Back from Ebola to teach the next generation
Dr Philip Ireland, an emergency physician, credits his survival from Ebola to timely clinical care and says the care from his family, the kindness and prayers of a health worker and the unity of Liberians motivated to drive Ebola from their country helped him get through the ordeal. Today, he is a strong advocate for strengthening infection prevention measures and is training and teaching Liberia’s next generation of medical workers.
Dr Philip Ireland was on his way to an emergency staff meeting at JFK Memorial Hospital in Monrovia, Liberia, when he suffered a headache so sudden and severe that he saw flashes of light.
That morning, the hospital’s senior medical advisor had been rushed to an Ebola treatment unit (ETU), gravely ill. He was soon followed by one of the hospital’s medical assistants, who had been treated by Dr Ireland.
The emergency staff meeting was called to discuss the gravity of the situation and concerns about staff safety. As he listened, Dr Ireland’s heart began to race and he felt feverish. He began to wonder if he was in fact the next staff member with Ebola virus disease.
"I knew something was very wrong and deep down I thought Ebola could be the culprit," recalls the 44-year old emergency doctor, born in Bong County. "I went to a hospital and asked to be tested. But they sent me home assuming I had malaria."
Unconvinced, Dr Ireland isolated himself. He sent his wife and 5 children to stay in other accommodation, but his mother refused to leave. Over the next few days, his health rapidly declined. He became weak, suffered a high fever, lost his appetite and began vomiting uncontrollably. But he stayed at home.
"This was late July 2014 when Ebola was sweeping through my country and smoldering in my city and there was not an available bed in an ETU here," says Dr Ireland. "My brave mother cared for me. She made homemade PPE (personal protective equipment) out of rain gear and household gloves and constantly washed her hands to disinfect herself."
Better off on the floor of an ETU than dying in my bedroom
"My colleagues offered advice, support and medicine through my window. But by day 7, when it became clear that I urgently needed IV fluids and would be better off on the floor of an ETU than dying in my bedroom, they managed to find an ambulance to collect me."
The doctor, who notes that he has lived through wars, coups, serious illnesses and a number of "hell and high water" near-death experiences, describes that first night in the ELWA II Ebola treatment unit as the worst of his life.
"On that plastic leak-proof sheet I was put on, I vomited and had diarrhoea all night long. I woke up barely alive, in a sea of mess," he remembers. "But in the most touching act of kindness one could ever imagine, a physician’s assistant named Patrick came to me that morning and said, ‘I’m going to clean you up’. And he cleaned me from nave to chaps. He cleaned me so thoroughly and then prayed with me and encouraged me. That man has changed my wheel when it comes to how to give empathy and care for a patient. I now know, because I was a patient who was dying."
He also recalls not being able to urinate and thinking to himself: "If I survive Ebola, I could still die of renal failure, because there’s not a single dialysis unit in the country."
A team of Liberian and foreign doctors and nurses, whom he credits with saving his life, "pumped him with fluids" and he very slowly started to revive.
"This was one of the few ETUs using IV fluids at the time and one of the first to start seeing higher rates of survival," Dr Ireland points out.
A triumphant welcome and return to work
On 15 August 2014, he walked out of the ETU to a singing crowd and a triumphant welcome from family, friends, colleagues and strangers.
"I was incredibly happy to be alive and rejoin my family. But it’s not like I was jumping and skipping all over the place," he says. "The man who went in was not the man who came out and my children were speechless at first. I was not the daddy they knew. Daddy took a very serious beating. I’m normally keep quite fit, but I was weak, frail, and for a long time, bed ridden.
I was haunted by all the dying around me and scared that I might have infected my mother. I was depressed because I felt we had failed our people and angry because we didn’t take infection protection and control serious enough. Our health workers responded to the call of duty. They tried. But they were not prepared, trained and equipped and too many got infected."
Dr Ireland says he was also "smacked in the face" by stigma. It was only when he emerged from his sick bed and was hugged by a prominent colleague in the presence of many others that the "perimeter around me that no one wanted to cross”"seemed to dissolve.
His recovery took months due to his frailty. His wife, who was at the ETU every day bringing food, water and medicine, would now nurture him back to health, and his 7-year old convinced him to eat.
Strengthening Liberia's health care preparedness
As soon as Dr Ireland started feeling stronger, he wanted to get back to work. "Caring for sick people is what I do." But he was still too weak to return to patient care right away, so volunteered instead at an Ebola response training centre, run by the United States Army. "We taught health workers how to wear protective gear, how to keep from getting infected, how to assist patients and what to expect while working in an ETU," he explained.
Now back working at the JFK Memorial hospital, which lost many staff to Ebola, Dr Ireland is doing his best to help rebuild Liberia’s health workforce by teaching medical students.
"Liberia has got to train more young minds in the health sector," he says, warning that he is going to become a "pied piper" about health training and protection in the future. "We need more clinicians and technicians, nurses and physician’s assistants. We need to increase the quantity and quality and they need to be trained here in Liberia by specialists. If they are trained on the ground, like I was, they are more likely to stay. If they train overseas, they rarely come back."
Dr Ireland says what gives him the most hope is that Liberians changed their attitudes and practices in order to beat Ebola.
"The entire country ultimately agreed to take precautions, to change their attitudes, to stop washing bodies and shaking hands and they did all the public health interventions that they needed to do," he says.
"There’s a line in our national anthem that I love, 'in union strong, success is sure.' That’s what happened here. We were united and together and we stopped Ebola in its tracks."