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Battling Ebola in Liberia: A Q&A with Adam Levine, MD

8/25/2014
Adam Levine, MD
Adam Levine, MD

One of Rhode Island Hospital’s emergency medicine physicians, Adam Levine, MD, is heading to Liberia to help care for patients during the Ebola crisis. We caught up with him shortly before he boarded his flight.

What made you decide to go to Liberia?

I am a member of the emergency response team for the International Medical Corps and they are now beginning to deploy doctors and nurses to help address the current humanitarian emergency in Liberia. They emailed a few days ago to ask if I could go for the next month to help.

Whenever I am considering whether to respond to a particular emergency, I always ask myself the same three questions:

  1. Is there a real need for me to go? In some humanitarian emergencies, there are actually plenty of local physicians and nurses available who can help meet the medical needs of the affected population.

  2. Do I have specific skills that will be useful in responding to this emergency? As an emergency physician, I am lucky enough to have a wide range of clinical skills, as well as the experience using them in resource-limited contexts, but in some humanitarian emergencies it's surgeons or water and sanitation engineers who are really needed.

  3. Are all the necessary precautions in place to keep me safe? Whether responding to an earthquake or an epidemic, it’s only safe to go with the support of an established organization with clearly defined security protocols and a track record of safely deploying its staff to similar settings.

In this particular case, the answer to all three questions was yes. The current Ebola epidemic in Liberia has led both directly and indirectly to a near collapse of the health care system, with a huge need for international physicians and nurses to meet the healthcare needs of the population. I have the skills to care for patients with a wide range of conditions that are common in Liberia, and the needed protocols and procedures are in place to keep me safe.

Have you ever made this type of trip before, specifically to care for patients during a health crisis or epidemic?

I have responded to several prior humanitarian emergencies, all very different. I helped run an emergency department in Port-au-Prince after the earthquake in Haiti, managed a trauma field hospital in Libya, and set up a refugee clinic in South Sudan. I have helped manage outbreaks of disease in refugee camp settings in the past, but have never responded to an Ebola epidemic before.

How do you prepare for such a mission?

Preparation starts with being well-trained. As a resident, I completed the humanitarian response intensive course organized by the Harvard Humanitarian Initiative, which provided not only classroom training but also the experience of responding to a simulated humanitarian emergency. I have since returned most years as faculty in the same humanitarian simulation. In addition, I have completed multiple security trainings through the United Nations and International Medical Corps to ensure that I know how to minimize risks to my own safety. For this particular emergency, I am also stopping in Brussels on the way to Liberia for a two-day course organized by Doctors Without Borders in how to diagnose and manage Ebola, and how to properly use personal Protective equipment to keep myself and my co-workers healthy.

Will you be taking supplies with you?

Like most international humanitarian organizations, International Medical Corps has logistical teams whose job it is to get supplies and equipment to where they are needed. In fact, there is no point in sending doctors into a humanitarian emergency if you don’t have the logistical capacity to also send the medications, supplies and equipment that are needed, since doctors tend to be pretty useless without the tools of their trade.

Who are you going with (volunteer group), or are you going to Liberia alone?

I am going with International Medical Corps to help staff some of the health facilities that have been set up by Doctors Without Borders. It’s never safe to deploy to a humanitarian emergency by yourself, and you are unlikely to be helpful to anyone without the logistical infrastructure to keep you housed, fed and safe as well as provide you with the needed supplies to do your job well.

Is there anything people here can do to help those who are most affected?

Absolutely: donate money, especially to those organizations like International Medical Corps and Doctors Without Borders that are responding to the current humanitarian emergency in Liberia and Sierra Leone. Even before the epidemic, both of these countries lacked the human resource capacity to meet the medical needs of their population. Due to the epidemic, many local doctors and nurses are afraid to go to work, and several international medical organizations have pulled out, leaving the population with desperately few healthcare providers. The organizations that are currently providing medical care in Liberia and Sierra Leone need monetary support in order to bring in more healthcare workers, logisticians, engineers, epidemiologists, medical supplies, protective equipment, food, water and other basic human needs for the affected populations.

Anything else you want to add?

I am quite grateful to Rhode Island Hospital, and especially to the department of emergency medicine, for their support of my humanitarian activities. The mission of our department is “to provide exceptional emergency medical care, education, research, and service to the people of Rhode Island and beyond.” I am proud of the extent to which we take those last two words very seriously, putting the necessary resources and support into our department’s international activities.

Learn more about emergency medicine at Rhode Island Hospital