Matt’s a dick

Hurricane Matthew is a currently a catagory 3 hurricane. However it was a catagory 4 hurricane when it smashed into the Caribbean nation of Haiti. Which is where I’m headed now. I guess an African Platypus can migrate as well.

You probably don’t think too much about Haiti. I tend not to. But I do know they got smacked hard with an earthquake in 2010 that they still haven’t recovered from. 

The wifi on this bus through the Domincan Republic is good, but not that good. So I’m going to rack my brain with what background knowledge I have.

Haiti was formed following a successful slave rebellion in the early 19th century. The haitians rose up and defeated the french on the Island.Haiti was originally supposed to be a breadbasket colony for the french in Louisiana. Strapped for cash and losing Haiti pushed Napoleon to sell the Lousiana territory. 

They speak french and creole

They are the poorest nation in the western hemisphere.

That’s all i got…

Heart to Heart international shot me an email asking for possible volunteers. I raised my digital hand and cleared it with work. 

Well I should say work begrudgingly allowed me to go under the auspices they could use me for full propaganda purposes. To which I dutifully agreed. Exploit away [redacted] exploit away.

Due to logistics we had to travel to Haiti via the Dominican Republic. Incase you didn’t know Haiti and the Dominican Republic share the island of Hispaniola.

The Dominican Republic speaks spanish and is doing pretty decent for itself. Besides not only producing a huge number of MLB stars(Sammy Soasa being one).

They also have KFC that delivers. I havent seen it yet, but I hear thr disparitybetween the two nations is huge.

My flight path originally had me go through panama city. Then to Santa Domingo in the Dominca.

Then it changed to JFK and Santa Domingo. I hate JFK. My only other experience was when I headed to Israel in 2012 switched planes there. When trump spoke of American air ports being third world. I think he was just talking about JFK. 

The day before I left I spent some time with my Daughter.

But not nearly enough. I gotta make it back in once piece, so when she’s a teenager I can tell her to quit complaining. Folks in haiti have it worse.

I left at around 430 am, got a ride to the airport from my dad. We said our goodbyes and I was off again. I slept from tarmack to tarmack with no recollection of the flight(time travel maan).I met up with John at JFK. Johns a good guy who I worked with in Africa.

The flight itself was good. I sat between two domincan girls who smelt like sunshine and beaches, but spoke no english. So I slept and watched a movie on that tiny screen on the seat in front of me.

We landed in Dominca and had our passports stamped by a little too friendly customs women, and were hurried to our hotel by an excited cab drivers.

The cab itself had seats covered entirely in plastics. John mentioned it was a little too dexterish for his likings.

Our hotel was nice, we were the first to arrive. And as such had to deal with a front desk clerk who lost our reservations. Then found them. Then couldn’t find proof of payment. In the end we spent around an hour at the front desk waiting to get our room.

After a hotel buffet and a sample of Domincas national beer el presidente we received our marching orders.

Assemble in the lobby at 6am. Depart via cab to the bus station and procede to thr Haitian capital of port a Prince. From there you will be picked up and taken to the heart to heart house. Where new orders will be delivered.
This is a rough draft im publishing now.i will finish later if i can(spotty wifi). Heart to Heart International has nothing to do with this blog and probably wishes i didn’t have it.

Tour through the empty ETU

Okay, so it’s been a couple weeks since the last update. Honestly there hasn’t been a ton going on. Were currently in “Standby” Mode. Which means the level of Ebola cases is so low, that we stopped triaging patients. We can open in an emergency, and our ambulance is still helping take potential cases to the nearest ETU in Ganta (About two hours north).

I did manage to get a video done and uploaded of how the suspect and confirmed wards of our ETU look. So, take a look.

The Journey Begins

The Journey begins.

Just getting to the airport this time around was an event in and of itself. Normally in the past, I would get a ride from one of my parents to the airport. My first time around it was my father driving, with my mother and girlfriend that dropped me off. This time, however, my father couldn’t make it due to a doctors appointment, and my mother was still recovering from eye surgery. The girlfriend currently only has her drivers permit, and couldn’t make the drive home alone. So I asked my friend Brandon (Brandon couldn’t get off work), so I called Lee. Lee agreed to it.

I also didn’t have a baby last time. So, after waking up and double checking everything; I said goodbye to my dad and started the journey. We dropped The girlfriends daughter off to be watched by her grandfather, and then the half hour drive to pick up Lee. Soon we were in Chicago and trying to find a place to park in the hell that is O’hare.  I said a very heartfelt goodbye to my baby girl, my girlfriend, and Lee.

(Haley the Bebe and I)

(Bebe and I)

(Heading off!)

I have a theory about airports, and it goes like this:

IF you are one of the few citizens of the world without citizenship to a particular nation, you can live in the terminal of an international airport. It’s one of the safe zones that exist to allow people to travel around the world – similar to international waters. So it exists as a sort of no mans land; a gap in the normally rigid borders of the world. Since it’s not really a place in space, one can assume that it does not exist in time, either. Which is why I find it perfectly acceptable to drink in airport terminals regardless of the time. Actually, I make it a point to drink when I fly.

There’s the 8 dollar bud light I had at the airport in O’hare. But, I never drink on Domestic flights; it costs way too much and I normally spend most of the flight passed out with my mouth open anyway.

My flight path was rather convoluted and confusing. I flew in the following order:
From O-hare
to Dullus in Washington DC
to Brussels in Belgium
to Belgium to Liberia

I don’t know why It wasn’t just from O’hare to Belgium, since O’hare is an international airport, but I digress.

I get to Dullus and my ticket is through United, but it doesn’t have a terminal.

Crap.

When you leave a flight, normally there’s a gentlemen as you walk out whose some sort of wizard. He knows where every flight is and when it heads out. I imagine this man as some sort of idiot savant, who’s dressed by his Uncle (who’s obviously tired of doing this every day), while muttering gate numbers and air carriers to himself.

“You’re going to have a good day today right, Alfred?” The Uncle straightens the mans tie, as he’s done 1,000 times in the past.
“Flight 9049 from Terminal C7 to Tel Aviv.”
“Good, good.” Uncle Charles knew that Terminal C was was used when Alfred was in a better mood; terminal B when in a foul mood, and you never, ever wanted to hear him mention terminal T.

I ask him where United to Brussels is and he spits out, “D-12. It’s on D-12, and leaves at 5:00.” I look at my watch and its 4:45. I do the reasonable thing and panic. I grab my bag and start running towards the gate. I’m in C something, and Dullis is pretty damn big. I’m shouldering babies and leaping over old men in strollers – I can’t miss this flight. I’ll have to end up staying in D.C and wait a few days to fly out again.

Somehow, I make it to the gate and It’s 4:54. I take my printed ticket up to the counter while dodging a woman’s Danish Volleyball team in the process. (Hmm, maybe I should have tried to take that flight). The woman – who looked like she was ready for her shift to be over – took my ticket and scanned it.

“Yeah, this flight is with United through Brussels airway. That’s terminal B”

Damn you wizard flight savant, you were wrong!

So, I hustle to find the B Terminal. Part of this involves traversing the tarmac in what appears to be a Star Wars sand crawler (minus the blaster marks), and hopping a shuttle train. I make it to the terminal and its 5:30. The flight leaves in 20 minutes. Luckily, I have my ticket at this point and manage to board.

An airbus can hold 338,  but there were only 66 people on my flight to Brussels. Maybe some of them had been confused by the terminal wizard and ended up missing the other flight. Either way, it was glorious, I had an entire row to myself, and no one behind me. I watched “The Judge” with Robert Downy Jr, had three Beglian beers, two meals, and passed out for a good six hours of the flight

It was an amazing flight.

This is my third time in the Brussels airport, as seemingly all roads lead through Belgium (Can ask the Germans about that). So I remember my way around.  I go through security and head up to the “Diamond Lounge”.

Now the Diamond Lounge is not, and I say again not, what its name suggests, and that is a strip club that straddles the boarder between Portage and Lake county in Indiana.

It’s a “rest and have some drinks while you wait for your next flight” sorta lounge. Now, when you’re in most airports you see these lounges as you head towards your flight.
“Lufthansa Business class”
“Brussels Airways Bourgeoisie lounge”
“Air Singapore, don’t even think of looking in here you filthy pleb lounge.”

All the while you walk by, carrying your backpack, or rolling around your hand-me-down luggage and you know, you just know that they’re in there, drinking their fancy machiatos with soy(extra wet of course) and laughing at you. Well, maybe that’s what I imagine.
However, for the low, low price of 26 Euro’s you can enjoy the same.  They have a buffet, water, soda, beer, hard liquor and a place to sleep. Remember that beer I paid for in O’hare? That one was 8 dollars. A sandwich? You have another 8-10 bucks, not counting a drink and a side. Throw in trying to pay for wifi and you’re looking at an easy 30-40 dollars just waiting for your flight.

I had around 6 hours before my flight left to Monrovia, so I paid the 28 bucks, enjoyed my food and beer and enjoyed some Wifi.

And for awhile, all was right in the universe.

I stretched, took a look in the mirror and headed to find my next flight – Brussels to Monrovia.

The only reason I remember my flight Terminal is because it was T-72, and for those that don’t know the T-72 is an old Russian tank model. So I start  following the signs for terminal T. Terminal B goes from B-1 to B-98, terminal T is about half way through that.

(This Tank did not get me to Monrovia)

I find the sign and head towards it – my overly full backpack digging into my shoulders with each additional step. The sign directs me down a ramp, which winds down, and down, and down to what appears to be a non functioning part of the airport. There are painters everywhere, tarps on the ground, and people working on lights. It’s like I went from the first world European airport to the Developing nations airport in one ramp. The ramp going to Africa.

I turn left, and to my surprise there is a gate marked “T” and an attendant there. He takes my ticket and tells me to wait for the next shuttle over to T terminal. A short shuttle ride over and I’m there, which is pretty much where every flight to Africa is. I’m still about an hour early, so I wander back and forth aimlessly down the short terminally, wander into the duty free stores and look at the overpriced jewelry and sunglasses.

When I manage to get back to the Terminal, an hour long queue has formed in front of the gate. Unlike my last flight, this one was packed.  No one really knew what the queue was for, was it to board? To get our tickets checked? Maybe Kim Kardashian had been spotted. I, like a good old Army Vet, fell right in because if eight years of serving taught me anything, it’s how to stand in a line for a really long time without knowing why.

One of my co-workers was also on the flight, so we stood and talked about what I had missed, which was apparently a lot. The old medical director is gone, and replaced by a new one. Several of the staff had resigned or were terminated. The general shuffle you expect you from an organization building its first Ebola Treatment unit. Only two people I met when I left Liberia were still there.

This flight was a little more on the rough side; packed to the brim with people, crying babies, and a kid behind me who kept kicking my seat.

He actually managed to pull out and inflate his life jacket mid flight. The flight attendant was visibly upset at this, as the kids father was next to him and just let it happen.

Had we not had an extra flight jacket on board, they would have had to do an emergency landing to restock another one. Yes, this is a real thing.

The flight dragged on forever and the only highlight was watching the dunes of the Sahara as we passed over them quickly. I briefly wondered if I had a life jacket at this point, then quickly remembered I’m flying over a desert..so then I slept to Monrovia.

Remember the little boy with the life jacket? As we landed, he kept asking his father if this was New York, since he was told that he would be visiting New York? Was this kid getting kidnapped? Or was he simply being a jerk? One answer we may never know.

A quick stamp on the passport and another 45 minutes was spent waiting for my luggage to arrive. With the packed flight, and one baggage terminal in the airport, things got a little chaotic.

(Anarchy)

Yeah, even the baggage inspectors just waved me through. Following the 16 hours of flying was another hour of driving to the capital itself and to the guesthouse. The same guesthouse I stayed in the last time I was in Monrovia.

The only difference being that I was the only one there this time. Which made it seriously creepy. In the past I had stayed in the back bedroom with Davis as my roommate. This time I took the one bed bedroom a little further into the house. Getting ready for bed.

I close my bedroom door (for whatever reason, despite no one else being there). I turn around and then hear footsteps in the hallway, quickly I open the door and find no one there.

Okay, hmmm. Weird, but I am tired after a long flight. The mind does have a way of playing tricks on you when you’re exhausted. I head into the bathroom to brush my teeth and take a shower. The bathroom door slowly creeks open as I brush, and the shower mount collapses with a loud clatter at the same time.

…Nope
….Nope
…..Nope
I like to say that I’m not a superstitious man, however that event was some scooby doo level trickery and I don’t have shaggy around to protect me. I retreated to the back bed room and stayed there, confident in my ability to defend myself from the ghosts of past guests.

I was told I would be leaving for Tappita on Thursday, and would attend a meeting with USAID on Wednesday, so I unpacked a few things. However, that meeting was cancelled and the drive to Tappita was to begin in urnest the next day.

Uploading photo’s here is rather difficult, so blog posts might either be more wordy or more sparse as it takes significantly longer to put the photos up.

Back in the Saddle again.

Some things –  like Aerosmith songs – can’t just happen once. So, after much consideration, I’ve decided to return to Africa for a second trip to Liberia. I’ll be gone from March 30th to May 30th.

“Well,” you’re probably asking, “You never finished updating your last journey there.” Well, you’re quite right internet stranger. I did do a poor job of finishing up my last experience. To that, I apologize. There really isn’t much of an excuse. I left Liberia, returned home and enjoyed a rather relaxing 21 day self imposed quarantine. Much netflix and counterstrike were enjoyed. I still have a post or two left in the brain box  to toss in here from my last experience. So expect an “Ebola throwback” episode now and then.

What have I been up to since? Not a whole lot. My beautiful girlfriend gave birth to a rather gorgeous baby girl on February 3rd. She pushed, and I actually delivered, which was quite a wonderful experience. If the little girl turns into a bad teenager (as we all turned into bad teenagers), I can pull the, “I brought you into this world, I can take you out of it.” Line.

Here, enjoy bebe pictures.

…and

Boom! Look at that. She’s healthy, enjoys doing baby activities, drinking breast milk, pooping, peeing, crying about things, and trying to figure out what hands are for.

Oh, and to commemorate my trip, I added another tattoo to the collection.

(Outline)

(Coloring it in)

(All done)

The thing in the middle is the actual Ebola Virus, and the words “A love of Liberty brought us here” happens to be the Liberian national motto. I think it fits pretty well. Although, it did hurt a little bit.

(Owww)

---

I started a new job at a Psych hospital, which was a interesting career move. I’ve never worked psych before, and dealing with the patients takes a lot of patience. Even though they may only claim to be the president of the United States, calling them commander and chief will help them take some meds. I’d been working two days, two whole days at this new position when I got the call to head back to Africa.

I couldn’t exactly say no – it was a great opportunity. So I walked into the Director of Nurses office, and told her about the situation. I expected a swift reprimand, a “Why are you wasting our time even coming” sort of attitude. However, I found her to be warmly receptive to the idea, she encouraged me to do it, and that my job would be waiting when I returned. I was pretty stunned. So I’d have a pretty good paying job when I get home as well.

Several obstacles have so far appeared, preventing a smooth move back to Kasava land.
1. Girlfriend needs a place to live before April 1st, the time I found I was leaving to Africa and the time I left is around three weeks. Finding an actual place to live in that short amount of time has been difficult. Most apartment complexes are full, and the one place we’ve found so far has pretty much required everything except my first born childs soul to get in. So far I’ve given:
1. Pay Stubs
2.W2’s
3.Ledgers
4.Current Contract for when I go overseas
5.Letter from Psych Hospital
6. Promised to give 3 months rent down payment plus a deposit.
Today is Thursday, I’m supposed to leave for Monrovia on Monday and we still haven’t moved yet. This, not leaving to combat Ebola is what currently fills my day with stress.

2. Needing a new vehicle. Sadly, my old car Winnona RideInHer was on her last legs. A recent attempt to change her oil was foiled by a blown oil gasket. So I, feeling like an adult, went to a car dealership and got a new vehicle. A fancy 2012 Chevy Equinox (Her name shall be CARline). Trading in a vehicle, getting insurance, and filling out the paperwork was significantly easier than finding a place to live.

Okay, well I guess there were only two main things impeding my return to Africa. I’m definitely going to miss my baby, girlfriend, dog, and family again. This stint is going to be a bit longer, from March 30th to May 30th, but It’s not as scary as it was before. Ebola is almost non existent over there, we’ll be mostly on standby in case an outbreak occurs. Plus, I’ve done it before. The first time jitters are gone.

Nights

With my foot healed, and around a week left in the ETU, I was put on night shifts.

Nights are a completely different beast than days at the ETU. While Days consist of frequent frantic admissions, blood draws, lab runs, and guests from dignitaries. Nights tend to be longer periods of slow time, with short bursts of activity.

The shift starts off with report, and medication preparation before you head in, which is no different than a day shift.  The difference starts with the complete lack of people. There’s seemingly half the number that are on days, and those that are there are quickly sleeping or lazily watching movies on their laptops.

Normally on nights you would go in around 9pm, stay for an hour or two, then go for a quick walk through at 5am to see if anyone had died.

Our situation was different. We had a 3 month old baby in the confirmed ward, and she required fluid every four hours. Normally a baby this young wouldn’t stand a chance against Ebola.

Bong has had one under five survivor -she was three years old, not three months.

This child had one thing going for her, the fact that her mother was an Ebola Survivor. The hope was that her breast milk would contain enough anti bodies to keep the child alive.

A normal gravity IV would give fluid to fast, so IMC “Acquired” tubing normally used for blood transfusions. This allowed us to measure down to the ML of  much we were giving.

We’d suit up, head into the hot zone, draw up the fluid into a syringe, and place it into the chamber. (60 of Ringers, 50 of D5, 10 of D50).

And we’d wait.
And wait.
And wait.

Forever will I change “watching paint dry” to “watching fluid drop”.  The IV itself was small a 23G (In IV’s the larger the number, the smaller the needle, 23g is quite small),  and it was positional, so every time the baby moved, the fluid would stop. We’d have to go over there, try to hold her arm so the fluid could continue.

We were in there once for two and a half hours, waiting for 120mls of fluid to go. To put that in perspective for my fellow freedom loving ‘Muricans, a can of coke is 355 mls.

I remembered an old game we use to play in the Army. As we often enjoyed(endured) the Army’s hurry up and wait policy, and without cell phones we had to actually look and talk to each other like a bunch of barbarians.

I present:
The Name Game
To start, you say the name of someone famous say, ” Jake Gyllenhaal”
The next person has to come up with a name that starts with the first letter of that persons last name -fictional or real.
So a proper response would be,
“George Costanza.”

I don’t like it Jerry, these Ebola wards have no pillows. How can you call yourself a hospital with no pillows? It doesn’t make any sense JERRY.

A reply would be
“Charlie Chaplin.”

And so on, and so on until you finish what you’re doing. The heat, and PPE made it quite the challenge. Normally you can spit out names without a problem for the first five or ten minutes, this time we were struggling. After awhile you get stuck on letters, and god help you if you land on X or Z.

Sometimes during this time the mother would breastfeed. We had to explain to her that her “Titty Water” (Their name for breast milk) would help keep the baby alive. Each day we would encourage her, and each day the baby would latch a little better. Her temperature maintained relatively stable, and she seemed to have more fight.

One night the IV wouldn’t push, and putting in an IV to a 3 month old dehydrated baby wasn’t any of our specialties, so it had to wait till morning. Each time they stuck the kid during the day, it would work for a few hours then give out. She was on her last scalp vein she spiked a fever of 40.9C (105.6) one day. Luckily the fever came down, and the baby was stable the last I heard.

After dealing with the fluids, we would doff, change into a new pair of scrubs and try to lay down for awhile.

Normally until around 1am, the staff would play a movie for the patients in confirmed. It really depended on who was more in confirmed, if it was kids, they’d try to play Disney films (The Lion King was a hit), adults preferred Nigerian films.

Which
Are
Terrible.
The projector cast the film on a sheet hanged between laundry and the doffing station, it being a sheet, meant that any wind would distort and contort the film. Combine the fact that the speakers were blown, and you have a near IMAX experience.

Mr. and Ms. Ibu was about a cross dressing Nigerian man who attempted to change is genders in order to avoid losing money, or to get money, The costumes and set design were quite well, but the dialogue and plot left much to be desired. 2/10 Wouldn’t make Ebola itself sit through it.

Another part of night shift, that day shifters don’t have to worry about are the bugs. With sun down, and the lights on inside, everything with more than four legs decides to hang out. Now these aren’t your normal moths and mosquitoes of the United states.
These are African moths the size of your hand, wasps an inch long, and whatever this thing is-
(Highlighter for scale)

Damn Africa you scary.

While the light is on, they dominate  the place, they outnumber us 100-1, if they wanted to revolt and take over the ETU, they would have the numbers to do so.  So as soon as were done going in the first time, and have finished any work we need to in the office, we turn the light off.

The office area had a cot inside, and we would clear off one of the tables against the wall to lay on, which often left the third person faced with a choice- Try to sleep sitting up, stay up, or lay across plastic tables. I would say that medical professionals are above childish games such as rock paper scissors to determine who would get the cot, but I will say that-

Always put your money on Rock if you want a good nights sleep.

I think that laying on that Army cot, with my eyes closed and listening to the African rain patter the tin roof- hearing the occasional rumble of thunder above will always hold a place with me.

(Bit loud)

(Rains looking outside our office)

You’d drift off to sleep, just to be awoken by the doc or other nurse telling you it’s time to go back in for the walk through or to give fluid.
During this time, the sprayers would start what I like to call,

“The Ritual Bathing of the Rocks.”

Every morning, they would fill up buckets with 0.5% chlorine and throw them over the whole compound. Every square inch would be covered. If you have to kill every living cell around? except no substitution. Chlorine is the way to go.

Here’s a sprayer making sure every filthy rock got what what was coming to it.

It also had the added effect of recreating a World War One battlefield. The air became incredibly hard to breath, it burned your throat, and there was no where to escape to to make it get better. They sprayed the inside of buildings, they sprayed the latrines, they sprayed the walls, they sprayed the sprayers and then did it all over again.

You don’t have really any choice but to accept the punishment, and hope that one day a lawyer will run an add on TV promising you part of a class action law suit if you were apart of “Ebola aid” and suffered from injuries related to chlorine inhalation (1-800-coughalot)

Day shift would soon come, you’d change into your civilian clothes, let them know if anyone died, who did well, who took a naked a walk down the ward and had to be corralled back under promise of FuFu in the morning. Then hopefully, you’d make it home by 8:30, be asleep by 9, to wake up and do it all over again.

The Slow Time

We got word on Friday that K would be okay, and two of our nurses went in the Friday we got the all clear.

I was instructed to wait until Saturday morning shift, and head in then.  I was excited to get back to work, It was now Friday, and I hadn’t worked since Monday night. Plus being trapped in the house was starting to give everyone a  bit of cabin fever.

On Friday, I noticed that there was something wrong with my left foot. The top of my foot had a open blister/sore about the size of a half dollar. It was very painful to touch, and any sort of pressure on it, and the pain would become nearly unbearable.

But, I came here to work, not to sit in a house.  So I went in for my shift at the ETU. Even putting my socks and shoes on quite painful, but I sucked it up and headed in. We still had a moderate patient load of around 13 or 14, and I’m sure they could have used my help.

Working in the ETU was painful., The gum boots rubbed against the wound constantly when I walked, I didn’t want to get a bigger size due to the possibility of tripping on something and ripping my suit. So I toughed it out and went in and did my shift. After little more than an hour in the ETU I was limping, and as we watched the last of the IV fluids finish administering I hobbled out to doff.

The doctors  took a look at it, and determined it was either a spider bite, or I had killed a Nairobi fly in my sleep, and then put on shoes and socks. The rubbing irritated it and led to the wound.

However I was told that I can’t work in the ETU itself until it heals. I was to wear flip flops and avoid irritation.

Little bugars have an almost acid like solution in them that can cause severe irritation when coming in contact with the skin. and I don’t like it.

One day back in the ETU and this thing set me back a few more days.

So after 6 hours of work, I was sent back to the guest house.

Three days of sitting around and doing nothing awaited me. I did what I could to keep my self entertained, movies, some games, went on a couple short walks. But not being able to wear shoes was a hindrance.

I did go into the little town near here with some of the IMC staff. We walked through the market, and picked up a few needed supplies.

The market itself was much fuller than the previous time I had been there, sellers hawked their goods as you passed. You were also hit by a unique smell of dirt, humans, fresh fruit, and unrefrigerated meat and fish that assaulted you as you first walked in.

Not my photo, but photo of the Market itself. Notice the cooking oil sold in water bottles on the right. They’ll often take empty bottles out of your trash to use them for this purpose.

Underwear, and fruit sellers were next to each other. Women sold cooking oil from empty water bottles. Fresh and cooked fish dominated another section of the market. Chicken burned black, and forest deer sat on another shelf. The crowds surged in this part of the market, having to turn side ways to head any deeper you were passed by small boys with bags of plastic water.

“Wata, Wata, Wata,” They shouted.

We made our way through the block long market, and emerged next to the street. I had bought a bottle of BBQ sauce for 200 dollars (about $2 American) and refilled the minutes on our wifi hotspot.

We all decided to go get something to eat, and asked our driver to take us to his favorite restaurant. The restaurant was a few blocks away. Like all establishments it had a chlorine 0.05% tank outside for us to wash our hands with before we headed inside. It was small, maybe a dozen tables all together with red and white checkerboard table cloths, and concrete floors.

The five us sat there and ordered, and were handed our very own bag of water to drink for the meal.

I had Goat soup and a side of fufu.What’s fufu you ask? It’s a ball of dough essentially. It has no real flavor, and just acts as a mass that fills up your gut.

Fufu on the right. Similar to what I ate on the left.

The African peppers made the whole soup incredibly spicy, I had to take breaks after a few bites. The fufu itself was flavorless and simply acted as filler. The goat was well cooked, but freshly slaughtered, Some of the pieces were the goats actual skin, and completely inedible

The whole meal cost around $5 American dollars. They often don’t have cash registers, and instead just have a bucket where they keep all of the money.

After that we left, the driver knew of a fresh fruit stand that wasn’t too far away from the ETU.

We headed out down the bumpy road. The “not to far” fruit stand ended up being nearly a 40 minute drive past the ETU and consisted of several stalls along the side of the street.

I bought a pineapple, a papaya, and 80 dollars worth of Bananas (Liberian dollars, but I never thought I’d get the chance in my life to say I bought 80 dollars worth of Bananas)

Nom Nom nom nom

They also had a bowl of live grubs for sale there.
i contemplated eating them, but didn’t have anything to wash them down with.
If anything so I could quote the Lion Kings, “Slimy yet satisfying.” line

We headed back towards our housing and went our separate ways. I waited another day before trying to head back to the ETU. I’ve slowly managed to get back into the hot zone. Each time spending a bit more time in the PPE and gum boots. The foot is healed now, and we have roughly three days left before heading home. All in all, the foot, and K being sick knocked me out of action for nearly a week. During that time our census went from 35 to 12. Now it’s down to about eight.

Only a few more days left, and I’ll be back to the shining Capital of Monrovia, with it’s paved road and and street sign.

A little too close to home

I hesitated for awhile to post this due to the sensitivity of the subject, but I think enough time has passed. I’m also not using any names either.

I had just ended the “Night Shift” when I came home to this situation. I was tired, emotionally frayed and running on an hour of sleep in the past 24 hours.

One of our normally more cheerful docs simply said “Hi” when she got to the ETU and looked very distracted. I didn’t think much of it at the time, but it was quite out of character for her.

I headed back to the guest house to hopefully get some sleep and repeat the process the next day. It was a good tired, the exhaustion of a hard days work.

When I got to the guest house, I was quickly pulled into one of the bed rooms by one of the other nurses.

“K’s, sick.” She said a worried look on her face.
“Sick?” I asked. This wasn’t good news, “What happened?”
“K had Diarrhea last night,  been running a fever of 101, and has body aches.”

“Shit” is the only word I can mutter. K has had close contact with Ebola Patients, is running a fever, and has Diarrhea. K fits all the criteria for a an Ebola Patient…. But also for Malaria, Typhoid, and the Flu.

K is also my roommate.

There’s a chair sitting at the threshold of the door.  People are taking turns sitting there and watching K.  It’s also acting as sort of the demilitarized zone between suspect and non suspect.

K was there, but there was an almost ethereal feel to speech. K was obviously in pain, and grimaced when moving.

“Hey, how are you doing?” I asked,
“Been better.” K replied, trying to force a smile.

When health care workers get sick in Liberia, they are not taken to the ETU as a regular Liberian would be. They are transferred to whats called the MMU or Military Medical Unit – It’s located next to the UN airport outside Monrovia. All the doctors and aid workers that were infected and diagnosed in Liberia, then sent back to the US after being treated at the MMU first.

The weekend before we left for Bong, a large portion of our group went and took a tour of the MMU. I didn’t go, I had no intention of ever seeing that place from the inside.  The others had described it as air conditioned and excellent.

But how exactly did one get someone sent to the MMU? We had been told that it would be handled by those over our heads. The Medical directors of respective ETU’s.

The other nurses in the house wanted me to call our medical director right away and let him know while the other doctor in the house wanted us to wait until she brought back reinforcements.

We discussed the problem for a few minutes before the other doctor and a Liberian national doctor arrived. The national crossed into the room, and started examining K, palpating K’s abdomen and feeling K’s pulse.

Which is NOT what you’re supposed to do with a suspected Ebola patient. You never touch a patient with out being in full PPE.

Wanting to help my friend, I went in and pulled K’s thermometer from their toiletry bag and handed it off.  I then quickly stepped out and bathed my hands in enough Alcohol hand sanitizer to drown a toddler. The doctor followed suit.

There was still some debate on rather or not to call our chief medical officer. I grabbed the phone, stepped in the other room and did this. Had this really been Ebola, we had to get K evacuated and treatment started as quickly as we could.

The medical officer was alarmed at the situation and promised to get working on it as fast as he could on his end. He was only a couple hours away and would head this way as quickly as he could.

The MMU has helicopters outside of it – or it did when our plane landed, at least. The other nurses were questioning why they wouldn’t send a bird to get K.

The next hour was mostly waiting, trying to find out what was going on, and nervously pacing the halls. I made a bottle of Oral rehydration salts for K and tried to flavor it the best I could. K had requested some cold coke from the ETU, but they only had pepsi. We tried to slip a little ORS and ice in with it.

The seconds on the clock came slowly, and our patience for some kind of guidance was running thin. We hadn’t received any word on what to do. I remembered that on our table, there had been a card left on the table. A captain, an aid to the general of the 101st airborn had left it. I called it and explained the situation, he understood and gave me direct contact information for the MMU.

We get word finally that they are going to send a team in to draw some blood for a Malaria and Ebola test, and then send him to the MMU by ground transport.

I think this is when the biggest shock came from. All of us were the ones used to being the ones in the space suit, the ones that received the shocked looks from those looking upon the PPE. To be on the other side, to watch the Ebola shock troops head into your house and into your room was something that none of us expected.

The sprayers came in first, coating everything in front of them with a layer of 0.5% solution bleach, They sprayed the door way, the floor leading to our room, the floor in the bed room, and the entire bathroom. They also filled his Coke/ORS with bleach and rendered it undrinkable (Spraying isn’t a precision art)

You could taste it in the air.  I can understand why those in villages around the country were scared. We knew what coming  and it was scary for us. Imagine yourself being from a village deep in the jungle, and these hooded white figured come in, spraying a noxious fluid over your village and taking your loved ones away. Loved ones who sometimes never came back.

Doctors and Nurses taking some Samples from K for testing

The doctor who had examined K earlier was back with a Liberian national nurse, they were in full PPE this time. They drew a blood sample for a Malaria test and Ebola test, and left the room.

We got a call over the phone that K would be transported with one of the International Medical Corps ambulances down the Military Medical Unit.

The pickup truck with the wooden slat for a back window was the transport vehicle used.

The Ambulance backed up to the door, and K slowly walked into the back and lay down on the mattress. K assured us everything would be fine, and the gate was lowered. We all stood and watched as the trucked disappeared behind the turn, unaware if we’d ever see K again.

The sprayers then return to the house, spraying every step that K had made, and returning again to the bed room, where they sprayed K bed, as well as my bed, and bagged the contents into red bio hazard bags (R.I.P Poncho Liner) they also took the mattresses out of the room to be burned as well.  They sprayed the closet as well, a good amount of my clothes are now ruined with bleach stains and have to be thrown away.

That room was locked, and placed off limits for the rest of us while we waited for the results.

It’s around 1300 at this point and I’m near the point of delirium. the past day, from the death during the night shift to K becoming ill had left me drained and exhausted. I collapsed on a very uncomfortable love seat and slept for several hours.

The next three days we were held in isolation in the house.  Since K had only shown the first symptoms during the night,  and Ebola is only spread after a patient becomes symptomatic, we all felt pretty safe. I had worked the night when K’s illness had began so I hadn’t been directly exposed.

I think we were all affected by this. K had been very diligent in the use of PPE. No breeches, no close calls or anything, if K could get it being that careful, whose to say the rest of us couldn’t get it either? K had been feeling tired and lethargic for a couple days prior, had K been symptomatic then? Were we exposed then?  Being isolated in a house for a couple days you tend to have a lot of these conversations.

Word came back the first night that it wasn’t Ebola, and it wasn’t Malaria. The Malaria test was good news, but K’s viral load for Ebola could still be low enough that it didn’t show up on the test. However, we took what good news we could get.

Every step in the process of transferring a potentially infected healthcare worker had been followed as it should have been. Both organizations responded quickly and did exactly as they should have.

We get a call the next day saying that K’s is feeling better, and that the anti-biotics they were giving were working. K thought it might have been typhoid, . However, we still needed another negative test to clear us for leaving the house. The whole ETU during this time was worried, they had some idea of what happened, but had less details then we did. We passed the time by watching movies and reading, I think two of us managed to watch a good 16 hours of game of thrones during that time (Winter is coming).

Finally, on the third day we get word that they’re taking K out of the MMU, the Ebola test came back negative. K would get some well deserved R&R in Monrovia and then head up.  It was a collective sign of relief, and just drove home how scary this virus could really be. I sometimes think what would have happened had it been positive? We were all pretty sure K could beat it, strength and determination had never been short, and K had no intention of letting this thing get them, regardless of the illness. Would we have been pulled out ? Would another one of us had been infected? Me, being is roommate had slept in the same room and used the same bathroom, what if he was infected and symptomatic and didn’t know it?

Luckily, all of these thoughts are just speculation and never came to fruition. K was fine, we were all fine, and we got to enjoy a free freshly cleaned floor and bathroom.

Into the Hot Zone

The first time I stepped into the donning room I was pretty nervous. Alright, that’s a bit of a an understatement, my stomach was in my shoes, and each step of donning felt slower and slower.

We had some patients who were just getting admitted from triage, we were gonna draw blood and  check on some other patients.

Slowly, over the course of ten minutes, you put on your gear, it’s called Personal Protective Equipment, but we just call it PPE for short.

Each step is checked and double checked to make sure its on right. There’s always a couple nationals in there to help you tie your hood, defog your goggles, tie your apron and hood. It’s oddly reminiscent of Knights suiting up for battle.  You stand their and look at yourself in the mirror as layer and layer of protection is applied and checked by the nationals.

You cease being who you are as an individual and become an Ebola Storm Trooper. The uniform of mad men and women either brave or foolish enough to work here.  The nationals  write our names on our foreheads so we can tell each other apart.  They also write the time we went in on our arms. They do this so someone coming in can tell if you’ve been in to long and need to go out. It’s sometimes easy to lose track of how long you’ve been working.

This is also the only place in the whole of Liberia where you can shake hands and touch other. Once you go inside, you cant due to the  risk of putting Ebola on someone, the same outside, but for those few minutes you can shake hands, hug, whatever you want. You’re pretty well protected in your full body condom.

Your senses are dulled as the suit goes on. You are suddenly aware of how heavy your feet are, where the straps touch your head – the placement of the mask on your nose – if the mask is high too high, if its too low.

You have to fix all these things before you cross over. If your mask slips, if something is wrong and uncomfortable – you can’t adjust it. You can not ever ever touch your face once you cross that line. I made the mistake of having my mask to low one day, and couldn’t breath through my nose for over an hour. You only do that once.

Finally, as the sweat starts to come out, and you feel like an Asthmatic astronaut you cross the red line into the Hot Zone.

I took a deep breath before crossing that line. Here it was, the whole reason I had came to Liberia, and volunteered for this mission. All the worries and doubts and questions rose up and I anxiety coursed through my body. Man didn’t go to the moon to sit in the Lunar Module and wait did? Not after the journey he took, no he took those steps and did his job.

Standing in my own space suit, I crossed that line. All the self doubt and worry disappeared.

It was replaced with a very itchy nose.

The first day I was working with two other Nurses, a nurse practitioner who is our charge nurse, and another nurse who came up with me.

We only went into Suspect that first day. The building itself is Spartan, constantly wet concrete floors – your boots splash in small pools that gather throughout the building. The building is separated into individual patient rooms. On the confirmed side you can have three or four to a room, in Suspect you don’t want someone who might have Ebola to be in the same room with someone who might not.

The walls are are blue tarp, and the wooden framing is exposed, there are nails jutting out from the walls near the beds (for IV’s to hang from)

The patients each have a plastic mattress, and paper sheets as well an outlet for a cell phone to be charged. There’s  a bucket to urinate/vomit/defaecate into. If they feel healthy enough there are tables and chairs outside for them to gather at. The insects that can fly buzz around above, any unfortunate to be caught in a chlorine sprayers path lay dead on the floor.

There’s a light bulb in every room that’s always on. They have no pillows,  the bed rails can not be lowered  or the beds adjusted.  I imagine the smell of chlorine is nearly palpable.
We had a patient in Suspect that we would later admit, the Nurse practitioner went for a blood draw and missed, then she asked if the two of us would want to give it a try.

I nodded and said sure. He wasn’t a hard stick, but drawing blood from someone with Ebola was particularly nerve racking. One slip, one second of distraction and I could infect myself.  I had drawn blood on maybe a thousand people in the past, but none of them ever had Ebola.  I took a second to settle myself and got the stick.

Remember I said you can’t touch your face? For the first ten minutes I’m in the ward I have an incredible urge to scratch my face or adjust my mask or something. You just have to ignore it and focus on a task,  it does go away after awhile. However, the intense awareness of anything and everything on or around your face doesn’t. Even after your out of PPE, you’re hyper aware of anything touching you or near your face.

The amount of care we can offer is pretty limited. It is in my mind at least comparable to a battalion aid station in the army:

We Give IV’s (A lot of them)
We draw blood
We give IV Meds (Cipro, Flagyl, Ceftriaxone)
IV Pushs (Metrocploromide, Haldol, Valium)
PO Meds
Cleaning patients
Changing beds

That’s really… about it. They’re were two occasions where Foley’s catheters were put in, but they’re really quite rare.  The actual scope of nursing care is pretty limited.

It’s the conditions that make everything a challenge. The suit narrows your field of vision, your hearing is dulled slightly from the hood.  You can’t listen to a stethoscope . We can’t use a BP for a blood pressure. Even palpating for puncture sites is difficult with three pairs of gloves on.

Supplies are an issue as well, if you don’t have supplies in the suspected ward, you just can’t walk out to the supply room and grab them. You yell over a fence until hopefully someone pays attention to you, you stand and wait for five minutes while they go get it, They then throw it over two layers of waist high fencing to get to you. Hopefully they have a good arm, or you wait all over again.

The heat is another factor inside those suits.  During the afternoon shifts it can hit 93*, and with humidity it feels around 110. Walking around in that normally wouldn’t be fun, throw on tyvex or god forbid tychem suit and suddenly you’re facing 100% humidity.  Every activity you do is slower, every step you take has to be for a reason.

Rolling a patient to clean them? Subtract some time you can be in there.
IV? More time
Even handing out PO meds gets you after awhile.  I force myself to walk slow and plodding along like Darth Vader to conserve energy.

If you can be in there for ten minutes or three hours there’s never any judgement for “tapping out” and leaving early. Utmost care and attention is given to your own safety. What would happen if you pass out in the confirmed ward? How exactly do they get you out?  Luckily the situation has never happened, but the risk is always there.

It’s Always Sunny at the Ebola Treatment Unit

(Note: I’ll write about going in and working in the ETU in a little bit, but I thought I’d share this recent update with you)

I had just finished a 13 hour shift working at the ETU, we had given report and handed off all information to the incoming shift. Myself and another nurse were just waiting for a ride, and I (being in a post 13 hour shift gregarious state) start talking to one of the drivers.

He’s about 6’2 and built like a tank. Instantly I miss the gym, picking stuff up, and putting it down (repeat).  He’s friendly enough, he’s wearing a blue International Medical Corps shirt, with a IMC vest and sunglasses.

“What’s your name?” I ask

“Sunshine.” He replies.

“Sunshine?” I ask my head tilting like a three month old chocolate Lab.

“Yes,” He smiled, his hands waving in front of him, “Like the sun, it shines? My name is sunshine.”

He seems friendly enough, and my mind banks it with all the other meet and greets I’ve had recently. Sunshine only difference was the fact he was a tank, and since the end of the civil war – you don’t see a whole lot of tanks in Liberia.

He was also well liked, I remember hearing some jokes between Sunshine and our supply guy about having a pushup and pullup contest.

Well, let’s fast forward a few days. Our chief medical officer comes in one morning fuming.  He’s very upset, and talking more with his hands than he normally does.

It turns out our resident Sunshine was never in fact a driver for IMC. He had buffaloed his way into the job, he never had an interview, someone gave him the IMC shirt and gear, and he had just started driving people around. He had no license, and was a convicted felon in the United States who was deported back to his Native Liberia.

Well if this wasn’t enough, it turns out he had stolen an IMC car and crashed it into a tree.  (In my head, I like to imagine Rage Against the Machine playing while he does this).  He was hurt and sent to the hospital.

Where he proclaimed he would be suing IMC for the medical costs incurred upon him from the hospital.

Were all a bit stunned. He had been a pretty likeable guy, I wonder why he had done it?  It’s the main topic of discussion for a few hours, but slowly it fades into the past, another quirky news story at the ETU.

A couple days later I work a night shift, come home and sleep violently.  I’m awoken by two of our doctors coming into the guest house in scrubs and their gumboots.  I look at the clock, it’s only 3:00 PM, they’re supposed to be working till 7:00 at the earliest.

They sit us down and tell us what happened-

The story of Sunshines return to the ETU.

Apparently disgruntled at his prospects of a successful lawsuit against IMC for stealing one of their cars and wrecking it, he decides to return to the Ebola Treatment Unit.  In America in a situation like this, a disgruntled employee might go confront of his boss, or make a, “Whose coming with me man?! Whose coming with me?!” speech.

Not Sunshine, Sunshine has a better idea, Sunshine is going to take matters into his own hands.

He rushes the waist high orange fence in the Confirmed ward and leaps over it.

(Dramatic Reenactment)

Sunshine has just placed himself voluntarily into the confirmed ward of an Ebola Treatment unit.  All the staff start freaking out, and they pull everyone out of the unit, one of the Liberian PA’s inside draws up a syringe of Haldol to put Sunshine down if he assaults him, but the risk of getting your mask or suit torn during a confrontation with a angry Liberian tank and being exposed to Ebola is high, so he retreats with the rest.  The whole compound- save for 5-10 people are evacuated and sent home.

The police are called, but don’t have the training/refuse to don PPE and go into a confirmed Ebola Ward. I can’t say I blame them.  We send in our pyscho-social lady in to try to talk him out. She’s in full PPE -turns out he had laid down on one of the empty beds and taken a bit of a nap. The sleep- combined with her negotiating skills convinced him to take a chlorine shower, change clothes and give himself up.

The whole affair leads to afternoon fluids/meds for the patients being skipped, and we get to clean up all the mess during night shift.

They send sunshine to the hospital to be quarantined for a few days, and we all breath a sign of relief that its finally over.

OR IS IT?!

The next day we get the news that Sunshine broke out of the hospital quarantine, and headed back to the College campus (Where we all live) Where he broke into his dorm room  and –

Took a nap for a couple hours.

He woke up, lazily stretched after his nap and took off, he was spotted later that day drinking a soda on a bench somewhere on campus. We currently don’t know where he is, if he’s infected,  or where he plans to nap next.

Welcome to the Ebola Treatment Unit – Now wash your hands

I keep intending to write about our week at the Department of Defense training, and I will…. Eventually.

However, I don’t really feel like writing about it right now.  So I’m to talk about the ETU itself, and how we got there.

We were originally supposed to be at our own ETU on November 16th, however due to construction, and that fact that Liberian infrastructure rivals16th century Turkey- the process has been delayed and delayed…and delayed some more.

We finished our cold training at the DOD on Friday the 14th, and were under the impression that we would start our “Hot” training at bong the following monday. Hot training would last another five days, and each day we would progressively spend more time in the hot zone. First we would do a walk through, then the next day maybe hand out food, the next day draw blood. Each day we would progressively provide more and more care until we were comfortable.

When we got home from our last day of cold training, we were told that hot training was cancelled. They couldn’t find any spots for us at the time.

For how long? They wouldn’t tell us, but it was looking like a week.

Now a week to explore the capitals of most countries is normally seen as a chance to go see the sites, try out the food, and have a good time.

Monrovia, sadly lacks any of these amenities . There is really nothing to do, I don’t know if the city has a bowling alley or movie theater. Well, actually I don’t know if there are any of those in the whole country. But that’s okay. I was alright being at the guest house  for a little bit, and we would always take short walks down to the beach or around the neighborhood if it became too boring.

On Monday, our fearless leader came in and announced that there was a sudden need for medical staff. A doctor and two nurses at the Bong ETU, and a doctor and two nurses at the Kakata ETU that was scheduled to open. Three headed off on Monday, and myself, Lucile, and another doc were to head out the next day.

I won’t lie at this point, I was pretty nervous. I know the reasons why I came, I came to help these people, and to make a difference, yet suddenly my own self preservation started barking. Are you sure you want to do this? Are you sure you can do this?  Why are you doing this? The whole night the thoughts swirled through my heads, I tried to distract myself by adding some movies to my laptop, and talking to my family back home. But the thoughts followed me to a restless sleep.

The road to Bong was long and often in states of Ill repair . The road went from being well paved and traversed at 60 mph to pot hole ridden dirt, crossed at 10 MPH, what could have probably been a hour, maybe hour and a half drive turned into four hours. We also had to stop at a county line check point to wash our hands and have our temperature taken.

Which was kind of nice to see that containment measures are still in place.

When we got to the ETU we got out and took a photo with the sign.

(There’s me in the back)

The ETU is tucked about a mile and a half in the jungle, through a winding dirt road filled with dips, blind turns, and hills.  The jungle swallows you up as you go in, you’re in it  You can easily forget the outside world, there’s no evidence here. Just a winding dirt road that could have been made hundreds of years ago.

Soon we make a turn and head up a hill
Blue buildings, two layers of chain link fences.  When we got out, renee walked us to meet the docs and nurses there.

When you first get there you wash your hands in a 0.05% solution and dip your shoes into a 0.5% bleach bath. You do this again as you pass through another gate.

The ETU is set up with the confirmed and suspected wards being in the back,  with the doffing area in the middle, and the donning area nearest the suspected side. The ground is covered in large rock gravel,  pipes with 0.05% and 0.5% bleach sprout up around the perimeter.

A few dozen stakes stand next to the laundry room  they’re used as boot drying spikes. And every morning you’ll spend a good amount of time trying to find a pair of gum boots that fits (43 for me).

The jungle surrounds and envelopes the ETU

We introduced ourselves to the staff. The Bong ETU is ran by the International Medical Corps, an American based NGO. They were all friendly and glad we were there. They gave us a quick five minute tour of the area, and sent us on the way to the guest house so we could unpack for the week.

My room for the next two or three weeks.

IMC needed us in there to help, they got hit with a good amount of patients and a good portion of their staff had departed on holiday, or their contract had ran out. So we were skipping the customary few days of hot training and just jumping into it. Outa- the frying pan into the fire sort of situation. Personally I was fine with it, I was tired of power point presentations at this point, and another week learning how to wash my hands might push me to psychosis.

So on Wednesday we headed for our donning and doffing training. The gear we actually use is different than the what we trained with for the World Health Organzation. While the WHO says its okay to have exposed skin, IMC protocols don’t allow it. Which, while adding a bit of heat, definitely makes you feel safer.

They also promoted me to “RN” when they wrote my name the exercise -When I told them I was a nurse. That’s okay, I only had to come to Africa and fight Ebola for the promotion.

Here’s the order of operations for donning the gear.

Gum boots
Two pair of Gloves

Tyvex or (God awful) tychem suit

N95 Mask

Hood with mask ripped open in the middle to allow you some air passage.

Another pair of gloves taped to your arms.

Waterproof apron.

Goggles. The goggles were a challenge at start, fogging was a big issue with the WHO training, turns out that some dish soap on the inside gets rid of the issue completely,

For those wondering how you get out of all that? Well there’s a process for that as well.

Stand in 0.5% basin for 30 seconds to disinfect boots. Sometimes when there’s a person in front of me, I just stand in the basin for awhile, even if it’s been sitting in the African sun for four hours, it’s cooler than you. You can almost close your eyes and pretend your bathing in the purifying waters of Lake Minnetonka.

Step into Doffing area.

Hold up your hands and wave them like you just don’t care (You could be covered with Ebola, so care and don’t wave them)

The sprayer will spray a 0.5% chlorine solution from neck down, on your hands, apron, legs, and boots. Then you turn around and they get the other side.

Next you wash your hands in a 0.5% solution

Remove the tape from your gloves, and take off your outer layer of gloves.

Wash your hands.

Take off your water proof apron. This part can be a bitch, trying to find the tucked away hidden string that magically causes the apron to fall off you is hard, and on one occasion I just had to push the apron off me and step out of it.

Place the apron in barrel of 0.5% solution

Wash your hands

Bend slightly forward , grab your goggles from the front and pull them off your head. Dip your goggles THREE times (no more, no less) in a 0.5% solution, then toss them through a hole in the wall into a bucket of chlorinated water.

Wash your hands.

Now comes the hood, The hood has three ties in the back, and one at the bottom of the hood that wraps around in front of you. You can untie the strings, but wet gloved hands have terrible dexterity, I always end up just ripping them.  Once all the strings are ripped, you bend forward slightly and grab the back of the hood, pulling it forward and off your head. Then you throw it away.

Whats next?
What the do you think is next?
Wash your damned hands.

Now comes the suit. The suit has two pieces of tape on it, one that closes a flap over the zipper, the other over your collar. You “Pop your collar” by peeling the tap off, then pop the tape down the front of the zipper.

Wash your ha…NOPE! (Guys thought you were getting it by now right?)
Now the sprayer sprays the newly exposed area of suit. Which at times can suck, since they start at the top, some 0.5% chlorine can hit your neck and face. This can cause some pretty severe skin irritation and burns. Luckily Mr. Beard protects my face and neck from such a chlorinated attack.

Now you unzip, starting from the top, making sure not to touch the inside of your suit when you grab the zipper at the very top.  Unzip it all the way down to your nether relms and then you…

WASH YOUR HANDS YOU FILTHY SAVAGE.

Once that’s done you

Reach on the inside of your suit, making sure not to touch the outside, and pull it off your shoulders. Then you kinda shake shimmy the suit off you. Basically you do the Bernie out of your Ebola suit.

Pulling your hands through it, make sure you only touch clean to clean, or dirty to dirty.  Now, pull your suit down your legs, touching only the inside.  Yeah, down to your boots, but don’t actually touch the boots while you do it.

Now, stand up and pull your boots out of the suit, this part can be a little tricky to, first you step forward, then you step back, then you lift your leg up, try to step on it with the other foot. Every time I do it, I feel like an idiot, I’m trapped for a good minute trying to step out of the suit, until finally I manage to pop my boots free.

Kick/slide the suit forward a few feet. The sprayer then gives the Ebola suit another chlorine bath, drowning any remaining ebola’s hopes and dreams in tidal wave of chlorinated goodness.

Now wash your hands.

At this point your wearing two pairs of gloves and a mask, so the next step is to carefully take off the outer layer of gloves.

Now wash your hands again.

Lean forward and pinch the front of your n95 duck billed mask, pull it off your head and throw it away.

(Pictured is a n95 Duck billed mask)

(Quack Quack)

Once that’s thrown away you wash your hands again.
Now you take a step towards the sprayer, and stand at attention. He/She sprays the the front side of your boot

you turn to the left, sprays that side of your boots, (Reverse Reverse!) You turn to the right side and that side is sprayed.
Then you turn away from them, where the back of the boots is sprayed, then you lift up one boot behind you and its sprayed, take a step back and the other sole of the boot is sprayed.

Now you’ve crossed over to the “Clean side” of the doffing area. You take off your last pair of gloves and throw them away.

Congrats you’ve ma…

YOU WASH YOUR HANDS AGAIN

This time with no gloves on, and a 0.05% solution. And normally a good 45-60 second process

(Minus the soap and water part for us)

Next you stand in a 0.5% solution for another 30 seconds as you exit the doffing area.

Right next to the station is some piping with pure water and 0.05% solution. I always cover my face/arms/neck with a good amount of 0.05% solution. Then rinse it off with pure water.

Congrats! You survived donning and doffing!

Now go enjoy a coke.

(Me right after I doffed, notice the moistness)