Inside an Ebola Treatment Unit: A Nurse Shares Her Experiences in Liberia

By Sylvia Foley, AJN senior editor

“It is extraordinarily difficult to establish an IV line in a dehydrated patient by generator-powered light while double gloved, with one’s goggles fogging.”—Deborah Wilson

Author Deborah Wilson at the Foya ETU cemetery. Photograph by Marcos Leitão.In one of this month’s CE features, “Inside an Ebola Treatment Unit: A Nurse’s Report,” author Deborah Wilson offers readers a rare look from the frontlines of the 2014 Ebola epidemic. Her stories about her patients and colleagues are as compelling as they are informative. Here’s a short overview of the article:

In December 2013, the first cases of the most recent outbreak of Ebola virus disease (EVD; formerly known as Ebola hemorrhagic fever) emerged in the West African nation of Guinea. Within months the disease had spread to the neighboring countries of Liberia and Sierra Leone. The international humanitarian aid organization Médecins Sans Frontières (MSF; known in English as Doctors Without Borders) soon responded by sending staff to set up treatment centers and outreach triage teams in all three countries. In August 2014, the World Health Organization declared the outbreak an international public health emergency.

In September 2014, the author was sent by MSF to work as a nurse in an Ebola treatment unit in Foya, Liberia for five weeks. This article describes her experiences there. It provides some background, outlines the practices and teams involved, and aims to convey a sense of what it’s like to work during an Ebola outbreak and to put a human face on this devastating epidemic.

Responding to the challenges. As Wilson notes, there is no cure for EVD. Current standard treatment is aimed at providing “‘aggressive’ supportive care, which consists of oral and IV medication, oral and IV rehydration, nutritional supplementation, and psychosocial support.” But meeting this standard can be challenging in places where even basic resources are limited or absent and fear runs high. And when the international community is involved in a local response, transcultural issues arise. At Foya, open and ongoing discussions between the international and Liberian health care workers proved essential to incorporating Liberian cultural values and fostering “creative thinking and mutual support.” Wilson also details the coordinated strategies necessary for effective intervention at the organizational and national levels.

To learn more, read the article, which is free online, and don’t miss our interview with Wilson.



2017-07-27T14:39:21+00:00 December 11th, 2015|infectious diseases, narratives, nursing perspective|4 Comments

About the Author:

Former senior editor at AJN.

4 Comments

  1. Connie Kress April 18, 2016 at 11:33 pm

    As a nurse, my motives for choosing this career choice were quite varied from the other unique stories I would hear from my colleagues. Finishing school and beginning my career I had no idea how much certain patients would affect me or how many instances I would wish there was something more that I could do. Unfortunately, I had to be okay with providing the best care I could as terrible illnesses played their course.
    Debrorah Wilson speaks of going to the front lines of an international public health emergency in Liberia in an effort to care for those that were afflicted with Ebola as well as to help contain the massive spread of the disease. Wilson’s work with Doctors Without Borders was helpful not only to the people she was serving, but to many others that would subsequently remain free of disease thanks to her selfless aid. Globally, the Ebola virus is an epidemic that, left untreated, would devastate nations without regard, including domestically. Wilson’s work tackled cultural differences while providing emotional support to those in desperate need. She put herself in the most vulnerable position as she cared for those plagued by the disease that would terrorize without regard in a land with minimal resources. Deborah Wilson’s work is the reason it makes me proud to say that I chose this career.

  2. Stephanie April 17, 2016 at 6:46 pm

    I would like to begin by saying that I commend all the volunteers that took off to support in the Ebola Virus Disease (EVD) outbreak. I could not imagine the pressure that you all felt to do your jobs and still remain calm and collected. It takes a strong character and professional to step into that role. I think about the panic theses communities must have faced and the importance of the volunteers had on them, not only physically but emotionally as well. I remember going through EVD PPE training in nursing school and could not imagine caring for patients in that environment. Add heat, and extreme conditions to that and I could only imagine the pressure and anxiety levels.

  3. Carlos Orive April 15, 2016 at 4:49 pm

    Is our actions who define us, and definitely the actions of nurse Deborah Wilson helping others define her bravery character. Is not an easy task help communities low and middle income countries, because the lack of resources, the difficult hygienic conditions, and the cultural, political and economic differences. Global health care helps the development of programs to assist these communities where the lack of health equity between the different social class place the poor in disadvantaged. In this century the development of the communications and internet and media make our planet a global community where we have to be involve. Illness like Ebola, Avian Influenza could travel the world in hours and can contaminate the planet making it control crucial for humanity. Nurse Wilson place the nurse profession in high standards and her commitment with these patients she helps, denote the spirit of the nurse profession in this century. Thank you for making an example to follow.

    Carlos Orive

  4. Olivia Vilaire April 8, 2016 at 4:05 am

    First off, I would like to commend you and all others that volunteered to help with the outbreak of the Ebola Virus Disease. Your work and dedication is not only appreciated by the patients and families, but with others around the world too. In regards to the challenges faced during your time in Liberia, they all seemed difficult to deal with. As I was reading, I felt great sympathy for the patients and healthcare workers. Having to provide care under the conditions of high temperatures and full PPE defintiely makes accomplishing tasks extremely difficult. I found it appalling that the Ministry of Health was not paying the nurses that were there under their contract. Their hard work should not have gone unrecognized and should have been compensated on time. They were not only risking their lives in order to help, but were also leaving behind family and friends whom they love. Was there any solution to the patients, in the probable and confirmed cases area, that were constantly found with vomit and diarrhea covering them?
    The implementation of the psychosocial team members and family members going in to talk to the patients, in the high-risk zones, was wonderful. I know that if I were in the patient’s position, I would want my family members to visit me and/or someone to come and just talk to me. That social interaction provides great comfort and a sense of hope.

Comments are moderated before approval, but always welcome.