Deep in eastern Liberia's Grand Gedeh County are a collection of “last-mile villages,” meaning it takes an entire day of traveling by vehicle and foot to reach them from the denser town of Zwedru, where the county's main hospital is located.
“The very last mile you can imagine is where the villages are located,” said Dr. Phuoc Le of UC San Francisco. “They are extremely isolated from care.”
Next month, Le will try to help ease that isolation when he becomes one of five UCSF doctors traveling to West Africa to provide health care to countries ravaged by the worst Ebola outbreak in history, which as of Saturday claimed nearly 5,000 lives. Liberia, where Le will spend most of November, has seen 2,705 deaths alone, which is more than any other country. UCSF clinician Dr. Dan Kelly is working in another Ebola-stricken country, Sierra Leone, and is scheduled to return to The City next month.
“I'm absolutely convinced that I need to go,” Le told The San Francisco Examiner.
Le has been to Liberia before. In 2011, he spent two weeks at the Martha Tubman Memorial Hospital in Zwedru to establish a partnership with Last Mile Health, which aims to bring health care to the world's most remote villages. UCSF has since sent global health fellows there for seven months of their yearlong fellowship.
But on this trip, Le will focus on teaching infection control training to doctors and nurses in Grand Gedeh County, which has a population of about 150,000. Years of civil war have weakened the health care system to a point where the lack of medical infrastructure is believed to be a root cause of the Ebola crisis, Le said.
“My day-to-day will be doing more capacity-building and working with the community to make sure they know exactly what to do when they encounter Ebola patients,” Le explained.
However, he said he will also care for nurses or doctors who become infected while caring for Ebola patients — and he knows that might carry a stigma here at home.
“There is such fear amongst the U.S. public and I don't want to add to that fear by doing anything that would be perceived as reckless,” Le said. “I'm ready to do whatever it takes for people to know that I pose no danger [when I return], including quarantining myself.”
Quarantines for health care workers returning to the U.S. from West Africa have been the subject of recent debates. The CDC is monitoring anyone who is known to have come into the U.S. from West Africa for 21 days, and several states, including Illinois, New Jersey and New York, have established mandatory 21-day quarantines.
There are no such restrictions in California, but UCSF prohibits returning health care workers from treating patients or going to any UCSF campuses for 21 days from their last known contact with an Ebola patient.