DiversityNursing Blog

A Nurse Decides to Get Hands-On in the Ebola Zone

Posted by Erica Bettencourt

Mon, Jan 19, 2015 @ 11:03 AM

By ANEMONA HARTOCOLLIS

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Lindsey Hallen is in the bug spray aisle at REI, the outdoor equipment emporium in SoHo, looking for exactly the right mosquito repellent to take to West Africa’s Ebola zone, when her phone rings. Three ascending tones, the personal anthem of an emergency room nurse, captured in a ringtone called “Summit.”

“Hello?” she says, pulling the phone out of her jacket pocket. Then in an aside, “I think this is them.”

Ms. Hallen listens, pacing back and forth along the aisle, as her gaunt face takes on the same wide-eyed look of concentration it assumes as when she works in the emergency room at Lenox Hill Hospital in Manhattan. Total Focus. Matter of Life and Death.

Since the latest Ebola outbreak entered public consciousness, most accounts of United States health workers have focused on the ones returning; the missionaries who were airlifted out and brought back from the brink of death, or Craig Spencer, the young doctor cured of the virus at New York City’s premier public hospital, Bellevue Hospital Center in Manhattan, while much of the city held its breath.

Now Ms. Hallen, a 31-year-old nurse with two years’ experience working with critically ill patients in this country, is going the other way, heading to West Africa to fight an epidemic that has sickened 21,000 people and killed more than 8,000.

“Why?” her friends and colleagues invariably ask when they find out what she is doing. Why would a relatively young, untested nurse want to risk putting her life in jeopardy to help save people living thousands of miles away, people sick and dying of a brutal, bleeding, contagious fever?

The question annoys her. Her reasons are instinctive, from the gut. You feel driven to do this or you don’t. The thinking only comes later.

“Why not?” she replies. “Why not me?” So the phone call shakes her. The woman on the other end of the line is a recruiter for Partners in Health, the Boston organization that is sending her to West Africa. Instead of Sierra Leone, as had been planned, the group now wants her to go to Liberia, the woman says. Ebola cases there have fallen, but they need people who can rebuild the shattered medical system, teach about controlling infection. She won’t have direct contact with patients. Yes, she can still go to Sierra Leone if she wants to, and take care of patients there. The final decision is up to her.

So the choice is this: Be an instructor, safe, teaching other people how to wear a protective suit, or be the one wearing the suit. She is given a day to decide.

Ebola officially reached American shores on Sept. 30, when Thomas Eric Duncan, a Liberian visiting family in Dallas, tested positive for the virus. Preparing for a possible onslaught, Lenox Hill Hospital set up a room within the emergency department where Ebola patients would be isolated. The staff had to be trained in wearing protective gear, the stifling, fluid-proof layers that include bootees, gloves, gowns, goggles and face shields. The more Ms. Hallen learned, the more she wanted to know. She volunteered for advanced training. She started lingering on the website of the Centers for Disease Control and Prevention. “I was looking at the case numbers and I started to become a little obsessed with everything that was going on over there, and how it was impacting us here,” she said.

She spoke of her newfound interest to her older sister, Kimberly, a real estate photographer, who sensed that this was more than a casual attraction. “She texted me saying she had volunteered to train how to handle Ebola if it came to New York City,” Kimberly recalled. “In the back of my head, I was like, ‘Oh, God, I feel like this is going to expand into her wanting to do a little bit more.’ But I kind of put it away. Maybe not.”

“She’s always been like this ever since she was little,” Kimberly Hallen said. “She was always the one who was trying to find the next fun thing to do. She was bored so easily.”

Lindsey Hallen, a slight blonde with eyes that shift from green to blue depending on the weather and her mood, grew up in suburban Cheshire, Conn., and was a communications major in college, but not a very serious one. “I was very social and that was what I cared about,” she said. After graduation, she moved to Hawaii, without knowing anyone or even having visited. “I was amazed how well everything fell into place,” she said.

She worked at an animal clinic and went to South Africa on an unpaid internship in wildlife conservation. After two years, she moved to Boston, where her sister lives, and began working at Global Vision International, the organization that had sponsored her internship. Her job sent her to South Africa, Guatemala and Costa Rica, to make sure projects were running smoothly. As a memento, she wears three bracelets on her right arm made of twisted copper and brass that she bought at street markets in South Africa. She never took them off, but she had to leave them with her sister before departing for Africa.

After three years, she wanted to grow. She thought about veterinary school, but she also wanted to travel. “Nursing came to mind as a perfect middle ground,” she said. Now, after two years in the E.R., the dread that she has done something wrong no longer wakes her at night. She can rattle off the medical script for an alcoholic with the shakes, a child with the flu or an elderly woman with a broken hip like someone reciting a Social Security number.

There has to be more to life than the three-block dash from her Upper East Side brownstone studio to the 8-a.m.-to-8-p.m. shift at Lenox Hill, and back.

The Ebola patient in Dallas died on Oct. 8, having set off a rapid chain of events. Two nurses who treated him fell ill, shaking confidence in the United States health care system. In mid-October, several New York hospitals volunteered to be Ebola treatment centers, including a sister hospital to Lenox Hill. On Oct. 23, Dr. Spencer, recently returned from Guinea, was rushed to Bellevue and tested positive. The next day, Kaci Hickox, a nurse returning from Sierra Leone through Newark Liberty International Airport, was forced into quarantine because of public officials’ fears.

Rather than being frightened, Ms. Hallen was swept away. Ebola was her 9/11, the disaster that nourished her sense of purpose.

Scrolling through the C.D.C. website, she came across a link to an application form for medical volunteers willing to go to West Africa, kind of like a universal college application online.

She recalls sending it in a few days after Ms. Hickox returned. Her first response, from Partners in Health, arrived on Halloween night. She sent back an email as she dressed for a Halloween party. She was not a sexy witch, or even a nurse. She wore a $12 zombie suit with a zipper splitting her face.

Still, she didn’t really think it would happen. And she assumed that even if she were selected, she would not be paid, and she could not afford that. But Partners in Health agreed to pay for her travel, expenses and medical insurance, as well as provide a stipend that would cover most of her lost salary for nine weeks; six weeks in West Africa and three weeks upon her return, during the disease’s incubation period. As a single person, she didn’t have to worry about disrupting anyone else’s life.

The agency also agreed to pay for her evacuation if she contracted Ebola — a further reminder of the dangers.

Her mother, Laura, cried when she heard the news. Her father, Dan, “had a million questions” but was proud of her.

“I think that she’s got the right mentality to perform in this type of environment,” Mr. Hallen said. “I guess what I would liken it to is firefighters that rush into a burning building when everyone else is running out. All I can say to that is, thank God for them. Where would we be without them?”

That mentality is not widely shared, the numbers suggest.

Since November, about 1,300 people have applied to travel to West Africa through Partners in Health, and about 360 have been hired, Sheila Davis, chief of the agency’s Ebola response, said. She said she was still looking for people with the right “humility,” but the number of applicants has declined as Ebola has moved off the front pages.

North Shore-LIJ Health System, the hospital network that includes Lenox Hill, has 54,000 employees. Ms. Hallen is only the second one to go to West Africa to treat Ebola, Joseph Moscola, the system’s chief of human resources, said. An informal survey of other New York City hospitals found few if any volunteers at most of them.

At some hospitals an internal debate rages over whether highly trained specialists should be volunteering to do menial work in African field hospitals or can make a better contribution at home, perhaps by doing Ebola research.

“Major academic institutions, you would think, would be those who would be pushing it,” Ms. Davis said. “But it’s the opposite. It’s definitely been Middle America, and California, but not the numbers you would think in Boston and New York.”

In preparation for Ms. Hallen’s trip, Partners in Health sent her a packing list. Mostly it is similar to a list for summer sleep-away camp: shampoo, toothbrush, underwear. But not entirely. She will need a headlamp, in case the electricity goes down, and some fancier clothes to wear for Embassy events. Also, styptic pencils to stanch cuts, and tampons, for nosebleeds, ominous inclusions in an environment where bodily fluids may be deadly. Ms. Hallen has scratched out the word “condoms.” She has enough contagion to worry about, she said. She trades email with other volunteers. Bring washable shoes, they say. Dried fruit, nuts and granola bars, to break the monotony of rice and beans.

She picks up her mosquito net at REI and jokes that she might use it to keep away the cockroaches in her apartment. Last night she slept with a hat on, haunted by a woman who had arrived at the emergency room with ear pain. The diagnosis: a cockroach stuck in her ear canal.

At the checkout counter, the brooding, longhaired salesman examines her basket and asks where she is going. “Sierra Leone or Liberia,” she replies.

“You should read this book,” he says, and on a scrap of paper writes the name Peter Piot, author of a memoir about the discovery of Ebola and AIDS.

The next night, she writes an email to the recruiter from Partners in Health. Deletes it. Writes it again. Presses “send” at 11:42 p.m.

At 10 a.m. Saturday, she was scheduled to fly to Sierra Leone, to care for people who are sick and dying of Ebola.

Source: www.nytimes.com

Topics: illness, sick, Ebola, outbreak, West Africa, epidemic, nursing, nurse, disease, medical, patients, hospital, treatment

Facebook's Mark Zuckerberg And Wife Donate $25 Million To Fight Ebola

Posted by Erica Bettencourt

Wed, Oct 15, 2014 @ 11:34 AM

By  JAMES MARTIN

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Facebook CEO Mark Zuckerberg and his wife Dr. Priscilla Chan are donating $25 million to the CDC Foundation to help fight the Ebola epidemic, which has taken the lives of more than 4,000 people and continues to rage out of control in West Africa.

The donation will be used for the CDC Ebola response effort in the most severely affected countries of Guinea, Liberia and Sierra Leone and other areas of the world where the disease poses the greatest threat, the foundation said Tuesday.

"The Ebola epidemic is at a critical turning point," Zuckerberg said Tuesday in a statement posted on Facebook. "It has infected 8,400 people so far, but it is spreading very quickly and projections suggest it could infect 1 million people or more over the next several months if not addressed."

The CDC Foundation says the money will go towards urgent needs on the ground, including equipping community care centers, hiring and training local staff, identifying Ebola cases and tracing contacts, vehicles to be used for specimen transport, burial support, and translation services and communications -- all of which it says are vital to fighting the outbreak.

"The most important step we can take is to stop Ebola at its source," CDC director Dr. Tom Frieden said in a statement. "The sooner the world comes together to help West Africa, the safer we all will be." He said today's "significant contribution from Mark Zuckerberg and Dr. Priscilla Chan will help us rapidly advance the fight against Ebola."

Source: www.cbsnews.com

Topics: Ebola, West Africa, epidemic, Mark Zuckerberg, Dr. Priscilla Chan, CDC, Facebook, donation

New York announces plan to boost HIV testing, treatment to end epidemic

Posted by Erica Bettencourt

Wed, Jul 02, 2014 @ 12:08 PM

By Associated Press

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New York state can end its three-decade HIV crisis by the year 2020, Gov. Andrew Cuomo said Sunday as he announced an ambitious plan to deliver a knockout blow to the epidemic by boosting testing, reducing new infections and expanding treatment.

The governor said the state is aiming to reduce new HIV diagnoses to 750 by the end of the decade - about the same number of tuberculosis cases seen in New York City each year - down from 3,000 expected this year and 14,000 new cases of the disease in 1993. If the state is successful, it would be the first time the number of people living with HIV has gone down since the crisis began with the first widely reported cases in 1981.

"Thirty years ago, New York was the epicenter of the AIDS crisis," Cuomo said. "Today I am proud to announce that we are in a position to be the first state in the nation committed to ending this epidemic."

To expand treatment, the state's Department of Health has negotiated bulk rebates with three companies producing HIV drugs. The state is also taking steps to make it easier to get tested, changing how HIV cases are tracked to ensure patients continue to receive treatment, and boosting access to "pre-exposure" drugs that can help high-risk people avoid infection.

Cuomo did not offer an estimate of the cost of the plan, but said it would end up saving the state more than $300 million per year by 2020 by reducing the amount the state pays for medical care for those with HIV.

Groups that have long advocated for HIV patients praised the governor's announcement, saying it shows that efforts to fight the disease are paying off, and that a scourge that once seemed unbeatable can be successfully fought.

"We have the tools and know-how to end the AIDS epidemic in New York, the only question is whether we have the political will," said Jason Walker, an organizer at VOCAL-NY, which advocates for low-income HIV patients. "Even without a vaccine or cure, Cuomo understands that we can dramatically reduce new infections below epidemic levels and ensure all people living with HIV achieve optimal health."

While the state's plan may sound overly optimistic, the number of new HIV cases in New York has dropped nearly 40 percent in the last 10 years because of better, faster tests; access to condoms; public outreach campaigns and other initiatives. Meanwhile, those with the disease are living longer thanks to significantly more effective treatments.

The goal of bringing the disease to below epidemic levels "is ambitious," said Mark Harrington, executive director of the anti-HIV organization Treatment Action Group, but "grounded in reality."

Source: foxnews.com

Topics: New York, epidemic, testing, treatment, HIV

'Drastic action is needed' now to stop Ebola epidemic

Posted by Erica Bettencourt

Wed, Jul 02, 2014 @ 11:59 AM

By Danielle Dellorto, Miriam Falco, and Jen Christensen

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The Ebola epidemic isn't getting any better in Africa.

The World Health Organization reports there have been 759 cases, including 467 deaths in Guinea, Sierra Leone and Liberia since the outbreak began in March, according to a statement the organization released on Tuesday.

The World Health Organization has said "drastic action is needed" to stop the deadly outbreak in West Africa. It has sent teams of experts to help locals deal with the epidemic. WHO will meet this week to discuss how to contain it.

Relief workers on the ground said the epidemic has hit unprecedented proportions.

"The epidemic is out of control," said Dr. Bart Janssens, director of operations for Doctors Without Borders.

Complicating matters, the countries hit hardest by the epidemic have major medical infrastructure challenges. There is also a real sense of mistrust toward health workers from communities. In Sierra Leone and Guinea, WHO has said that community members have thrown stones at health care workers trying to investigate the outbreak.

In April, CNN Chief Medical Correspondent Dr. Sanjay Gupta traveled to Conakry, Guinea, to report on what was being done to treat patients and contain the outbreak.

"It took only moments to feel the impact of what was happening here," Gupta wrote after landing in Conakry. "There is a lot we know about Ebola, and it scares us almost as much as what we don't know."

Ebola outbreaks usually are confined to remote areas, making the disease easier to contain. But this outbreak is different; patients have been identified in 60 locations in Guinea, Sierra Leone and Liberia.

Officials believe the wide footprint of this outbreak is partly because of the proximity between the jungle where the virus was first identified and cities such as Conakry. The capital in Guinea has a population of 2 million and an international airport.

People are traveling without realizing they're carrying the deadly virus. It can take between two and 21 days after exposure for someone to feel sick.

Ebola is a violent killer. The symptoms, at first, mimic the flu: headache, fever, fatigue. What comes next sounds like something out of a horror movie: significant diarrhea and vomiting, while the virus shuts off the blood's ability to clot.

As a result, patients often suffer internal and external hemorrhaging. Many die in an average of 10 days.

Doctors Without Borders, also known as Médecins Sans Frontières, has been working to fight the epidemic since March. The group has sent more than 300 staff members and 40 tons of equipment and supplies to the region to help fight the epidemic.

Still, the group warns, it's not enough.

"Despite the human resources and equipment deployed by MSF in the three affected countries, we are no longer able to send teams to the new outbreak sites."

The good news is that Ebola isn't as easily spread as one may think. A patient isn't contagious -- meaning they can't spread the virus to other people -- until they are already showing symptoms.

Serious protective measures

Inside the isolation treatment areas in Conakry, doctors focus on keeping the patients hydrated with IV drips and other liquid nutrients. Health officials have urged residents to seek treatment at the first sign of flu-like symptoms.

There is no cure or vaccine to treat Ebola, but MSF has shown it doesn't have to be a death sentence if it's treated early. Ebola typically kills 90% of patients. This outbreak, the death rate has dropped to roughly 60%.

The outbreak will be considered contained after 42 days -- twice the incubation period -- with no new Ebola cases.

Source: cnn.com


Topics: virus, Ebola, epidemic, medical

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