despite the pitch darkness in the room at this hour. At that time of the night, I could do nothing. Almost nothing. I pulled out my Bible from underneath my pillow, which I had stopped keeping there for several years now. For some reason I had decided to indulge in a ritualistic behaviour since the time I landed in Sierra Leone and had been religiously keeping my Bible under the pillow although not necessarily reading it. I read a few verses and just knelt down and prayed and Thanked God. I woke up the next morning and it was business as usual, on the frontlines of Ebola response.
During my short stay of a month in Sierra Leone, I woke up every morning, Thanking God that I could see another day, that I continued to be symptom free, that I continued to be afebrile (without fever), that there was no scratchy feeling in my throat.
Upon return to US, although as per the recommended protocol there was no need for isolation or living separately from the family, I self-imposed on myself a 21-day basement isolation. Not a scientifically right thing to do but given the unfortunate situations my colleagues had to face, this was a necessity. Two of my colleagues who returned from Ebola response had their spouses, who were school teachers, forced to stay away from the school for 21 days and in another instance a child in the elementary school was to stay at home. Having an eight year old at home, I felt it was best for me to stay away from my son for 21-days, just in case the school would be concerned if he was ‘exposed’ to me and then force him to stay away from school.
Those 21 days were interesting, distressing and most importantly very revealing, allowing me time for thoughtful introspection on many things in life. Returning from a work travel of a month-long duration and then staying at home but isolated in the basement for another three weeks, it was not an easy experience. The desire and want to play, to hold and hug my little boy and yet being not able to do so reminded me of the situations that the health care workers on the frontlines in Sierra Leone and other countries were living in. They who had responded to the call of duty and rather a call of humanity were touching the victims and comforting them as part of their physician duties. And yet when it came to their own personal lives they missed the same touch and comfort. One of the nurse had not held her children in a month, she was afraid of infecting them. They had to really struggle and hold themselves back from affectionately hugging their own loved ones, even someone who would have just lost ten of his/her family members or crying for the five children who were buried in unmarked graves, perhaps in a mass grave, because they died before anyone could get their names.
I was eating and drinking in disposable paper and foam plates and glasses. My wife would walk half way down the basement stairs and leave my dinner in a paper plate on the floor of the stairs that I would then pick up, take it to the basement room. Nothing that I touched would go back up to the main floor. I was to record and report my temperature and status on a twice-a-day basis to three different health departments / agencies and do so for 21 days. If I missed reporting any day, I would get a phone call from them checking on me if I was alright or not. This was an experiential indicator of a well-functioning health care system that was so very much wanting in West Africa. Identifying contacts of cases and tracing them over a period of time was one of the most crucial activities in the response and continued to be the most challenging and demanding activities requiring larger resources and failure to fool-proof it was what driving the outbreak.
My eight year old had, by now, read and knew pretty much a lot about Ebola. During those few moments of family time in the back yard, separated from my wife and son, by no less than 15 feet of distance, my son would show an imaginary line on the ground and call it ‘The Ebola Line’ and tell me, “Daddy, do NOT cross this line.” It was funny but was so very symbolic of the many such lines that the health care workers in the affected countries were required to or forced to cross during the Ebola times, in response to their call of duty, making me feel ashamed and guilty that I left in a month and there was so very little we could do and expected so much more from the locals.
To date I continue to live with that shame and guilt as I still continue to carefully and cautiously not cross that Ebola line, that may threaten my or my family’s existence.
