For most U.S. doctors, Ebola is more of an abstract threat than something they are likely to encounter in practice. But for Nicole Cooper, a resident physician training in internal medicine and pediatrics at Miami’s Jackson Memorial Hospital, West Africa’s Ebola epidemic is tangible. Cooper, a Liberian-American, plans to return to Monrovia, Liberia’s capital, after finishing her training next year. Between studying and caring for patients, she spends much of her time reading situation reports from the Liberian Ministry of Health and obtaining supplies for Monrovia’s John F. Kennedy Hospital, the country’s main academic teaching hospital, where she worked last year, before the outbreak.
Even then, the hospital lacked resources and staff. It took 24 hours to get the results of routine labs. The intensive-care units lacked ventilators, and specialized blood products such as fresh frozen plasma (used to improve clotting) were non-existent. Doctors also lacked the simple non-invasive monitors that detect patients’ blood oxygen levels—basic equipment that health workers in the U.S. take for granted.
“We were woefully unprepared,” Cooper said. “You can give IV fluids, but you can’t respond appropriately” to changes in a patient’s blood chemistry. Liberia’s civil war devastated JFK Hospital. In recent years, its physicians and nurses had worked hard to rebuild the hospital and improve its training programs. Cooper had planned to return there after passing her U.S. board exams. “I’ve had several messages from people in Liberia asking, ‘Why aren’t you here? We have fewer than 100 doctors, why aren’t you here?’” she said. This summer, she tried to arrange a month in Liberia to help, but logistics made it impossible, as her vacation time is limited and she would have to spend 21 days after her return away from patient care.