After a month on the front lines in the battle against Ebola, working amid the harsh conditions in a remote, virus-ravaged village in Liberia, a volunteer doctor named John is set to face another challenge when he returns to his home in California next Tuesday: his state’s new mandatory 3-week quarantine.
For decades, John has tried to set aside one month every year to help treat patients in “resource limited” regions of the globe, volunteering his medical expertise in various war and disease-afflicted countries where thousands live without adequate care. And like most all such volunteers, John isn’t paid for his month of service – in his case, he uses his paid vacation days to volunteer his time.
He’s been to places such as Afghanistan, Syria, and Sudan over the years, and he thought he’d return to the Middle East for this year’s annual tour. But when the Ebola epidemic exploded in West Africa, he knew this was the place to go.
“Once you take the first such mission, though, you come back for the team as much as the particulars of the emergency or the project,” John says via email. “There are only a few opportunities that most people have in life to meet a group of like minded strangers and develop relationships working and living together in adversity – something that for most people is a one-time opportunity.”
But as he gears up for his return, John finds himself at the center of stigma and controversy.
As the quarantine issue continues to rage across the United States, returning Ebola health workers from West Africa – as well as doctors and nurses in New York now treating Dr. Craig Spencer, the only person currently infected with the virus in the US – are increasingly seen as public dangers. [After days of sharing his story with a Monitor reporter, John asked for anonymity.]
Indeed, the specter of contagion has profoundly gripped the nation this week, tapping, perhaps into instinctual fears woven into human nature.
Two polls showed a large majority of Americans – up to 80 percent – support the general idea of quarantines for anyone exposed to Ebola, even though these polls didn’t specify the duration, manner, or place of such restrictions.
As a result of public fears, the governors of a growing number of states from Connecticut to California have issued a patchwork of policies of often vaguely-defined mandatory confinement for anyone exposed to Ebola patients, at home or abroad, even if they are not sick and test negative for the virus.
Most governors have argued their duty to protect the public outweighs the burdens placed on these health workers, even if experts say the chance of their spreading the disease is next to nil.
On Friday, however, a judge in Maine said such fears were “not entirely rational,” rejecting the state’s attempt to confine Kaci Hickox, a nurse who had served in Sierra Leone with Doctors Without Borders, and was confined to a tent by New Jersey officials upon her return to Newark last week, and then to her home when she finally returned to Maine.
The ruling struck a blow to supporters of mandatory quarantines, but the judge also chided Ms. Hickox, who, as a health professional, should “demonstrate her full understanding of human nature and the real fear that exists," he wrote in his ruling. "She should guide herself accordingly."
Still, Hickox’s adamant public fight for her freedom, and her insistence that her quarantine was both unjust and irrational, sparked a backlash against the nurse.
Indeed, many newspapers across the country ridiculed Hickox, saying she “dispatched the iconic image of emotive nurses and selfless physicians, replacing them with an all-too-believable caricature of arrogant caregivers and jerk doctors,” as one writer wrote in The Seattle Times.
For John, an emergency medicine specialist and one of six physicians now on rotation in a clinic run by International Medical Corps in Liberia, the quarantine issue is, on the whole, a minor one. Compared with the ordeal the families and villages he serves must endure most days, he says, returning volunteers can certainly handle reasonable restrictions based on sound medical science.
But as he follows American news between exhausting shifts in rural Liberia – including the criticisms of Hickox – he is appalled by the growing fear and stigmatization of Ebola health workers.
“I'm disappointed in our people, and in the leadership, who are responding to media frenzy,” John says via email. “Still, at a time when the response needs capable volunteers, this stigmatization is definitely not helpful.”
“There are quite a number of people who persist in thinking returning health care workers threaten their very existence, and should shut up and accept their loss of freedoms as an added cost...Takes my faith in the US citizenry to a new low.”
The mandatory 3-week quarantines continue to meet with intense criticism from health experts, volunteer organizations, and the White House, who say they are, in effect, fear-guided health protection overkill that creates undue burdens on those trying to quell the virus at its source.
“We don’t want to discourage our health care workers from going to the front lines,” President Obama said of the workers during a brief statement Tuesday. “They are doing God’s work over there, and they are doing it to keep us safe. And I want to make sure every policy we put into place is supportive of their efforts.”
Such efforts take their emotional toll on workers.
“As someone who has seen some of the worst insults that a human body can take,” John says, “I didn't expect to feel so helpless to get patients through their illness to recovery….”
Even so, the volunteer medical staff in Liberia, he says, is one of the most dedicated and cohesive he’s ever encountered.
“This is a workplace that any organization would envy as far as the culture of responsibility and drive to do everything right,” he says about the clinic run by International Medical Corps. “Our number one responsibility is to not let the infection spread – not to staff, not to family, and not to the community.”
“The returning providers are probably the best informed and most cautious group that could be assembled,” John continues, “and time in the field brings a heightened level of awareness that clearly the average citizen doesn't appreciate or understand.”