Ebola: From Machetes to Policy

By Linda Mobula, 2014-15 Executive Branch Fellow, U.S. Agency for International Development

When I landed in Liberia last July, I had no idea that the following two weeks would be critical in shaping the international response to the world’s deadliest Ebola outbreak. I had arrived to contribute my clinical and public health skills with Samaritan’s Purse, a faith-based relief organization.

With only two functional Ebola treatment units in the country, Liberia was faced with a surge of patients. Stationed at the Eternal Life Winning Africa (ELWA) treatment unit in Monrovia, we were soon at full capacity with neither enough beds nor staff to treat additional patients. 

Then, the unimaginable occurred: colleagues Dr. Kent Brantly and Nancy Writebol contracted Ebola. It was devastating. The rest of the staff struggled to continue caring for patients while trying to manage the fear of succumbing to Ebola ourselves. As I cared for them, I often wondered if they would see their loved ones again. Knowing they might not survive, I struggled to contain my tears when Brantly’s family would call or when speaking with Writebol’s husband.

Added to this was the tension from the surrounding community – it did not welcome an Ebola clinic in its backyard. Neighbors protested outside, sometimes with machetes. As these events unfolded, Liberian President Ellen Johnson Sirleaf declared the outbreak to be an international public health emergency.

On the clinical side of the equation, we had to deal with the ethical complexity of ZMapp, an experimental Ebola drug that had never been tested in humans. Brantly and Writebol became the first patients to receive an experimental drug for the treatment of Ebola under compassionate use. Later, the World Health Organization issued a statement on ethical considerations for use of unregistered Ebola interventions.

After we were evacuated in August, I had an emotional reunion with Dr. Brantly in September when he testified to Congress about the need to increase funding for the Ebola response. Soon after, the USAID Office of Foreign Disaster Assistance (OFDA) activated a disaster assistance response team (DART) to Liberia.

In November and December, a few months into my STPF fellowship, I was asked to return to West Africa. This time I was placed in Guinea as a field/health officer on the DART team. Instead of clinical care, I conducted evaluations to inform policy and decision-making, attended coordination meetings of the Ebola coordination cell in Conakry, met with government officials and community leaders, and occasionally briefed the ambassador.

While in Guinea, I was able to collaborate with key U.S. government representatives who had worked on Ebola during my Liberian stay. My experience was greatly enriched by the opportunity to share and contrast our perspectives.

Though I longed to provide medical care in Guinea, I knew I was making a difference at a higher level. I helped combat a disease ravaging West Africa not as a clinician, but as a fellow. The AAAS S&T Policy Fellowship has provided me a wonderful opportunity to fight Ebola in a new capacity.