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June 17, 2015 11:18 am

How a Jewish Doctor Took on Ebola (INTERVIEW)

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A hospital in Kenema, Sierra Leone, where Ebola virus samples are tested. Photo: Wikimedia Commons.

A hospital in Kenema, Sierra Leone, where Ebola virus samples are tested. Photo: Wikimedia Commons. –  The following article was written by Diana Kofman, a 16-year-old resident of the Queens section of New York City and a junior at Francis Lewis High School.

It’s almost surreal to see how we’ve recovered as a nation just a few short months after the Ebola outbreak and pandemic. Covered by every news station and newspaper in the United States, Ebola was taking the world by storm—from West Africa, to parts of Europe and Asia, and even reaching America. The World Heath Organization (WHO) describes Ebola as being “a severe, often fatal, illness in humans,” with the overall death toll passing 14,000.

With Ebola’s first outbreak coming in 1976, the 2014 outbreak has been the most serious one to date. Doctors and researchers believe that the disease originated in Guinea, spreading next to Sierra Leone and Liberia. From there, Ebola reached Nigeria and Senegal, eventually hitting Asian countries and the United States. The fruit bat transmits Ebola, when a human comes into contact with either its secretion, blood, organs, or other bodily fluids of infected animals. For another human to become infected with the disease, they would have to then come into direct contact with the already-infected human’s blood, secretions, organs, or any other bodily fluids. A human does not become infectious until they begin to display symptoms of the virus, which include fever fatigue, muscle pain, headaches, sore throats, vomiting, diarrhea, rashes, symptoms of impaired kidney/liver functions, and internal/external bleeding.

As the outbreak became more and more serious, with WHO declaring it a “Public Health Emergency of International Concern,” many infectious disease specialists began to enlist to travel to infected countries to try and stop the disease from spreading any further, and to help save those infected. One such professional was Dr. Steven Hatch, a Jew from Worcester, Mass. Having grown up in Mansfield, Ohio, Hatch originally majored in English as a college student, with plans to receive a Ph.D. and eventually become a professor. Soon realizing that this was not what he wanted to do, he decided to enlist in pre-medical classes after working at the University Hospital in Cleveland.

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Hatch was one of the courageous doctors who left their safe and healthy homes for countries far away and dangerously affected by Ebola. His first journey to Liberia began on Sept. 30, 2014, and lasted until Nov. 8, 2014, when he returned to his family and community. I was fortunate enough to get to interview him about his experience. (The interview was conducted via email.)

Diana Kofman: Can you briefly explain what your job is and what it entails? 

Steven Hatch: “My job in the U.S. is to see patients with infectious diseases, both inpatient and outpatient. There’s all kinds of infections: HIV, Tuberculosis, Hepatitis C, Lyme disease, patients with surgical infections, the list goes on and on. I prefer the inpatient side of things. The clinical side accounts for about 60 percent of the work I do. The other 40 percent is taken up with my educational work: I teach medical students how to become doctors, and I teach residents how to become mature doctors. I really love that work a lot.”

DK: When and how did you decide that you were going to go to Liberia? How did your family react? 

SH: “I have always been interested in Ebola, but never really thought I’d have the chance to do anything. Most Ebola outbreaks are contained within a few months, and it is very hard to get involved clinically in an outbreak situation. But I had been to Liberia in 2013 and I know the kinds of viruses that cause hemorrhagic fever (like Ebola) very well, so when I saw last summer that the outbreak was getting out of control, I realized I could help out and I was qualified. I made the decision to do everything I could to get over there when a fellow doctor from Liberia whom I had befriended became infected and died. I made a lot of phone calls to all sorts of people, and this was in July when there were still very few doctors who really understood how bad things were going to get, so I was able to just call up important doctors at the CDC (Centers for Disease Control and Prevention) and get them on the phone. One doctor in particular was helpful, and he referred me to someone who worked for WHO, and that person referred me to someone else, and so on, until eventually I spoke with a doctor who was looking to hire people for the International Medical Corps as part of their response in Liberia. That all happened by mid-August. If I had tried to do that a month later, I don’t think I would have been able to go, because there were hundreds of doctors and nurses volunteering at that point, and sorting through all the applications takes a lot of time.

“As for family, my kids were concerned but my wife Miriam wasn’t. She has always known about my career interests, so none of this surprised her. She has a health care project that she is working on in Haiti, which although safer than what I was doing still is work that comes with some risk, so she knows about what it means to do field work, and the joy it brings. So she never really blinked.”

DK: Can you describe the moment you landed in Liberia? 

SH: “I got in at 2:30 in the morning after a long flight from Morocco! Then I spent an hour in line waiting to clear immigration, then we got picked up by our driver and it takes a bit more than an hour to get to Monrovia, where we arrived at about 4:45 a.m. and had to get up at a 7:30 meeting! What a day that was. Anyway, it’s hard to describe what it’s like in a third-world airport unless you’ve been to one, but for the temperature, you have to envision that it’s like the most hot and humid day of the summer in New York, and that’s just another standard day there.”

DK: What was your entire experience like as a whole? What were the people there like? 

SH: “That’s a big question! I would say that there was a lot of routine in what I did, and the routine was what sustained me through watching all the suffering around me. I had a job to do—taking care of my patients—and that job is something I spent years learning how to do, and it all had a very clear feeling of, okay, time to get up and round on my patients. Rounds took about three hours, and I usually did it twice a day. I had to spend time documenting what was going on with the patients, fill out death certificates, write progress notes. The afternoons usually had an hour or two of down time and I checked email and Facebook, and then in the late afternoon the new admissions came in, so that took a few hours. That was pretty much the routine every day for the time I was there.

“The people in Liberia were wonderful. They’re very appreciative of all the help they received. Can’t describe them adequately but they are very energetic and friendly. And they have a special relationship with Americans for historical reasons.”

DK: Were you ever for a moment scared that maybe you might contract the disease while in Liberia? 

SH: “Not scared. I knew it was a possibility; the infection rate for people who work in Ebola Treatment Units was between 1 and 2 percent. But all of the doctors and nurses who went over there during that time had made their peace with the idea that they might become infected, and that might mean that they might die, and I was no different than anyone else. We all just made our peace with that decision. I think soldiers do the same thing before they get deployed, and probably cops have to do it every day they go to work. Most cops and most soldiers never die, but some of them do, and once you acknowledge that, you just go about doing your work because you have a purpose. So I was never scared, although that didn’t mean I wasn’t careful.”

DK: When you first went to Liberia, the disease was becoming almost pandemic. Now, it seems as though it has calmed down quite a bit. Where do you think the disease is headed? Do you think that the outbreak that started last year is over? 

SH: “It was pandemic—there were cases in the U.S. because a Liberian named Thomas Eric Duncan had infected two nurses in Dallas in October, and a nurse in Spain got infected too. Plus there was a small outbreak in Nigeria which was very scary because unlike West Africa, Nigeria has ahuge population and is the center for all African travel, so if that outbreak had gotten worse, it could have created incredible chaos.

“But you are right that the outbreak has calmed down—a fact that people in the U.S. are only starting to realize, so bravo to you for being aware! I think that we don’t yet know how things are going to turn out, but over the past few weeks I think the global health experts are starting to feel more confident in saying there’s a reasonable chance that we’ll have the outbreak eliminated by the end of 2015. I’m not as sure, but I’m not an expert.”

DK: I know I asked you to describe the moment you got off the plane in Liberia, but what was it like the moment you touched down in the United States? 

SH: “No fun! I got whisked into a room where I was held for four hours in a cold office while the CDC tried to figure out what to do with me. I found that very frustrating because I had spent two weeks notifying the people from my state’s Department of Public Health that I was returning, and it shouldn’t have been very difficult for them to figure this stuff out. But they were trying to do their best under trying circumstances, so I’m not angry about it.

Dr. Hatch, who went to Liberia with the American charity organization International Medical Corps, traveled again to Liberia on Jan. 27, 2015, to continue his work with Ebola patients. Currently, there is no vaccination available to those with Ebola, and treatment consists of constant rehydration using intravenous fluids. 

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