Les Roberts – Freetown, Sierra Leone – October 22nd, 2014
Day 18: The Departure of Hurricane Katrina
There are few upsides to this Ebola outbreak. All of us in the WHO office are working very hard to do little things (e.g. get Standard Operating Procedures in place for prioritizing different kinds of lab samples or getting a facility inspected and deemed safe enough for the Cuban Medical Brigade to work there) and we all know the sum of those little things is not even close to adequate. But, the huge upside is that I work with some astonishing people. The world has sent it’s “A Team” here and it is really flattering to get to rub shoulders with them.
I remember “sliming fish” in salmon processing factories in Alaska during the summer in the 1980’s. I worked in four of them. These were big unheated metal factories with concrete floors. There were processing lines with distinct task stations and the first major station in each line was the person who cut the head off the fish. That person would typically set the work pace for the teams of 30-50 people farther down the processing line who did other chores like ripped out the gills, cut open the body cavity… There was one guy, a guy who had not gone to college and had a humble job the rest of the year, who could cut off 100 salmon heads per minute. There were two lines of people behind him who handed him fish, he had a guillotine-type device with a V-shaped blade, operated by a foot pedal, and he would chop off the head of each fish. This was Alaska, so he had removed the Federally mandated safety guard which allowed him to go faster. He would grab a (typically seven pound) fish fed to him by a line behind him on the right with his right hand, slide it across in front of his torso and chop off the head, and then keep sliding the fish to processing line in front of him on the left side, and at the same time he would have been moving a fish with his left hand chopping a head off and passing to the other line in front of him on the right. When he was in full blast, you could not see his hands they moved so quickly and the blade made a bang, bang, bang sound that was very 1984esque. He would perform his magic for three or four minutes until huge piles of fish were backed-up at the various processing stations and then just lean back for a while, cross his arms and gloat at the workload and work frenzy he had created. He was an astonishing worker who had this one tiny niche in which he was not just excellent, but superhuman. I have seen very few humans that struck me that way through the decades: Tiger Woods at his peak, Bill Foege, the former CDC Director. There has been a gal here these past weeks in Freetown who has left today, she is equally superhuman.
Katrina, whose husband claims she is the one for which the Hurricane was named, is an Australian virologist and epidemiologist. She came to do epi but there was a need for safety training and somehow she fell into that billet. She might not be my first pick for accompaniment on a lifeboat lost at sea: she is rather high energy. Think Katherine Hepburn meets Taz. She has so much drive that when she does not get the support she expects from her supervisors in country, she starts cc:ing the WHO Assistant Director for Ebola in Geneva. She only has one engagement level, 200%. Don’t get me wrong, she is very polite and respectful. She is less than 100 pounds and unintimidating. But, this full throttle need to engage about something is operating whether it is 7AM or 11PM or any moment in between. But, man has she been an astonishing trainer!
She arrived in Sierra Leone just as a three-day training on how to stay safe in a Red Zone was developed and the developer’s time here was up. So in she stepped. The course has a day of lectures about ebola and general infection control principles. This worked well with her virologist training. When students would ask questions she did not know, she would study at night and answer the next day digging into the most esoteric aspects of virus physiology or urine collection techniques. And days two and three are all about PPE: a little about how to get it on, but a lot about how to get it off. Again, and again, and again. They walk around outside in the sun for 45 minutes in PPE. They pass through a mock ward in the PPE. They learn about the buddy system for quality control while removing PPE. And this could be boring but with Katrina these were three days of riveting self-confidence building. Adding to it the Chief Matron nurse gave Katrina a few of her best nurses, who took the course, watched the course, and then took over the course. Over six weeks she got four teams of trainers up and going and the course trained-up over 700, mostly nurses, in Ebola safety and PPE. As of last report, none of her first cohorts has become infected. The very first cohort almost all went to the largest ETU in the country here in Freetown where they have had a lot of staff infected over the months, so these were the highest risk trainees.
Being high energy certainly helped a lot in her success, but was not the largest part. The biggest part is that she just loves engaging with trainees. I suspect you have seen this, the really really great teachers, the Sharron Schwartz and Linda Cushman types, just exude love and happiness when engaging in the process of teaching. At the breaks, Katrina was constantly going around and visiting with the attendees and getting their stories. She was tired, but this is what energized her. The trainers made a special send-off meal for her for her last day. Katrina and many of these hard, tough senior nurses who have all lost co-workers, got all teary-eyed at the send-off. It was excruciating for them to not be able to hug good bye.
Wow, is it inspiring being around people like that!