news and events » news

News Header

News Item

return to News

Ebola Volunteer Returns Home

by Richard Halstead, The Marin Independent Journal |

After six weeks serving as a volunteer treating Ebola patients in Liberia, Davis Perkins relaxed Friday on his living room couch in San Rafael.

"I'm still kinda jet-lagged out," said Perkins, whose 30-hour trip home this week included stops in Brussels and Washington D.C.

At Washington Dulles International Airport, Perkins received a medical exam and was debriefed by officials with the Centers for Disease Control and Prevention. Perkins, 64, a landscape painter who has worked as a paramedic, smoke jumper and U.S. Army paratrooper, left for Africa on Nov. 4 on two days notice after the nonprofit Heart to Heart International accepted his offer to help.

This isn't the first time that Perkins has volunteered to leap into a foreign disaster area. He previously served on medical teams that provided aid in Haiti, Cambodia and Ethiopia.

"I've seen a lot of reality in my professional career," Perkins said. "This was stark. This was the real thing. This was something unprecedented in my life."

In Monrovia, the Liberian capital, Perkins and other volunteers received about a week of "cold training." They were instructed in the painstaking ritual of putting on and doffing their personal protective equipment (PPE). Perkins wore a Tyvek suit, made of heavy duty paper, covered with a rubber apron, goggles, a face mask, hood, rubber boots and three pairs of rubber gloves. Just putting on the PPE took a minimum of 15 minutes.

"There was a whole team of people that's all they did was dress you," Perkins said.

Taking the suits off was a much longer process. The person removing their PPE is sprayed with a chlorine solution, throughout the doffing.

"First you take the tape off your gloves. You do it very carefully. You throw it in the trash, and then wash your hands," Perkins said. "Then you start with your outer gloves. You take one glove off. Then you take the other glove off. Then you wash your hands.

"Once I was going to count how many times I washed my hands," Perkins said, "but I got tired of counting."

One of the scenarios dealt with during cold training is how to deal with a resistant patient.

"One of the greatest fears is having a combative patient because they could rip your mask off," Perkins said. "Fortunately in real life I didn't have any."

Perkins said there were no bodies on the streets of Monrovia as there had been just a few months before his arrival; but he said signs of the epidemic were everywhere.

"There is no touching," Perkins said. "People don't shake hands, and wherever you go, there is a chlorine container to wash your hands. You don't go into any public place without having your temperature taken."

Usually, the next step for volunteers like Perkins is to receive "hot training," where they begin treating Ebola patients under the supervision of an instructor.

"We didn't have the luxury of that," Perkins said. "Three of us were farmed out to an Ebola Treatment Unit (ETU) in Kakata." That ETU was operated by International Medical Corps, which works closely with Heart to Heart International.

ETUs feature plastic walls and ceilings, and concrete floors. The beds are also covered in plastic, so they had be hosed down. The ETU in Kakata has 88 beds.

Perkins said most of the medical assistants he worked with were Liberian, although there were also some Americans and a few Europeans. The assistants slept in a Liberian army barracks adjacent to the ETU.

Wearing the PPE's in the 80-degree heat was a trial. Perkins said shifts had to be limited to two or three hours.

"At the end of your shift, the sweat would be running off of you," he said.

His main job was to keep patients hydrated by injecting them with intravenous fluids. The danger of a needle stick for volunteers always loomed. Perkins said the volunteers worked in pairs to make sure they remained properly covered by their PPE.

"Throughout your time in the ETU you're constantly evaluating your partner to make sure his goggles are not askew," Perkins said.

He said the work demanded a constant vigilance that he had never had to muster before.

"It could be a death sentence if you made a mistake," Perkins said. "So you just had to take a deep breath and move very, very slowly."

He estimates that perhaps a dozen patients died in the ETU he was working in. The last patient he watched perish was 2 years old.

Margaret Aguirre, head of global initiatives for International Medical Corps, said, "In Liberia, we've made very good headway. We are seeing declines in the rates of cases, and we feel like we're really making progress; however, in Sierra Leone and Guinea we still have a really long way to go."

Quarantine

There is no reason to believe that Perkins is infected with Ebola. Nevertheless, Dr. Matt Willis, Marin County's public health officer, has placed Perkins under a 21-day quarantine. Willis is following a directive issued in October by State Health Officer Dr. Ron Chapman to quarantine anyone traveling from an Ebola-affected area who has had contact with someone who has a confirmed case of Ebola.

"It's a home quarantine with some freedom to engage in activities where he is not coming into close contact with other people," Willis said. "He is expected to avoid public transportation and gatherings of people, such as movies, church services, and parties."

But Willis said Perkins is free to go out for walks or to drive his car.

"It's not ethical to limit his behavior more than that," Willis said. "There is no scientific rationale for preventing him from leaving his house.

"One of the fortunate aspects of Ebola is that people are not infectious before they become symptomatic," Willis said, "That is one of the reasons we're monitoring so carefully."

Perkins takes his temperature twice a day and public health workers are in daily contact. Willis said an infectious disease doctor from Marin will leave next week for Sierra Leone to work as an Ebola volunteer.

"We want to make sure that when people do serve in this way that they are welcomed home," Willis said. "This epidemic has shown us that we live in a single global ecology when it comes to infectious diseases, and that it's in everyone's interest to mobilize resources to the source of these epidemics."

Perkins said he has no problem with the quarantine, which extends to his wife, Crystal Wright.

"No hand shaking, no passionate embraces, no passionate anything," Perkins said. "It's hard; but it's only three weeks -- what the hell, I've gone through worse."