1. Living through

    Ebola

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    A virus is spreading. It's moving through people's bodies, through entire countries. We hear that the case count has hit a new high. First 1,000. Then 2,000. Now, more than 20,000. A new patient infected, a doctor dead, passengers on planes in panic. We hear that this is the worst-ever epidemic of Ebola — a violent virus that kills 70 percent of its victims — and, while it has come under control in some places, it continues to spiral in others.

    These descriptors, these cold calculations of cases and deaths — unconfirmed, confirmed, probable — don't tell us what Ebola means for people. This virus turned up in West Africa for the first time ever, and changed people's lives forever. We have been collecting stories, focusing in particular on those who are living and working at the epicenter of the epidemic in Guinea, Sierra Leone, and Liberia. Check back regularly for new narratives. And if you have a story of your own to tell, contact us.

    My dad was the first Liberian doctor to die from Ebola: One daughter's story

    Dr. Samuel Brisbane is one of more than 200 health workers who have lost their lives to Ebola during this outbreak, and the first Liberian doctor to die from the virus this year. On July 26, the day he died, he was only three days shy of turning 75. Dr. Brisbane could have long retired from practice, but his dedication to his patients kept him going — even in a hospital with a dire shortage of safety gear, regular power outages, and an onslaught of patients with a virus that terrified him. His daughter, Elizabeth Brisbane, talks about her father and his life's work at John F. Kennedy Memorial Medical Center in Monrovia.

    The regretful thing is, the guns didn't kill Daddy, but Ebola did kill him. He survived all of the wars in Liberia. He never did fight. He was there while all that took place in Liberia was Charles Taylor's wars, and he was able to survive that. He trained in Germany in the 1970s, and he decided to return to Liberia and work through the wars to be of service to his country. He knew that his patients needed him the most.

    During his last days, while he was waiting for his Ebola test results, he told my brother Samuel that if the test came back positive, he would fight the disease like he fought everything else. We had prayed that he would survive. After all, he was fearless that way, and if anyone could beat the odds, he could.

    For the last 10 years, he had worked at the JFK medical center in Monrovia, where he started a diabetes program, a stroke program, and an HIV program. He was later joined by Dr. Abraham Borbor, who took over the leadership of the HIV program. Daddy and Dr. Borbor were very close. Dr. Borbor also died a month later, in August, from Ebola.

    I jokingly called my father Dr. Ebola. I said, "Dr. Ebola, how are you doing?" Little did I know Ebola would be the cause of his death.

    I had hoped in his old age, Daddy would retire. See, in addition to his love of medicine, he loved farming. On his farm he had coffee, pineapples, and peppers. When I saw him last, in April, I said, "Go on your farm and if you love medicine that much, open a clinic." I said, "You're working too hard. That hospital is going to kill you."

    In April, he was already treating Ebola patients. When I visited Daddy in the hospital, I heard they would count gloves to give the nurses because they don't have enough. I jokingly called my father Dr. Ebola. I said, "Dr. Ebola, how are you doing?" Little did I know Ebola would be the cause of his death.

    I knew that I could not stop my father from treating Ebola patients. My father once had a neurological problem with his back and he couldn't walk. He saw patients in a wheelchair. Because of his dedication and commitment, he stayed there treating patients.

    In the last few months, the foreign doctors had left the JFK because they didn't have the proper equipment for Ebola. But because of Dad's commitment to medicine and his patients, he provided treatment and care to them even though he didn't have personal protective equipment.

    I could not go to his funeral. Because the government says people who die with Ebola must be buried the same day, I could not make it back to Liberia fast enough.

    Dad had chosen a spot on his coffee farm that he wanted to be buried at, and the government honored his request. He could have ended up cremated or in the mass graves with the other Ebola bodies.

    For Daddy, they were able to put his body in a body bag and then place the body bag in the casket. The burial team escorted the casket to the farm for interment with my brother Samuel showing them the way. I am grateful Daddy has a grave that I can visit.

    My dad was the first Liberian doctor to die from Ebola: One daughter's story

    My life on an Ebola treatment ward: One doctor's story

    Dr. Daniel Bausch, an associate professor at Tulane University School of Public Health and Tropical Medicine, arrived in Freetown, Sierra Leone in July, just as the Ebola outbreak began to grip the country. He was already familiar with the virus: a world-renowned Ebola expert, Dr. Bausch has researched hemorrhagic fevers for the Centers for Disease Control and Prevention for nearly 20 years. He helped set up Ebola treatment wards, cared for Ebola patients, and contributed to the CDC's first-ever training course on treating the disease. But doing this work amid the fear and violence the epidemic sparked in West Africa — and the emotional toll of losing friends to the outbreak — has been the greatest challenge of Bausch's career. We spoke more than six times between July and September 2014 about the difficulties of caring for Ebola patients, why the virus is so deadly for healthcare workers, and what this epidemic means for the future of West Africa.

    If you're in a hospital in Sierra Leone or Guinea, it's not unusual at all to say, ‘I need gloves to examine this patient,' and for someone to tell you, ‘We don't have gloves in the hospital today.' Or, ‘We're out of clean needles.'

    I've worked in the same region for many years just by chance, on other projects in Sierra Leone and Guinea. I was really familiar with these places before the Ebola outbreak ever started. These countries are coming out of many years of civil war. They are the poorest countries on the planet. Their health systems are struggling. They have poor infection control practices. Recognizing that, when these sorts of outbreaks happen, it's very difficult to get local health-care workers to keep working. They have seen colleagues get infected and die. They have severe shortages of staff.

    So when I got to Kenema, Sierra Leone, in July, there were times when I went into the ward and all the nurses had gone on strike for the reasons I explained. There were 55 people who had Ebola in the ward, and just me and one other doctor to treat them.

    Having so many very sick patients and the needs they have — not only for medical care but providing food and water, and all the other needs — it's a very difficult and potentially dangerous situation for everybody. The environment is not cleaned, and there's a lot of soiling from patients with vomiting and diarrhea.

    In this particular setting, where there are not the nurses and the other staff to take care of this environment, it was very frequent to come in and have two to five patients that had fallen out of bed, or had a degree of delirium, on the floor, soiled with stool or vomit or blood.

    There were 55 people who had Ebola in the ward, and just me and one other doctor to treat them

    What should happen in that environment when a patient falls out of bed is that there should be numerous nurses and a sanitation officer who should come and decontaminate the area. They would then gently help the people back up to bed. But when you don't have that support, you have people falling out of bed, delirious, lying on the floor. Obviously it gets more dangerous to care for them. These are very sick people who may be very infectious.

    I don't want it to come across as blaming or pointing fingers at the nurses who declined to work. I empathize. It's totally terrifying. We would all have the same reaction. It's the right reaction to have. You can take care of patients with Ebola safety. But the scale of this outbreak is so large, it has outstripped the resources of these very impoverished countries in Africa to deal with it on their own.

    One of the things that is not always that well understood is just how difficult it is to find the labor to do this work in West Africa, both nationally as well as the expats. Take Liberia as an example, where the medical school was closed all during the war, so they were graduating no medical doctors. Since the end of the war in 2003, they graduated a handful of doctors. I'd imagine half of them are drawn off by the brain drain: moving away for better opportunities.

    And then in the last six months, how many have been infected and killed by Ebola virus? Then obviously if you're one of the ones who haven't been infected with Ebola, how enthusiastic are you about doing that work when you see colleagues getting sick and dying? So you go to West Africa, and say, ‘Raise your hand if you want to work in an Ebola treatment unit.' You don't see many hands in the air.

    This epidemic has been really painful. There is an added pain for me. It's very personal. People I've worked with, a lot of people who are friends and colleagues, have died. We have the potential of having tens of thousands of people with a terrible disease, other people dying of other diseases because they can't get the health care they need. I don't know how to phrase it in any more poignant a way. One could talk about other things — global security, economic impact, destabilizing the region — and I'm not belittling their importance. But I'm a health-care worker. To me those things are secondary. The first thing is that there is a whole bunch of people who are sick and that's so terrible. This is a war.

    When I think about this getting worse, I think about dangerous and unhealthy social adaptation. I see the community reaction to this as somewhat akin to the five stages of grief when someone is told they have a fatal disease, described by American psychiatrist Elisabeth Kübler-Ross. First you have denial, then it passes to anger, bargaining, and depression. In healthy adaptation, there is ultimately acceptance.

    I don't want to it to come across as blaming the nurses who declined to work. I empathize. It's totally terrifying.

    Many of these communities with Ebola have been resistant to accepting the reality around them. They are clearly in denial, violent denial. I hope that we can get to a point in the not-too-distant future like we would with a dying person where they can get to acceptance. And acceptance can mean that these communities collaborate, try their best to be part of the solution, and limit the horror that's happening around them.

    If we can't do that I fear a much more unhealthy social adaptation: that the violence against the international community, like with the killing of a health team in Guinea in September, would become so ferocious that we just can't continue the work. None of us, of course, are going to risk our lives on working there. I might say I'll go into a controlled environment and treat people with Ebola. But if you say ‘Everywhere we go people are attacking and killing health workers,' no one is going to risk their lives on that level.

    If that were to happen, my fear will be that the response efforts will largely cease. The potential for violence and frustration will turn inward. People will ostracize people who are sick, perhaps even perpetrate violence toward people who are sick.

    That's horrific social adaptation. In the process of course you would have the society that further breaks down: people not getting treated for malaria, people dying of starvation. All the trade routes, commercial processes, people growing food, all broken down. We risk having a breakdown of social fabric that can be very dangerous in many sorts of ways: in terms of both direct and indirect impact on people's health, with the frustration of the communities involved, and no minimal risk of violence. I hope we don't see this.

    My life on an Ebola treatment ward: One doctor's story

    "The war was better than Ebola": One Sierra Leonean on how the virus transformed his country

    Ishmeal Alfred Charles is a husband, father of two, and aid worker trying to spread messages about Ebola prevention and public health in his native Freetown, Sierra Leone. Since the first-ever arrival of the virus in his country in May, life has changed drastically. Schools are closed. Food prices are up. There is no more hand-shaking, hugging, or public gathering. Everyone is suspicious of everyone else, and there is nowhere to hide from an enemy that could be lurking anywhere. This is Charles's description of life in Freetown, drawn from more than a dozen interviews between July and October 2014.

    Sierra Leone is a country that is recovering from 11 years of brutal civil war. The war was better than Ebola. People could seek asylum, become asylees in other countries and gain recognition. But with Ebola, you're not allowed to seek any asylum because no one wants to bring you to their country.

    During the war, I was a child soldier. There was room to escape. I was able to escape even though I was captured three different times. I was able to escape all those times yet I'm still alive. With Ebola I find it difficult to understand what means or what routes there are to escape. Under these circumstances you don't have the opportunity to escape to any other country, any other place. Flights are too expensive. You don't know where Ebola is going to be next. You don't know who has Ebola. When you go on public transportation you don't know who is sitting next you.

    The young ladies in Freetown try to put on long sleeves even with the sun and humidity so when you have body-to-body touch you will not contract Ebola. That is the situation where everyone is really concerned. In Sierra Leone, people are going through a lot of psychological challenges, feeling a strong sense of hopelessness. It's not just Ebola. It's the poverty. It's the feeling of being left alone. When is this all going to end?

    Sierra Leone is a country that loves hand-shaking. When we see anyone the first thing we do is shake hands. We hug people. Now with Ebola, people don't shake hands anymore. People don't hug anymore. People are worried. Everyone is suspicious.

    In front of my house, there is chlorinated water in buckets. People have to wash their hands before they get into my house. It's difficult. I'm telling people, "You're not clean to come into my house." But it's the reality under which we live. If you want to protect yourself, protect your family, you want to make sure people wash their hands as often as they can.

    Now with Ebola, people don't shake hands anymore. People don't hug anymore.

    Schools are closed. The whole country from Freetown to the farthest northern village, from Freetown to farthest southern village, from Freetown to farthest eastern village, there is no school operating. People aren't going to school. When they sit at home, they are left on their own. It creates the burden psychologically. In a country that has less than a 50 percent literacy rate, closing schools indefinitely will not help the situation. It's going to worsen the situation. It's only going to increase the economic burden on the people. That will hamper the development of the country.

    My two daughters have been home since July. They cannot go to school because schools are not functioning. It's a very difficult situation. Even to hire a private lesson teacher you find it very difficult. You're not sure who the teacher might have come into contact with, and whether they have Ebola.

    Freetown used to be very lively. Now around eight or nine o'clock everyone runs home. No more night clubs, no more pubs, no more restaurants. At nine o'clock the city is locked down because every public gathering poses a risk in a public health emergency. You can't hang out with your friends anymore. You can't watch soccer. It's frustrating and it increases the pressure, the psychosocial impact.

    The prices of commodities have tripled. The staple food we survive on is rice with some vegetables, some meat or chicken. We cook it differently with different sauces. We eat rice for breakfast, lunch and dinner. The price of rice currently is about $50 for a 50 kilogram bag, and it was initially about $25.

    There are two reasons for this: there is a lot of panic buying and Ebola has reduced the number of vessels that are docking in the docks in our country. So there are not so many vessels coming in these days and there are only two flights into the whole country each week. So food isn't coming into the country.

    In a country that has less than a 50 percent literacy rate, closing schools indefinitely will not help the situation. It's going to worsen the situation.

    We only found out yesterday that because the burial teams who pick up the corpses of Ebola victims were not being paid their weekly stipend, they went on strike. A woman on national TV was complaining that in her house, her sister died. It has been six days, the corpse has been lying there. This is happening a lot.

    In my community, we recently had six corpses, and it took 48 hours or more before people came to pick them up. I called again and again. They picked the bodies up yesterday. Corpses have the highest rate of infection, and many infections here are from dead bodies.

    Ebola is getting worse here. The number of deaths keeps going up. We have fewer numbers of people who are surviving, but the infectious numbers go up. We continue to do what we can do, but the health facilities don't have the capacity to handle the number of patients who need care. In certain circumstances, we can't hold people in the holding centers or treatment centers, there are no beds to accommodate the people. The numbers are too overwhelming.

    Things are getting worse. People are losing their jobs because businesses are closing. I spoke with a friend who was running a hotel. It's gone extremely bad, and she is looking for another job. They just don't have the number of guests that they need to keep the business running. So those problems are continuing to get worse and worse.

    It's as if you live in a world where everything is not working, nothing is happening, and all you're looking for is a divine grace.

    'The war was better than Ebola': One Sierra Leonean on how the virus transformed his country

    Why I never felt unsafe while caring for Ebola patients: One nurse's story

    Nurses are always on the front line of healthcare, giving patients moral support, mopping up their vomit, changing their sweat-drenched bedsheets. In an Ebola treatment ward, these mundane tasks can kill. Nurses have sustained some of the highest rates of infection and death among health workers during this epidemic. One such nurse is Monia Sayah, who works with Doctors Without Borders in Africa when she's not in Brooklyn, New York. Sayah found herself in rural Guinea — ground zero of this Ebola epidemic — just as it was starting in March 2014. And she went back in July to help again as the infection curve was rising and patients were flooding her clinic. We spoke shortly after she returned to New York about what it's like saving someone else's life while trying to sustain your own.

    An Ebola patient's condition can change within an hour. We have patients asking for lunch, and we would go to see them a few hours later, and suddenly they would just die.

    It's a violent virus. You never know what's going to happen.

    Patients die from multiple organ failure, from heart attack, from exhaustion. The hemorrhagic bleeding does not happen in a lot of patients. I've encountered it only a few times, in less than five patients in all the patients that we have seen. Sometimes those hemorrhagic signs are very subtle, maybe just bleeding at the eyes or gums.

    There was one case, a woman I went to see in the community, who was lying in a pool of blood. This particular woman, when I went to see her, I thought she had a miscarriage, there was so much blood. Soon as we got to the treatment facility, we were able to stop the bleeding. We were able to give her supportive care, replace the fluid loss she had had. She was very weak, unable to move. She just had fear in her eyes.

    Often you'll see that in the eyes of patients; there's no resolution. They just know, they're not fighting anymore.

    She died shortly after.

    The symptoms of Ebola virus are non-specific. There's nothing in particular, especially at first, that we can say, "This is Ebola." Somebody with a bad case of malaria could present with the same symptoms.

    Trying to make a diagnosis is difficult because we're in a village, you have nothing with you. All you have is a thermometer. And the workload was very high. It's very stressful because you're constantly on alert: a patient here, a patient there. The physical stress of working is very hard because you lose a lot of fluid wearing protective clothing, and get very tired in the heat as well.

    Every patient has a dramatic story. It's amazing how they are able to cope with the loss and trauma.

    There's a specific set of behaviors, the way we dress, to make sure there's nothing exposed. Especially around the face because of the mouth, eyes, and nose. To care for patients, we have to gown up in waterproof and airtight suits. We wear headgear, goggles, two pairs of gloves, and rubber boots.

    Every inch of the body is covered.

    At the end of the day, the gowns we use, the gloves, everything gets burned except for the rubber boots, which get decontaminated with chlorine solution. The hospital scrubs we wear underneath the gown, these also get washed with chlorine solution.

    You need to undress in a very specific manner. It can take five minutes to undress properly. We have to do this step by step. Every time we touch one item, we have to wash our hands again with chlorine.

    I have never had any incidents inside the treatment facility. I follow the procedures strictly. I think it's very important when you're about to go on a project to feel comfortable. It's important to be comfortable so that we can help the patients.

    I made sure I understood the virus, the way it is spread, the way it could contaminate me. We have very, very strong infection control measures, and a set of behaviors that come along with the dressing so I have never felt unsafe or at risk. It's just very scary when a virus has such a high mortality rate.

    You see patients who are completely distressed. But you always have to think about yourself and make sure you're constantly on alert. If someone coughs too close you you, you make sure you're not so close but also not stepping back so quickly as if they had the plague.

    There's no treatment for Ebola. Care is supportive care. We rehydrate the patients. We give them antibiotics to ward off any infection so the immune system can focus on the virus. We give them high-quality nutrition. It's very important to boost them up. We give them vitamins. If patients can't eat anymore, the nursing care is washing them, helping them to walk. Patients have a lot of body pains, so we try to massage them. It's all the nursing care you give to someone whose very sick in bed.

    We try to do everything we can for them. You have to respect their dignity.

    We touch them a lot. It's very important. They're alone, they are isolated. It's true. Normally in this part of Africa, people are never alone when they're sick. There are always family members around them and tending to them. But when we diagnose someone with Ebola, we take them away from their families. We know we're bringing them to a treatment facility, the place they should be to receive the best care, to isolate the virus. But the virus is inside a person.

    There are so many stories. Every patient has a dramatic story. People do survive, some of them do survive, and it's a wonderful thing. I just want to give the message that they show incredible resilience and survival skill. It's amazing how they are able to cope with the loss and trauma.

    Why I never felt unsafe while caring for Ebola patients: One nurse's story

    I can't get to my family, and they're dying from Ebola one by one

    Musa Peter Moigua is the finance manager at the Christian aid organization Caritas in Freetown, Sierra Leone. Over the course of eight weeks last July and August 2014, he lost his aunt Soa, his uncle Gbassay, and his brother Alhaji — all to Ebola. What follows is a transcript of our conversation, edited for length and clarity.

    UPDATE: On November 15, 2014, Moigua also lost his older sister. The cause of death is believed to be Ebola.

    I lost three family members to Ebola: my aunt, my uncle, and younger brother. My aunt was the first person who got Ebola. Two weeks after she died, my uncle got the disease, and he died. My younger brother got it and has also died.

    My aunt was staying two miles off from our own village in Bambara, in Kenema district. When she got Ebola, she came back to her village, and she was there for four days. After four days she was dead.

    There is a custom in our country: you stay with the sick. My aunt's brother, my uncle, could not avoid her. He was sympathizing with her. He wanted to be with her while she was sick. But two weeks after her death, my uncle had a fever and was taken to the closest health center.

    Ebola is a new disease for us. We are not used to isolating our own family.

    They detected the virus. After five days, he was also dead. He was never brought back to the village. He was buried where the other Ebola cases are. I have heard reports from Kenema that sometimes they have to bury them together. This can be like a mass burial.

    My aunt was buried by the medical team in the village. When she died she was lying there for two days because we were waiting for the medical team to come and confirm they needed to bury her.

    I was able to see my uncle before he was dead but not with close contact. The message here in Sierra Leone is, even if you have your relative who is dying, you don't go close to the person. You don't touch the person. That's when you advise the person to go to the closest health center.

    My younger brother was a bike rider who rode a commercial bike in Sierra Leone. He was also affected by this sickness. He was in the village for three days, where he had a fever and was becoming worse. He was taken to the government hospital in Bo. By then Kenema had been quarantined. There was no way for us to go to Kenema.
    After one week he was dead.

    I have not gone home to my township for the past four months. The district is being quarantined. So I send food items and non-food items to my family, to the children of my aunt and uncle, and the child of my brother. I just send them food.

    Ebola is a new disease for us. We are not used to isolating our own family. Because we have a culture of not isolating our own people, some families are adamant not to identify sick people. Because when sick people are identified they are taken away to health centers. Even in the slum areas, people are dead and they will leave them in houses. They are not reported. People don't want family members taken away even if they are dead.

    We have love for our family. We are compassionate about our family. When someone is dead in your family, if you're a Muslim, a burial takes place that day. If you're Christian, a burial is given to that person. Now, people's loved ones are buried in a way families don't like. That's why people are very stubborn. That's why people are exposing loved ones to people who are dead with Ebola.

    This is upsetting my whole family. It is disturbing. It is frustrating.

    In Freetown things are getting worse. It's getting worse every day now. It is difficult for a community, for one family, to leave home to go for a visit to another person. After work everybody comes home. It's not like in normal times. We used to pay visit to our loved ones. We used to pay visit to our friends after work.

    The issue is about touching. You can't touch people now. The reality is: a virus has entered our country. It's not about politics, it's not about gender, it's not about tribe. Ebola is a reality.

    I can't get to my family, and they're dying from Ebola one by one

    Meet the man who has dedicated his life to hunting for Ebola in Africa's rainforests

    Bob Swanepoel is a virologist at South Africa's University of Pretoria. Over the last 40 years, he has hunted in the rainforests of Africa for microscopic pathogens, including the hemorrhagic-fever viruses Marburg and its sister Ebola. Knowing which animals can live with Ebola could help scientists better understand and predict outbreaks, and identify an Ebola vaccine. It could also help researchers figure out which behaviors or activities might put humans at risk for Ebola. But the work is painstaking, involving trapping animals at all hours of the night and testing them for a deadly virus, while trying not to get infected yourself. So, despite four decades of trying, Bob and his colleagues still haven't solved the mystery of Ebola's natural reservoir. Their best guess is that the virus lives in fruit bats when it's not ravaging humans — a theory they haven't been able to prove. Here he explains why the work of virus hunting is "no Sunday school picnic" and how the answer to the question at the center of this Ebola epidemic has eluded him all these years.

    I got involved in this work during the second outbreak of Marburg ever, which happened in 1975, when two Australians who had hitch-hiked in Zimbabwe became sick in South Africa. But then Marburg disappeared and Ebola hadn't even been of heard of. The first known outbreaks of Ebola only happened in the following year, 1976.

    Hunting for viruses is no Sunday school picnic. You've got to go out at night, into forests. Say you have to take a leak. So you walk 10 minutes away from the others on your team. You've got a headlight on, but suddenly the others are gone, and you're totally disoriented.

    You start shouting or running in the wrong direction. They're gone. You've walked hours to get to this place in the forest to catch these bats. Then you're lost.

    The bats will come out just after sunset, and they will fly until about 9:30 or 10 pm. Then they will go back home and they'll only come out again as the sun comes up. They fly in the evening and the morning. In the depth of the night, they are not flying. So you can either hang around or put up your nets and go home and come back the next day.

    The trouble is, these bats — despite being big and strong — can't take the cold. They die. So the next morning they're stiff and you can't bleed them.

    You've got to make sure you're catching the right bats, too. When I worked on the 1995 Ebola outbreak in Kikwit in the Democratic Republic of the Congo, I had discovered that the really big fruit bats they were selling for food, the Africans were catching them high in the trees. They would climb up the trees and put their nets 40 meters up. If we put up nets the ordinary way, we'd put them 10 meters up, so we would catch the wrong kind of bats.

    People say, "Kill all the bats." That's nonsense. You'll make the situation worse.

    This whole game is far more complex than you would think. It's a very tricky business.

    When you catch the bats, funnily enough, these things are huge and strong. Their wingspan is very wide. They have teeth like you won't believe. On top of that, you think, not only can they bite you, they might have Marburg or Ebola. You have to be careful of all of that, but despite your best efforts, you will get bitten.

    While in the forest, we tested thousands of other animals, not just bats: rodents of every kind, birds, insects, snakes, slugs, snails, frogs, anything we could catch. Therefore, before you put your bat nets out in the evening, you put out rodent traps. If you put those out in daylight, the baboons or monkeys will take them.

    Late at night you return to base with the bats you have caught and work until the early hours of the morning dissecting them. Then you have time for a quick wash and to rest for an hour or two before you have to go out and collect the rodent traps before dawn. You have time for a hasty breakfast and then you have to dissect the rodents.

    Now it's 10 or 11 in the morning and you've got to wash all your traps and nets. And by three o'clock, you've got to be on the road to do the next day's trapping.

    That's day after day after day.

    By the end of the week, you may give your team a day off. But you'll be exhausted. You're not eating too well. You've been bitten to hell by mosquitos. If you brush against a leaf they'll be 50 fire ants biting your arm. You'll be on fire. The next branch, you turn around, you knock into thorns six inches long. Little flies cover your skin. They love going into your ears. If you put cotton into your ear, they'll go up your nose.

    You have to be tough. The toilet arrangements and facilities leave much to be desired. Sanitary conditions are unbelievable, and privacy doesn't exist.

    Doing this work, I got malaria in 1995 and again in 1999. I nearly died.

    So why did you do it?

    The same reason, when George Mallory was asked why do you want to climb Everest, he famously said, "Because it's there." It's curiosity. For this game, you've to have the curiosity of a child.

    Besides the difficulty of the work, the reason Ebola's host has been so hard to find has to do with the fact that, in the past, outbreaks were rare. It was very difficult to get permission to go in and look for the virus when there wasn't an outbreak. There was also an element of "let sleeping dogs lie. We don't have Ebola now, so please don't find it." There's lots of downsides to having this virus in your country. People really didn't want to know about it.

    And when you asked your boss for funds to go out and do research on Ebola, and an outbreak wasn't happening, they'd say, "This disease has killed less than 1,000 people in the whole of history. Why are you bothered about it?"

    While an outbreak is happening, we also found if you want to go there and hunt for viruses, the international response teams and the locals will tell you to get lost. They've got more important things to do like stopping the outbreak.

    I'm hopeful. I think we'll confirm the source of Ebola quite soon.

    In any case, getting into these countries at the right time is always difficult. First of all, almost invariably in every Ebola outbreak, there is a long interval before the outside world picks up that an outbreak is happening. By the time investigators get there, the original source of infection is no longer relevant since it's been almost a year now that this thing has been spreading from human to human. So where it came from originally is not going to affect how it's controlled right now. If it was a bat, the season might have changed, so the type of bat that caused the outbreak may have gone elsewhere.

    We have some consensus that Ebola lives in bats. In the very first outbreaks that happened simultaneously, in Sudan and Zaire in 1976, the first six people to get Ebola in Sudan, the very first people in history known to get Ebola, worked in the same room. There were holes in the ceiling above them and there were bats in that hole.

    Then subsequent to that, if you go to every outbreak in history you find something that suggests there could have been a bat connection. So the indications are strong that it is bats that are involved.

    I inoculated bats and snakes and frogs and spiders with Ebola virus. I inoculated tortoises, geckos, everything with the virus, to see what would happen. What happened was — in most of these animals, the virus didn't multiply — except in bats.

    In bats, the virus multiplied like crazy, but it didn't do them any harm, which suggests that they're the natural host of Ebola virus.

    But we don't have the second-step proof, though. If the virus is in bats, you can do a 'PCR' test that picks up the genetic material to say the virus is there. But you have to get the virus to grow in the lab. If you've got genetic material in a bat, and you can't grow that virus, you haven't proved that this is live virus. The Marburg virus has been grown on several occasions and there is little doubt that bats harbor it. But we haven't been able to do that with Ebola virus.

    I'm hopeful. I think we'll confirm the source of Ebola quite soon. I think it'll happen in the not-too-distant future. But the problem is: what do you do about it then? You can't stop everybody, you can't reach down into the primeval forest, get the word into every nook and cranny and say, "Don't eat bats." You can try but it'll probably still happen.

    Other people say, "Kill all the bats." That's nonsense. You won't succeed, and you'll make the situation worse. If you upset the ecology of these things, suddenly the virus is everywhere.

    Meet the man who has dedicated his life to hunting for Ebola in Africa's rainforests

    'Here you don’t see your enemy': A war surgeon's Ebola story

    Dr. Gino Strada — an Italian war surgeon and founder of the NGO Emergency — never planned to work on a disease outbreak. He spent the bulk of his life treating patients in conflict zones, from Iraqi Kurdistan to Afghanistan to Sudan. Then, in 2014, the war on Ebola broke out. Dr. Strada found himself delaying a long-overdue vacation to open an Ebola treatment center in Sierra Leone, where his NGO had been running a post-civil war hospital that was suddenly overwhelmed with Ebola patients. I spoke to him at the end of October 2014, as he awaited the opening of a second Emergency Ebola facility. He was wracked with the worry that he was not going to be able to recruit enough personnel to care for patients.

    I left Sudan and arrived in Sierra Leone a month ago. For the past seven years, I did not have any chance to take holidays, and this year, I decided I was due to have a holiday.

    Then all of a sudden, we had this crisis come up, and it's very violent. A lot of our staff were down here, so I didn't feel like going on a holiday. People much younger than me are here working on Ebola by themselves. I thought I'd come here if only to give them psychological support.

    This is the first time Emergency got involved in a disease outbreak. We didn't choose this. We have been here in Sierra Leone for 13 years because of the civil war, running a surgical center and a pediatric hospital. But we were faced with this problem of seeing children outside our pediatric hospital, they were coming with fevers, but we couldn't let them in because they might have had Ebola that would spread to others.

    For a long time, we had to keep our hospital open because the others here in the capital shut down. A lot of health personnel got infected during this Ebola crisis, and we were the only ones that were operational. At certain points, our pediatric hospital has been the only one open in all of Sierra Leone.

    Now we are running a small center for Ebola treatment, with only 22 beds. It was supposed to be a holding center, but it's not possible to hold patients when you know they are positive with Ebola. You have to treat them.

    This is what we see every day: all our beds are fully occupied, and we always have someone lying down on the ground outside the gate waiting for a free bed to have access to medical attention.

    You're not even able to admit one person and you already have another one waiting. The number of treatment facilities and the number of beds in the country are very, very limited. And that is by itself a factor that helps spread the disease.

    The minister of health and the president asked us to set up another, bigger facility. So we are waiting for a 100-bed facility to be ready within the next four weeks.

    I hope we will have enough staff for the new facility. We are now trying to recruit among the Cubans, among the British, among the Italians.

    My perception is that the level and skills and training of the national health personnel in this region is so low. Across the country you find very few nurses who are able to attend properly to patients. So this job has to be done mainly by international personnel.

    And here international personnel is very scarce at the moment.

    To keep Ebola patients alive you need to provide them with supportive care: IV infusions, drugs to control pain, vomiting, diarrhea. You need to provide blood transfusion if they bleed. You need to provide sedation.

    You have to be there. You cannot just go in and visit the patient and get out and then leave the patient on his own for 10 hours.

    Imagine a 100-bed facility like the one we're going to have in a month here: to be able to provide each patient with a minimum of five to six hours of medical attention means you have to work on a rotation basis, so you need 100 nurses, and 10 to 15 doctors.

    The amount of personnel you need is much more than what you need in a standard intensive care unit. In our ICUs, a nurse or doctor can stay on a shift for eight hours. But here the time limit is one hour, and then you need to stay away for two hours to rehydrate and rest.

    In the clinic, despite some air conditioning, you have a high temperature in the range of 35 degrees Celsius [95 degrees Fahrenheit] and very high humidity. On top of it, you have to wear full personal protective equipment. When you do that, you lose a couple of kilos an hour from sweating. So you cannot attend to patients for more than a couple of hours before another team has to go in.

    At the end of the day, everyone is exhausted. You have to rehydrate yourself. Providing medical assistance is difficult. The job is very physically demanding.

    Economically it's a big, big challenge. We calculated that to run this 100-bed facility, we will need to have something like just under a million dollars a month.

    This is a very different type of situation from the war zones I've worked in. There, you could see the risk coming or approaching. Here you don't see your enemy. You know it's there, but you don't see it.

    All you can do is adhere very strictly to the safety measures and protocols. The point is that despite all the risks and difficulties linked to the fact that you're treating patients infected with Ebola, you have to provide medical and nursing care. Containing the suspected or confirmed cases here is very helpful in avoiding spreading this epidemic.

    We know the best supportive care decreases the mortality rate of the disease very significantly. If thousands of Ebola patients appeared in Europe or other countries, where there is a well developed health system, the patients would survive.

    This is once again a disease of poverty.

    This very low survival rate here is linked to the fact that there is no health system here, these countries have been ravaged by war and poverty, with very little attention paid to developing the health structure.

    Even still, if I got sick with Ebola, I would get treated in the Emergency hospital here. Emergency has always had this philosophy: a hospital is good enough for the Africans or Iraqis when you are ready to be cared for in that hospital, when you are ready to have your family members cared for in that hospital. The locals are not class B citizens. They have been much more unlucky than we are. But they have the same dignity and the same rights.

    'Here you don’t see your enemy': A war surgeon's Ebola story

    Why I lied to my family about being an Ebola doctor

    When Ebola broke out in West Africa in 2014, Franklin Umenze, a 29-year-old doctor in Lagos, Nigeria, knew it was only a matter of time before the virus arrived in his country. Sure enough, by July, a Liberian-American man named Patrick Sawyer boarded a plane in Liberia bound for Lagos. Sawyer collapsed on arrival, and died days later, infecting several others and sparking fear around the world about what would happen if the virus spread through Africa's biggest metropolis. Umenze was one of several doctors who volunteered to work on the first-ever outbreak in the country. This is his story:

    When Patrick Sawyer came to Nigeria with the virus, an urgent call was made for clinicians. I got an email and immediately decided to volunteer. I had grown up to understand that we will be remembered for the impact we made on the lives of others and not the wealth we made. I wanted to add value to mankind. Watching my fellow brothers die in other countries from Ebola made me very sick and unhappy.

    I was responsible for the clinical welfare of the patients. I was initially trained by Dr. David Brett, an American, on how to don and doff the personal protective equipment and other safety measures. The first lesson I learned from Dr. Brett was: be afraid of Ebola.

    Initially, the Ebola center was poorly structured. The wards were untidy. The changing rooms were very close to the isolation wards. It was really a mess.

    I live with my family, and I couldn't tell them what I was doing

    The first time I wore the personal protective equipment, I was so scared. It was really uncomfortable and hot. I thought of my life, my little achievements. I was praying to God to forgive all my sins should I contract the virus and die.

    One particular incident occurred while I was on a night shift. One of the patients was really sick and needed attention. The only available personal protective equipment was not my size. I wore it but had parts of my hands and face exposed. We secured an IV access, cleaned up the patient to the best of our abilities.

    I was scared to death when I came out. I thought I had the virus. I developed a phantom fever, body pains and avoided contact with people. I was always checking my temperature. It was terrible.

    The most horrifying part was my inability to tell my loved ones what I was doing for the fear of being stigmatized. I live with my family, and I couldn't tell them what I was doing. I was avoiding them as much as possible. I never disclosed what I was doing to any of my friends or my boss for fear of being stigmatized.

    You worry you might lose your job. One of the survivors working in an oil and gas company was fired here. Friends will shy away from you, church members would never visit. You would be an outcast. I was afraid I was going to lose my job, lose my friends, and bring a lot of negative attention to my family

    Looking back now, I think this period of my life was the most exciting. I felt really special knowing that I helped save some lives.

    My life is almost back to normal now. I am back at work. I have told my family I did this work but I still haven’t told my friends or my boss. My mom was proud. My siblings were glad I did not get infected.

    The first lesson I learned from Dr. Brett was: be afraid of Ebola

    Luckily this outbreak started in Lagos, where a lot of people were enlightened. It would have been a disaster had it first occurred in the northern part of Nigeria. These were Nigeria’s first Ebola cases, and we successfully contained the outbreak.

    I think Nigeria as a nation deserves to take all the credit. Immediately when the outbreak broke out, there was a massive media campaign, an informational website was developed, hotlines were made, posters and discussions on Ebola came to life. Large public gatherings were discouraged. The movement of corpses was barred. There was screening at the ports, and the immediate mobilization of the isolation unit in Lagos.

    Kudos must also go to Dr. Stella Ameyo Adadevoh, who died treating Sawyer. She stood her ground despite all the pressures she went through. We must not also forget the four other doctors that were also infected in First Consultant hospital. They were infected doing their jobs. Three of them died.

    Why I lied to my family about being an Ebola doctor

    How Ebola goes after children

    Lina Moses is an epidemiologist based at Tulane University in New Orleans. She has been working on and off in Sierra Leone for nearly six years — and happened to be there, at the center of the worst Ebola epidemic in history and the country's first outbreak, just as it was taking off. Here Moses talks about leaving her daughters behind to go back to Sierra Leone, and the children she found there.

    I can tell you I'm going to miss my daughters when I go back to Sierra Leone. And I think the hysteria that has been propagated in the US has made it really tough on them because they keep hearing things that are untrue about the risks of Ebola to myself as well as to others in the US. Kids are making up songs about Ebola. They are making fun of getting Ebola in Texas. There's fear of contagion. It scares them.

    I'm anxious to get back to an environment where I feel very useful and effective. But honestly, what I’ve been hearing about what’s going on in Sierra Leone across this whole outbreak is scary to me. Not scary for myself but scary for this country that I love, Sierra Leone.

    Early on in June, there were very few people responding to the Ebola outbreak. And I was one of them. I was in Sierra Leone from February until September, and I had been working on Lassa fever when Ebola showed up.

    Even the best-trained person is going to make mistakes after working 12 hours a day

    I studied hemorrhagic diseases in my training but had never seen Ebola before. We didn't quite understand how quickly this thing could explode.

    I can tell you it’s was a lot worse on the ground. It was pretty horrific. For the first couple of months, when the outbreak was in Guinea, I was working closely with the Ministry of Health in Sierra Leone and their surveillance teams. We were looking hard for Ebola. We were responding to every rumor we heard, surveying along the Guinean border. And we didn’t find it. So when it popped up in Sierra Leone at the end of May — and it clearly had been going on in Kailahun district for some time — it was pretty shocking.

    I felt completely overwhelmed. I'm nervous about feeling that way again when I go back. At this point, I have been working in Sierra Leone for nearly six years. I have people very close to me whom I have lost. I lost a lot of friends to Ebola. I haven't counted in my head how many people.

    It's very difficult to pinpoint where people are getting infected. There have been many lab technicians in Kenema Government Hospital who got infected. But they all had active Ebola transmission in their neighborhoods and communities. Whether they were exposed in hospital or at home, we can’t tell for certain.

    Even the best-trained person is going to make mistakes after working 12 hours a day. People are human. The system needs to provide the best possible environment to protect health care workers but it infuriates me when people blame people.

    No one wanted to take this boy for the 21-day incubation period

    This virus, it’s hell. It’s devastating. How it devastates the social fabric in communities, in towns and villages. It’s horrendous. This outbreak just exploded rapidly. I don’t think anyone was expecting this.

    There was a small child who came in to our hospital in the ambulance with his mother. The mother had classic Ebola symptoms, and was unconscious. The mother couldn't give us any information. The child was 16 months old. We didn't know if he had Ebola or not. Because of the contact with his mother, he was in the suspected ward. The mother died that night. What do you do with the child? We were not sure if he had Ebola or not.

    The child tested, and he was negative. But that child clearly had very close contact with someone who had Ebola. How do you place these children in foster care?

    No one wanted to take this boy for the 21-day incubation period. Basically he ended up being looked after by all the nurses and the hospital workers. We kept an eye on him for a long time during the day. At night we made sure he was sleeping. A couple of days later he started developing a fever.

    He had Ebola. He went into the treatment center and died.

    I can tell you about another four-year-old girl like this. There are countless stories about children like this.

    How Ebola goes after children: A report from Sierra Leone

    My uncle was the first person to die from Ebola in America. We still don't have his remains.

    Josephus Weeks is the nephew of Thomas Eric Duncan, the first person to be diagnosed with Ebola in America. In late September, Weeks found out that Duncan — a Liberian man who was visiting the US for the first time — had been hospitalized in Dallas. On October 8, Thomas Eric Duncan died, leaving behind two sons in America and two daughters in Africa. From his home in North Carolina, Weeks talked about the uncle he loved, how health officials here failed his family, and what it was like to suddenly be in the national spotlight because of the virus.

    On the day of my birthday I made a phone call, and all hell broke loose. It was September 29, a Monday morning.

    Eric was in the hospital in Dallas, and they weren't moving on his blood work. So I called a Centers for Disease Control and Prevention hotline. Eric had his blood work sitting at the hospital in Dallas for a whole 48 hours. I had been telling them, "You know, he's from Liberia." I don't think they knew what Ebola was before Thomas Eric Duncan came in.

    This was his first visit to America, and he didn't survive. He didn't get to see anything here. He spent most of his time in hospital. He arrived on the 20th, and by the 24th, he was sick. By the 30th, I found out through the news that he had Ebola, and then the hospital called us and told us. That's the same way I found out he died — through the news.

    This was his first visit to America, and he didn't survive

    When he was in the hospital, he asked me, "Josephus, how long does this thing stay in your body?" I said, "Well, based on what I had seen with the other two other patients transported from Liberia, both survived — Dr. Kent Brantly and Nancy Writebol." I told him, "In three weeks, you'll be okay."

    He kept saying he was in pain. He was trembling; he was cold all the time. He had diarrhea. He was nauseated. He was having trouble breathing. But mostly he complained about the pain.

    The bleeding stuff I didn't hear much about, except for one time while he was in the hospital. I heard they were trying to give him an IV and they missed, and there was blood everywhere.

    On that Friday morning before he died, he was on the oxygen mask. Through the phone, I could hear the oxygen tanks hissing. We told him to go to sleep, that we'd call him that afternoon. And we never talked again.

    What bothers me is the lack of attention and lack of humanity about his death. Still today, President Obama has not called on my grandmother to say, "My condolences." He sent prayers to Amber Vinson and Nina Pham, the other nurses who got infected. But he never gave prayers to Thomas Eric Duncan's family.

    The media attention was painful. Here's my brother on the bed, fighting for his life. Every time I turned around, my grandma had to turn on TV and see him in that green shirt. I was at the airport trying to take a flight to Chicago and we were standing here, and he came up on the screen big as the Brooklyn Bridge. I wanted to say, "Please stop showing his picture." It was hard for us to deal with. As a family, we are praying people. We just keep praying, and supporting each other.

    There's a human being out there, but you can't give him a burial.

    We don't have Eric's remains. We don't know where they are. It's a big old mess. The indignity he faced in death is really upsetting to me. We should have had his remains and figured out if we were going to take them to Liberia and find a decent place to bury this man.

    He still doesn't have a place to rest. There's a human being out there, but you can't give him a burial.

    People think Eric came here with malicious intent, and that's not the case. I always refer to Dr. Craig Spencer. He was a doctor who knew better, but he arrived in New York, went around the city, and then got sick. Eric was a regular old civilian. He came here and was just living his life. He got sick, and it turned out to be Ebola.

    My uncle was the first person to die from Ebola in America. We still don't have his remains.

    Ebola and the power of film: How my students and I saved lives by making movies

    Divine Anderson runs Liberia's first and only film school, the Liberia Film Institute. The 37-year-old started making movies in 1996 and has stuck to the medium because he thinks it's the best way to reach his fellow Liberians, many of whom can't read. When the Ebola outbreak was peaking last fall, he turned his attention to creating public-health awareness films that he spread through a mobile cinema — essentially a motorcycle retrofitted with a cart that carried him, his students, and a TV. We talked to Anderson in March — just before what appeared to be Liberia's last Ebola patient was released from the hospital — about how these films saved lives.

    I teach students how to make low-budget or no-budget movies. You just make do with what you have. You use your smartphone. You make sure you don't use professionals, because you have to pay them. You look to your friends for help.

    We started doing the Ebola films because it was a way for students to learn how to engage their community with films. Only 60 percent of the population can read and write.

    Ebola was frightening. It was the unseen enemy. Eventually the government shut down the schools, so our film school was also shut down.

    By November, there was a drop in the death rate. We now understood Ebola properly. It was not as deadly as the media made us believe. Ebola is simple. Obey the rules, and you don't get infected. We took all the precautions —wash hands, use sanitizers — and we were fine. People were still moving around, going to the market, entering public transportation, and nothing happened to them. So in October and November, we called a couple of the students we knew very well and invited them over.

    The fear of Ebola probably killed more people than the virus

    Together we made educational films about Ebola, to engage the community. Our health messages were based on the rules the Centers for Disease Control came up with, some basic rules for the "Ebola Must Go" campaign. There were five key public-health messages: Don't touch the sick, don't touch the dead, don't shake hands, report sick persons, and contact tracing (when health officials seek out all the people who have potentially been exposed to the virus and quarantine them if they become sick).

    We saw it as our responsibility to create a film that would carry those five key messages, that would help the people who cannot read and write to understand Ebola. That's exactly what we did. We also had a Christmas film about keeping families home during the season.

    We retrofitted three motorcycles to travel around and show the films. We would leave at 6 in morning and just keep going from street to street to show people the films. We did it 10 hours a day for several weeks, all over Monrovia. At the end of the day, we would spend one hour collecting reports and feedback from people. Then we would go to bed. The next morning, we would take off again.

    More than 50,000 people saw these movies. Monrovia alone has more than 900,000 people, and it gets more crowded during the Christmas season, which is when we screened these movies street to street, market to market, and in the most crowded places.

    We had mixed reactions at different points and from different communities. To some, it was was timely and educating. Some were happy. Some asked to know more about Ebola and the Ebola survivors' stigma. Some people thought we were sponsored by government and didn't listen to us. When we explained that we are an NGO, they accepted us and listened to us.

    People understand Ebola better now. The films we made, this is just a starting point.

    When you understand how Ebola works, you will no longer be afraid of it. Fear killed a lot of people, because they didn't understand what Ebola was. People were afraid of helping even when they could, because they didn't understand the virus. I lost my sister-in-law. She was three months pregnant. She had low blood pressure, and for three days we were trying to get her medical assistance. Her own hospital couldn't admit her, and she eventually died. Because of the fear of Ebola. The fear of Ebola probably killed more people than the virus.

    Now Ebola is going but not gone. People are no longer afraid of Ebola. People understand it better. The films we made, this is just a starting point. I would love to do more.

    Ebola and the power of film: How my students and I saved lives by making movies

    I was a journalist covering Ebola in Liberia. Then I caught the virus.

    Ashoka Mukpo was the only American journalist to contract Ebola during this epidemic. The 33-year-old had been working in Liberia as a freelance reporter and cameraman for various media outlets when he suspected he was sick. He was diagnosed in Monrovia at the beginning of October, and by the end of that month he was released from the Nebraska Medical Center, virus-free. Here's what he had to say about coming down with the disease in Liberia, getting treated in the US, and recovering physically and emotionally.

    I have the dubious distinction of being the only American reporter to catch Ebola. I can definitely think of things on my resume I'm more proud of.

    I have no idea how I got it. I think there was a dirty surface somewhere, or someone bumped into me. But there were journalists who did far more risky things than me — some went into treatment wards, some really got quite close — so I was very surprised when I got sick.

    When I first suspected I had something, I stuck a thermometer in my mouth, and the temperature jumped up to 101.3. There was instantaneous recognition on my part — the chances of that being something that wasn't a big deal were small. The first thing I did was quarantine myself. I went into a room in the place where I was staying and wiped down all the doorknobs. I worried about infecting my roommate. I isolated myself and started making phone calls. My father is a doctor, so I called him. He was able to locate colleagues of his volunteering with the World Health Organization in Liberia. They gave me a call and started to work out a game plan: to go to Doctors Without Borders the next day and get a test.

    The thought crossed my mind that I needed to start preparing for my death

    I woke up the next day and felt sick. The night before it was only a fever. The next day, I had other symptoms. I couldn't eat. I started to develop a mild headache. My body felt strung out. I felt tired and a little bit foggy. I started to get sicker. I got a ride to the treatment center.

    When I arrived, the man checking me in looked at me and said, "What are your symptoms?" I started to list them off: joint pain, tiredness, I don't want to eat. The look on his face said it all.

    I went over to the suspected ward. It takes five or six hours to get the results. So I waited.

    It was very emotional to be in that space and realize the barrier that had existed between me and the Ebola patients I had been covering for the last month had broken down and now I was in that situation with them. At that point, my whole mentality was, "Let's get a confirmed diagnosis and see what comes next."

    The hours passed, and two doctors wearing full protective outfits came up to me, stood there, and paused. They said, "The results of your test came back. You've been confirmed as carrying the Ebola virus."

    I knew this was coming, but to get it in those clear terms was shattering — sad, frightening, lonely.

    The needs in the moment were so pressing. The thought crossed my mind that I needed to start preparing for my death. I might not survive this. I called my girlfriend and started to talk to her about the need to prepare herself. I realized most of her money was in my bank account. Did I need to make a phone call to the bank? Get her added as a beneficiary to the account?

    I'd spent three nights and four days sick in Liberia when the US State Department got involved. They have the ability to get one of the very few planes that exist in the world to carry you back for medical treatment if you're a US citizen. It costs $150,000. They don't ask you for that up front. And I very foolishly didn't check if my insurance covers Ebola. It turns out it didn't.

    To get into the medevac, I had to put on a suit. I was really sick at this point. I was very weak. I had these recurring bad headaches and couldn't walk very well. I had to get up, get out of bed, and put on the whole Ebola outfit — gloves, boots, mask, goggles — and they put me in back of an ambulance. We drove 40 minutes to the airport, where there was a giant gray jet sitting on the tarmac, and that was my ticket home. It was air-conditioned, with a comfortable bed. I wouldn't say it was the Ritz-Carlton. But compared to the gym mat I had been sleeping on at the Doctors Without Borders facility, it felt like a whole new world.

    It took about 18 hours to get to Nebraska, and I slept most of the time, running a fever of 104 degrees. When we arrived in the US, my symptoms got worse. I started to vomit. I had diarrhea, a classic symptom associated with contracting Ebola. I was having muscle pains. My eyes were really red. I felt really foggy. My head was swimming. I was very short of breath, and it was hard to talk. I still didn't know if I was going to live or die. I asked the doctor, and he said, "I don't know."

    It was a frightening experience but also a gift: I got to see what I really care about

    I had 40 nurses tending to me. I always had someone there in the room. Every day, a doctor did a full-body examination to ask me about my symptoms. One day, I got a nosebleed — partly because the climate had changed so much since I left Liberia. But I got afraid that it was the beginning of crazy hemorrhagic symptoms. Thankfully, that was it. I didn't eat for a full three days. They fed me through a line in my neck.

    I don't know what helped me and what got me through this. I got a blood plasma transfusion from Kent Brantly, the American doctor who survived Ebola after contracting the disease earlier in 2014. When I was at my sickest — that was a really tough day. I felt like the blood transfusion was making things worse. I felt cold. The next day I woke up and felt much better.

    When you have a brush with your own mortality, you see what's important to you boiled down to the bare essentials. It was a frightening experience but also a gift: I got to see what I really care about, what I'm most afraid of losing. The whole experience has been so overwhelming and such a major life break. It provided me with an opportunity to evaluate what I want to accomplish and use my time wisely, because it can be so brief.

    My recovery has been much milder than I thought it would be. I was concerned it would take years to get my strength and health back. There are lasting effects: I have joint pain, muscle aches come and go, it's easy for me to pull a muscle, and if I sit in the wrong position I can experience pain. I still have fatigue. I used to be able to run four or five miles, no problem. Now it feels good to get to a mile.

    NBC has agreed to help me pay the debt from my treatment and take care of me as someone who is working with them. That is such overwhelming good fortune, to not be saddled with this unpayable debt for the rest of my life.

    People said I recovered a bit quicker than some of the other survivors. I have no memory loss. It could have been a lot worse.

    I was a journalist covering Ebola in Liberia. Then I caught the virus.

    • Editor: Eleanor Barkhorn
    • Illustrator: Chris Walker
    • Designer: Tyson Whiting
    • Developer: Yuri Victor
  2. My dad was the first Liberian doctor to die from Ebola: One daughter's story

    Dr. Samuel Brisbane is one of more than 200 health workers who have lost their lives to Ebola during this outbreak, and the first Liberian doctor to die from the virus this year. On July 26, the day he died, he was only three days shy of turning 75. Dr. Brisbane could have long retired from practice, but his dedication to his patients kept him going — even in a hospital with a dire shortage of safety gear, regular power outages, and an onslaught of patients with a virus that terrified him. His daughter, Elizabeth Brisbane, talks about her father and his life's work at John F. Kennedy Memorial Medical Center in Monrovia.

    The regretful thing is, the guns didn't kill Daddy, but Ebola did kill him. He survived all of the wars in Liberia. He never did fight. He was there while all that took place in Liberia was Charles Taylor's wars, and he was able to survive that. He trained in Germany in the 1970s, and he decided to return to Liberia and work through the wars to be of service to his country. He knew that his patients needed him the most.

    During his last days, while he was waiting for his Ebola test results, he told my brother Samuel that if the test came back positive, he would fight the disease like he fought everything else. We had prayed that he would survive. After all, he was fearless that way, and if anyone could beat the odds, he could.

    For the last 10 years, he had worked at the JFK medical center in Monrovia, where he started a diabetes program, a stroke program, and an HIV program. He was later joined by Dr. Abraham Borbor, who took over the leadership of the HIV program. Daddy and Dr. Borbor were very close. Dr. Borbor also died a month later, in August, from Ebola.

    I jokingly called my father Dr. Ebola. I said, "Dr. Ebola, how are you doing?" Little did I know Ebola would be the cause of his death.

    I had hoped in his old age, Daddy would retire. See, in addition to his love of medicine, he loved farming. On his farm he had coffee, pineapples, and peppers. When I saw him last, in April, I said, "Go on your farm and if you love medicine that much, open a clinic." I said, "You're working too hard. That hospital is going to kill you."

    In April, he was already treating Ebola patients. When I visited Daddy in the hospital, I heard they would count gloves to give the nurses because they don't have enough. I jokingly called my father Dr. Ebola. I said, "Dr. Ebola, how are you doing?" Little did I know Ebola would be the cause of his death.

    I knew that I could not stop my father from treating Ebola patients. My father once had a neurological problem with his back and he couldn't walk. He saw patients in a wheelchair. Because of his dedication and commitment, he stayed there treating patients.

    In the last few months, the foreign doctors had left the JFK because they didn't have the proper equipment for Ebola. But because of Dad's commitment to medicine and his patients, he provided treatment and care to them even though he didn't have personal protective equipment.

    I could not go to his funeral. Because the government says people who die with Ebola must be buried the same day, I could not make it back to Liberia fast enough.

    Dad had chosen a spot on his coffee farm that he wanted to be buried at, and the government honored his request. He could have ended up cremated or in the mass graves with the other Ebola bodies.

    For Daddy, they were able to put his body in a body bag and then place the body bag in the casket. The burial team escorted the casket to the farm for interment with my brother Samuel showing them the way. I am grateful Daddy has a grave that I can visit.

  3. My life on an Ebola treatment ward: One doctor's story

    Dr. Daniel Bausch, an associate professor at Tulane University School of Public Health and Tropical Medicine, arrived in Freetown, Sierra Leone in July, just as the Ebola outbreak began to grip the country. He was already familiar with the virus: a world-renowned Ebola expert, Dr. Bausch has researched hemorrhagic fevers for the Centers for Disease Control and Prevention for nearly 20 years. He helped set up Ebola treatment wards, cared for Ebola patients, and contributed to the CDC's first-ever training course on treating the disease. But doing this work amid the fear and violence the epidemic sparked in West Africa — and the emotional toll of losing friends to the outbreak — has been the greatest challenge of Bausch's career. We spoke more than six times between July and September 2014 about the difficulties of caring for Ebola patients, why the virus is so deadly for healthcare workers, and what this epidemic means for the future of West Africa.

    If you're in a hospital in Sierra Leone or Guinea, it's not unusual at all to say, ‘I need gloves to examine this patient,' and for someone to tell you, ‘We don't have gloves in the hospital today.' Or, ‘We're out of clean needles.'

    I've worked in the same region for many years just by chance, on other projects in Sierra Leone and Guinea. I was really familiar with these places before the Ebola outbreak ever started. These countries are coming out of many years of civil war. They are the poorest countries on the planet. Their health systems are struggling. They have poor infection control practices. Recognizing that, when these sorts of outbreaks happen, it's very difficult to get local health-care workers to keep working. They have seen colleagues get infected and die. They have severe shortages of staff.

    So when I got to Kenema, Sierra Leone, in July, there were times when I went into the ward and all the nurses had gone on strike for the reasons I explained. There were 55 people who had Ebola in the ward, and just me and one other doctor to treat them.

    Having so many very sick patients and the needs they have — not only for medical care but providing food and water, and all the other needs — it's a very difficult and potentially dangerous situation for everybody. The environment is not cleaned, and there's a lot of soiling from patients with vomiting and diarrhea.

    In this particular setting, where there are not the nurses and the other staff to take care of this environment, it was very frequent to come in and have two to five patients that had fallen out of bed, or had a degree of delirium, on the floor, soiled with stool or vomit or blood.

    There were 55 people who had Ebola in the ward, and just me and one other doctor to treat them

    What should happen in that environment when a patient falls out of bed is that there should be numerous nurses and a sanitation officer who should come and decontaminate the area. They would then gently help the people back up to bed. But when you don't have that support, you have people falling out of bed, delirious, lying on the floor. Obviously it gets more dangerous to care for them. These are very sick people who may be very infectious.

    I don't want it to come across as blaming or pointing fingers at the nurses who declined to work. I empathize. It's totally terrifying. We would all have the same reaction. It's the right reaction to have. You can take care of patients with Ebola safety. But the scale of this outbreak is so large, it has outstripped the resources of these very impoverished countries in Africa to deal with it on their own.

    One of the things that is not always that well understood is just how difficult it is to find the labor to do this work in West Africa, both nationally as well as the expats. Take Liberia as an example, where the medical school was closed all during the war, so they were graduating no medical doctors. Since the end of the war in 2003, they graduated a handful of doctors. I'd imagine half of them are drawn off by the brain drain: moving away for better opportunities.

    And then in the last six months, how many have been infected and killed by Ebola virus? Then obviously if you're one of the ones who haven't been infected with Ebola, how enthusiastic are you about doing that work when you see colleagues getting sick and dying? So you go to West Africa, and say, ‘Raise your hand if you want to work in an Ebola treatment unit.' You don't see many hands in the air.

    This epidemic has been really painful. There is an added pain for me. It's very personal. People I've worked with, a lot of people who are friends and colleagues, have died. We have the potential of having tens of thousands of people with a terrible disease, other people dying of other diseases because they can't get the health care they need. I don't know how to phrase it in any more poignant a way. One could talk about other things — global security, economic impact, destabilizing the region — and I'm not belittling their importance. But I'm a health-care worker. To me those things are secondary. The first thing is that there is a whole bunch of people who are sick and that's so terrible. This is a war.

    When I think about this getting worse, I think about dangerous and unhealthy social adaptation. I see the community reaction to this as somewhat akin to the five stages of grief when someone is told they have a fatal disease, described by American psychiatrist Elisabeth Kübler-Ross. First you have denial, then it passes to anger, bargaining, and depression. In healthy adaptation, there is ultimately acceptance.

    I don't want to it to come across as blaming the nurses who declined to work. I empathize. It's totally terrifying.

    Many of these communities with Ebola have been resistant to accepting the reality around them. They are clearly in denial, violent denial. I hope that we can get to a point in the not-too-distant future like we would with a dying person where they can get to acceptance. And acceptance can mean that these communities collaborate, try their best to be part of the solution, and limit the horror that's happening around them.

    If we can't do that I fear a much more unhealthy social adaptation: that the violence against the international community, like with the killing of a health team in Guinea in September, would become so ferocious that we just can't continue the work. None of us, of course, are going to risk our lives on working there. I might say I'll go into a controlled environment and treat people with Ebola. But if you say ‘Everywhere we go people are attacking and killing health workers,' no one is going to risk their lives on that level.

    If that were to happen, my fear will be that the response efforts will largely cease. The potential for violence and frustration will turn inward. People will ostracize people who are sick, perhaps even perpetrate violence toward people who are sick.

    That's horrific social adaptation. In the process of course you would have the society that further breaks down: people not getting treated for malaria, people dying of starvation. All the trade routes, commercial processes, people growing food, all broken down. We risk having a breakdown of social fabric that can be very dangerous in many sorts of ways: in terms of both direct and indirect impact on people's health, with the frustration of the communities involved, and no minimal risk of violence. I hope we don't see this.

  4. "The war was better than Ebola": One Sierra Leonean on how the virus transformed his country

    Ishmeal Alfred Charles is a husband, father of two, and aid worker trying to spread messages about Ebola prevention and public health in his native Freetown, Sierra Leone. Since the first-ever arrival of the virus in his country in May, life has changed drastically. Schools are closed. Food prices are up. There is no more hand-shaking, hugging, or public gathering. Everyone is suspicious of everyone else, and there is nowhere to hide from an enemy that could be lurking anywhere. This is Charles's description of life in Freetown, drawn from more than a dozen interviews between July and October 2014.

    Sierra Leone is a country that is recovering from 11 years of brutal civil war. The war was better than Ebola. People could seek asylum, become asylees in other countries and gain recognition. But with Ebola, you're not allowed to seek any asylum because no one wants to bring you to their country.

    During the war, I was a child soldier. There was room to escape. I was able to escape even though I was captured three different times. I was able to escape all those times yet I'm still alive. With Ebola I find it difficult to understand what means or what routes there are to escape. Under these circumstances you don't have the opportunity to escape to any other country, any other place. Flights are too expensive. You don't know where Ebola is going to be next. You don't know who has Ebola. When you go on public transportation you don't know who is sitting next you.

    The young ladies in Freetown try to put on long sleeves even with the sun and humidity so when you have body-to-body touch you will not contract Ebola. That is the situation where everyone is really concerned. In Sierra Leone, people are going through a lot of psychological challenges, feeling a strong sense of hopelessness. It's not just Ebola. It's the poverty. It's the feeling of being left alone. When is this all going to end?

    Sierra Leone is a country that loves hand-shaking. When we see anyone the first thing we do is shake hands. We hug people. Now with Ebola, people don't shake hands anymore. People don't hug anymore. People are worried. Everyone is suspicious.

    In front of my house, there is chlorinated water in buckets. People have to wash their hands before they get into my house. It's difficult. I'm telling people, "You're not clean to come into my house." But it's the reality under which we live. If you want to protect yourself, protect your family, you want to make sure people wash their hands as often as they can.

    Now with Ebola, people don't shake hands anymore. People don't hug anymore.

    Schools are closed. The whole country from Freetown to the farthest northern village, from Freetown to farthest southern village, from Freetown to farthest eastern village, there is no school operating. People aren't going to school. When they sit at home, they are left on their own. It creates the burden psychologically. In a country that has less than a 50 percent literacy rate, closing schools indefinitely will not help the situation. It's going to worsen the situation. It's only going to increase the economic burden on the people. That will hamper the development of the country.

    My two daughters have been home since July. They cannot go to school because schools are not functioning. It's a very difficult situation. Even to hire a private lesson teacher you find it very difficult. You're not sure who the teacher might have come into contact with, and whether they have Ebola.

    Freetown used to be very lively. Now around eight or nine o'clock everyone runs home. No more night clubs, no more pubs, no more restaurants. At nine o'clock the city is locked down because every public gathering poses a risk in a public health emergency. You can't hang out with your friends anymore. You can't watch soccer. It's frustrating and it increases the pressure, the psychosocial impact.

    The prices of commodities have tripled. The staple food we survive on is rice with some vegetables, some meat or chicken. We cook it differently with different sauces. We eat rice for breakfast, lunch and dinner. The price of rice currently is about $50 for a 50 kilogram bag, and it was initially about $25.

    There are two reasons for this: there is a lot of panic buying and Ebola has reduced the number of vessels that are docking in the docks in our country. So there are not so many vessels coming in these days and there are only two flights into the whole country each week. So food isn't coming into the country.

    In a country that has less than a 50 percent literacy rate, closing schools indefinitely will not help the situation. It's going to worsen the situation.

    We only found out yesterday that because the burial teams who pick up the corpses of Ebola victims were not being paid their weekly stipend, they went on strike. A woman on national TV was complaining that in her house, her sister died. It has been six days, the corpse has been lying there. This is happening a lot.

    In my community, we recently had six corpses, and it took 48 hours or more before people came to pick them up. I called again and again. They picked the bodies up yesterday. Corpses have the highest rate of infection, and many infections here are from dead bodies.

    Ebola is getting worse here. The number of deaths keeps going up. We have fewer numbers of people who are surviving, but the infectious numbers go up. We continue to do what we can do, but the health facilities don't have the capacity to handle the number of patients who need care. In certain circumstances, we can't hold people in the holding centers or treatment centers, there are no beds to accommodate the people. The numbers are too overwhelming.

    Things are getting worse. People are losing their jobs because businesses are closing. I spoke with a friend who was running a hotel. It's gone extremely bad, and she is looking for another job. They just don't have the number of guests that they need to keep the business running. So those problems are continuing to get worse and worse.

    It's as if you live in a world where everything is not working, nothing is happening, and all you're looking for is a divine grace.

  5. Why I never felt unsafe while caring for Ebola patients: One nurse's story

    Nurses are always on the front line of healthcare, giving patients moral support, mopping up their vomit, changing their sweat-drenched bedsheets. In an Ebola treatment ward, these mundane tasks can kill. Nurses have sustained some of the highest rates of infection and death among health workers during this epidemic. One such nurse is Monia Sayah, who works with Doctors Without Borders in Africa when she's not in Brooklyn, New York. Sayah found herself in rural Guinea — ground zero of this Ebola epidemic — just as it was starting in March 2014. And she went back in July to help again as the infection curve was rising and patients were flooding her clinic. We spoke shortly after she returned to New York about what it's like saving someone else's life while trying to sustain your own.

    An Ebola patient's condition can change within an hour. We have patients asking for lunch, and we would go to see them a few hours later, and suddenly they would just die.

    It's a violent virus. You never know what's going to happen.

    Patients die from multiple organ failure, from heart attack, from exhaustion. The hemorrhagic bleeding does not happen in a lot of patients. I've encountered it only a few times, in less than five patients in all the patients that we have seen. Sometimes those hemorrhagic signs are very subtle, maybe just bleeding at the eyes or gums.

    There was one case, a woman I went to see in the community, who was lying in a pool of blood. This particular woman, when I went to see her, I thought she had a miscarriage, there was so much blood. Soon as we got to the treatment facility, we were able to stop the bleeding. We were able to give her supportive care, replace the fluid loss she had had. She was very weak, unable to move. She just had fear in her eyes.

    Often you'll see that in the eyes of patients; there's no resolution. They just know, they're not fighting anymore.

    She died shortly after.

    The symptoms of Ebola virus are non-specific. There's nothing in particular, especially at first, that we can say, "This is Ebola." Somebody with a bad case of malaria could present with the same symptoms.

    Trying to make a diagnosis is difficult because we're in a village, you have nothing with you. All you have is a thermometer. And the workload was very high. It's very stressful because you're constantly on alert: a patient here, a patient there. The physical stress of working is very hard because you lose a lot of fluid wearing protective clothing, and get very tired in the heat as well.

    Every patient has a dramatic story. It's amazing how they are able to cope with the loss and trauma.

    There's a specific set of behaviors, the way we dress, to make sure there's nothing exposed. Especially around the face because of the mouth, eyes, and nose. To care for patients, we have to gown up in waterproof and airtight suits. We wear headgear, goggles, two pairs of gloves, and rubber boots.

    Every inch of the body is covered.

    At the end of the day, the gowns we use, the gloves, everything gets burned except for the rubber boots, which get decontaminated with chlorine solution. The hospital scrubs we wear underneath the gown, these also get washed with chlorine solution.

    You need to undress in a very specific manner. It can take five minutes to undress properly. We have to do this step by step. Every time we touch one item, we have to wash our hands again with chlorine.

    I have never had any incidents inside the treatment facility. I follow the procedures strictly. I think it's very important when you're about to go on a project to feel comfortable. It's important to be comfortable so that we can help the patients.

    I made sure I understood the virus, the way it is spread, the way it could contaminate me. We have very, very strong infection control measures, and a set of behaviors that come along with the dressing so I have never felt unsafe or at risk. It's just very scary when a virus has such a high mortality rate.

    You see patients who are completely distressed. But you always have to think about yourself and make sure you're constantly on alert. If someone coughs too close you you, you make sure you're not so close but also not stepping back so quickly as if they had the plague.

    There's no treatment for Ebola. Care is supportive care. We rehydrate the patients. We give them antibiotics to ward off any infection so the immune system can focus on the virus. We give them high-quality nutrition. It's very important to boost them up. We give them vitamins. If patients can't eat anymore, the nursing care is washing them, helping them to walk. Patients have a lot of body pains, so we try to massage them. It's all the nursing care you give to someone whose very sick in bed.

    We try to do everything we can for them. You have to respect their dignity.

    We touch them a lot. It's very important. They're alone, they are isolated. It's true. Normally in this part of Africa, people are never alone when they're sick. There are always family members around them and tending to them. But when we diagnose someone with Ebola, we take them away from their families. We know we're bringing them to a treatment facility, the place they should be to receive the best care, to isolate the virus. But the virus is inside a person.

    There are so many stories. Every patient has a dramatic story. People do survive, some of them do survive, and it's a wonderful thing. I just want to give the message that they show incredible resilience and survival skill. It's amazing how they are able to cope with the loss and trauma.

  6. I can't get to my family, and they're dying from Ebola one by one

    Musa Peter Moigua is the finance manager at the Christian aid organization Caritas in Freetown, Sierra Leone. Over the course of eight weeks last July and August 2014, he lost his aunt Soa, his uncle Gbassay, and his brother Alhaji — all to Ebola. What follows is a transcript of our conversation, edited for length and clarity.

    UPDATE: On November 15, 2014, Moigua also lost his older sister. The cause of death is believed to be Ebola.

    I lost three family members to Ebola: my aunt, my uncle, and younger brother. My aunt was the first person who got Ebola. Two weeks after she died, my uncle got the disease, and he died. My younger brother got it and has also died.

    My aunt was staying two miles off from our own village in Bambara, in Kenema district. When she got Ebola, she came back to her village, and she was there for four days. After four days she was dead.

    There is a custom in our country: you stay with the sick. My aunt's brother, my uncle, could not avoid her. He was sympathizing with her. He wanted to be with her while she was sick. But two weeks after her death, my uncle had a fever and was taken to the closest health center.

    Ebola is a new disease for us. We are not used to isolating our own family.

    They detected the virus. After five days, he was also dead. He was never brought back to the village. He was buried where the other Ebola cases are. I have heard reports from Kenema that sometimes they have to bury them together. This can be like a mass burial.

    My aunt was buried by the medical team in the village. When she died she was lying there for two days because we were waiting for the medical team to come and confirm they needed to bury her.

    I was able to see my uncle before he was dead but not with close contact. The message here in Sierra Leone is, even if you have your relative who is dying, you don't go close to the person. You don't touch the person. That's when you advise the person to go to the closest health center.

    My younger brother was a bike rider who rode a commercial bike in Sierra Leone. He was also affected by this sickness. He was in the village for three days, where he had a fever and was becoming worse. He was taken to the government hospital in Bo. By then Kenema had been quarantined. There was no way for us to go to Kenema.
    After one week he was dead.

    I have not gone home to my township for the past four months. The district is being quarantined. So I send food items and non-food items to my family, to the children of my aunt and uncle, and the child of my brother. I just send them food.

    Ebola is a new disease for us. We are not used to isolating our own family. Because we have a culture of not isolating our own people, some families are adamant not to identify sick people. Because when sick people are identified they are taken away to health centers. Even in the slum areas, people are dead and they will leave them in houses. They are not reported. People don't want family members taken away even if they are dead.

    We have love for our family. We are compassionate about our family. When someone is dead in your family, if you're a Muslim, a burial takes place that day. If you're Christian, a burial is given to that person. Now, people's loved ones are buried in a way families don't like. That's why people are very stubborn. That's why people are exposing loved ones to people who are dead with Ebola.

    This is upsetting my whole family. It is disturbing. It is frustrating.

    In Freetown things are getting worse. It's getting worse every day now. It is difficult for a community, for one family, to leave home to go for a visit to another person. After work everybody comes home. It's not like in normal times. We used to pay visit to our loved ones. We used to pay visit to our friends after work.

    The issue is about touching. You can't touch people now. The reality is: a virus has entered our country. It's not about politics, it's not about gender, it's not about tribe. Ebola is a reality.

  7. Meet the man who has dedicated his life to hunting for Ebola in Africa's rainforests

    Bob Swanepoel is a virologist at South Africa's University of Pretoria. Over the last 40 years, he has hunted in the rainforests of Africa for microscopic pathogens, including the hemorrhagic-fever viruses Marburg and its sister Ebola. Knowing which animals can live with Ebola could help scientists better understand and predict outbreaks, and identify an Ebola vaccine. It could also help researchers figure out which behaviors or activities might put humans at risk for Ebola. But the work is painstaking, involving trapping animals at all hours of the night and testing them for a deadly virus, while trying not to get infected yourself. So, despite four decades of trying, Bob and his colleagues still haven't solved the mystery of Ebola's natural reservoir. Their best guess is that the virus lives in fruit bats when it's not ravaging humans — a theory they haven't been able to prove. Here he explains why the work of virus hunting is "no Sunday school picnic" and how the answer to the question at the center of this Ebola epidemic has eluded him all these years.

    I got involved in this work during the second outbreak of Marburg ever, which happened in 1975, when two Australians who had hitch-hiked in Zimbabwe became sick in South Africa. But then Marburg disappeared and Ebola hadn't even been of heard of. The first known outbreaks of Ebola only happened in the following year, 1976.

    Hunting for viruses is no Sunday school picnic. You've got to go out at night, into forests. Say you have to take a leak. So you walk 10 minutes away from the others on your team. You've got a headlight on, but suddenly the others are gone, and you're totally disoriented.

    You start shouting or running in the wrong direction. They're gone. You've walked hours to get to this place in the forest to catch these bats. Then you're lost.

    The bats will come out just after sunset, and they will fly until about 9:30 or 10 pm. Then they will go back home and they'll only come out again as the sun comes up. They fly in the evening and the morning. In the depth of the night, they are not flying. So you can either hang around or put up your nets and go home and come back the next day.

    The trouble is, these bats — despite being big and strong — can't take the cold. They die. So the next morning they're stiff and you can't bleed them.

    You've got to make sure you're catching the right bats, too. When I worked on the 1995 Ebola outbreak in Kikwit in the Democratic Republic of the Congo, I had discovered that the really big fruit bats they were selling for food, the Africans were catching them high in the trees. They would climb up the trees and put their nets 40 meters up. If we put up nets the ordinary way, we'd put them 10 meters up, so we would catch the wrong kind of bats.

    People say, "Kill all the bats." That's nonsense. You'll make the situation worse.

    This whole game is far more complex than you would think. It's a very tricky business.

    When you catch the bats, funnily enough, these things are huge and strong. Their wingspan is very wide. They have teeth like you won't believe. On top of that, you think, not only can they bite you, they might have Marburg or Ebola. You have to be careful of all of that, but despite your best efforts, you will get bitten.

    While in the forest, we tested thousands of other animals, not just bats: rodents of every kind, birds, insects, snakes, slugs, snails, frogs, anything we could catch. Therefore, before you put your bat nets out in the evening, you put out rodent traps. If you put those out in daylight, the baboons or monkeys will take them.

    Late at night you return to base with the bats you have caught and work until the early hours of the morning dissecting them. Then you have time for a quick wash and to rest for an hour or two before you have to go out and collect the rodent traps before dawn. You have time for a hasty breakfast and then you have to dissect the rodents.

    Now it's 10 or 11 in the morning and you've got to wash all your traps and nets. And by three o'clock, you've got to be on the road to do the next day's trapping.

    That's day after day after day.

    By the end of the week, you may give your team a day off. But you'll be exhausted. You're not eating too well. You've been bitten to hell by mosquitos. If you brush against a leaf they'll be 50 fire ants biting your arm. You'll be on fire. The next branch, you turn around, you knock into thorns six inches long. Little flies cover your skin. They love going into your ears. If you put cotton into your ear, they'll go up your nose.

    You have to be tough. The toilet arrangements and facilities leave much to be desired. Sanitary conditions are unbelievable, and privacy doesn't exist.

    Doing this work, I got malaria in 1995 and again in 1999. I nearly died.

    So why did you do it?

    The same reason, when George Mallory was asked why do you want to climb Everest, he famously said, "Because it's there." It's curiosity. For this game, you've to have the curiosity of a child.

    Besides the difficulty of the work, the reason Ebola's host has been so hard to find has to do with the fact that, in the past, outbreaks were rare. It was very difficult to get permission to go in and look for the virus when there wasn't an outbreak. There was also an element of "let sleeping dogs lie. We don't have Ebola now, so please don't find it." There's lots of downsides to having this virus in your country. People really didn't want to know about it.

    And when you asked your boss for funds to go out and do research on Ebola, and an outbreak wasn't happening, they'd say, "This disease has killed less than 1,000 people in the whole of history. Why are you bothered about it?"

    While an outbreak is happening, we also found if you want to go there and hunt for viruses, the international response teams and the locals will tell you to get lost. They've got more important things to do like stopping the outbreak.

    I'm hopeful. I think we'll confirm the source of Ebola quite soon.

    In any case, getting into these countries at the right time is always difficult. First of all, almost invariably in every Ebola outbreak, there is a long interval before the outside world picks up that an outbreak is happening. By the time investigators get there, the original source of infection is no longer relevant since it's been almost a year now that this thing has been spreading from human to human. So where it came from originally is not going to affect how it's controlled right now. If it was a bat, the season might have changed, so the type of bat that caused the outbreak may have gone elsewhere.

    We have some consensus that Ebola lives in bats. In the very first outbreaks that happened simultaneously, in Sudan and Zaire in 1976, the first six people to get Ebola in Sudan, the very first people in history known to get Ebola, worked in the same room. There were holes in the ceiling above them and there were bats in that hole.

    Then subsequent to that, if you go to every outbreak in history you find something that suggests there could have been a bat connection. So the indications are strong that it is bats that are involved.

    I inoculated bats and snakes and frogs and spiders with Ebola virus. I inoculated tortoises, geckos, everything with the virus, to see what would happen. What happened was — in most of these animals, the virus didn't multiply — except in bats.

    In bats, the virus multiplied like crazy, but it didn't do them any harm, which suggests that they're the natural host of Ebola virus.

    But we don't have the second-step proof, though. If the virus is in bats, you can do a 'PCR' test that picks up the genetic material to say the virus is there. But you have to get the virus to grow in the lab. If you've got genetic material in a bat, and you can't grow that virus, you haven't proved that this is live virus. The Marburg virus has been grown on several occasions and there is little doubt that bats harbor it. But we haven't been able to do that with Ebola virus.

    I'm hopeful. I think we'll confirm the source of Ebola quite soon. I think it'll happen in the not-too-distant future. But the problem is: what do you do about it then? You can't stop everybody, you can't reach down into the primeval forest, get the word into every nook and cranny and say, "Don't eat bats." You can try but it'll probably still happen.

    Other people say, "Kill all the bats." That's nonsense. You won't succeed, and you'll make the situation worse. If you upset the ecology of these things, suddenly the virus is everywhere.

  8. 'Here you don’t see your enemy': A war surgeon's Ebola story

    Dr. Gino Strada — an Italian war surgeon and founder of the NGO Emergency — never planned to work on a disease outbreak. He spent the bulk of his life treating patients in conflict zones, from Iraqi Kurdistan to Afghanistan to Sudan. Then, in 2014, the war on Ebola broke out. Dr. Strada found himself delaying a long-overdue vacation to open an Ebola treatment center in Sierra Leone, where his NGO had been running a post-civil war hospital that was suddenly overwhelmed with Ebola patients. I spoke to him at the end of October 2014, as he awaited the opening of a second Emergency Ebola facility. He was wracked with the worry that he was not going to be able to recruit enough personnel to care for patients.

    I left Sudan and arrived in Sierra Leone a month ago. For the past seven years, I did not have any chance to take holidays, and this year, I decided I was due to have a holiday.

    Then all of a sudden, we had this crisis come up, and it's very violent. A lot of our staff were down here, so I didn't feel like going on a holiday. People much younger than me are here working on Ebola by themselves. I thought I'd come here if only to give them psychological support.

    This is the first time Emergency got involved in a disease outbreak. We didn't choose this. We have been here in Sierra Leone for 13 years because of the civil war, running a surgical center and a pediatric hospital. But we were faced with this problem of seeing children outside our pediatric hospital, they were coming with fevers, but we couldn't let them in because they might have had Ebola that would spread to others.

    For a long time, we had to keep our hospital open because the others here in the capital shut down. A lot of health personnel got infected during this Ebola crisis, and we were the only ones that were operational. At certain points, our pediatric hospital has been the only one open in all of Sierra Leone.

    Now we are running a small center for Ebola treatment, with only 22 beds. It was supposed to be a holding center, but it's not possible to hold patients when you know they are positive with Ebola. You have to treat them.

    This is what we see every day: all our beds are fully occupied, and we always have someone lying down on the ground outside the gate waiting for a free bed to have access to medical attention.

    You're not even able to admit one person and you already have another one waiting. The number of treatment facilities and the number of beds in the country are very, very limited. And that is by itself a factor that helps spread the disease.

    The minister of health and the president asked us to set up another, bigger facility. So we are waiting for a 100-bed facility to be ready within the next four weeks.

    I hope we will have enough staff for the new facility. We are now trying to recruit among the Cubans, among the British, among the Italians.

    My perception is that the level and skills and training of the national health personnel in this region is so low. Across the country you find very few nurses who are able to attend properly to patients. So this job has to be done mainly by international personnel.

    And here international personnel is very scarce at the moment.

    To keep Ebola patients alive you need to provide them with supportive care: IV infusions, drugs to control pain, vomiting, diarrhea. You need to provide blood transfusion if they bleed. You need to provide sedation.

    You have to be there. You cannot just go in and visit the patient and get out and then leave the patient on his own for 10 hours.

    Imagine a 100-bed facility like the one we're going to have in a month here: to be able to provide each patient with a minimum of five to six hours of medical attention means you have to work on a rotation basis, so you need 100 nurses, and 10 to 15 doctors.

    The amount of personnel you need is much more than what you need in a standard intensive care unit. In our ICUs, a nurse or doctor can stay on a shift for eight hours. But here the time limit is one hour, and then you need to stay away for two hours to rehydrate and rest.

    In the clinic, despite some air conditioning, you have a high temperature in the range of 35 degrees Celsius [95 degrees Fahrenheit] and very high humidity. On top of it, you have to wear full personal protective equipment. When you do that, you lose a couple of kilos an hour from sweating. So you cannot attend to patients for more than a couple of hours before another team has to go in.

    At the end of the day, everyone is exhausted. You have to rehydrate yourself. Providing medical assistance is difficult. The job is very physically demanding.

    Economically it's a big, big challenge. We calculated that to run this 100-bed facility, we will need to have something like just under a million dollars a month.

    This is a very different type of situation from the war zones I've worked in. There, you could see the risk coming or approaching. Here you don't see your enemy. You know it's there, but you don't see it.

    All you can do is adhere very strictly to the safety measures and protocols. The point is that despite all the risks and difficulties linked to the fact that you're treating patients infected with Ebola, you have to provide medical and nursing care. Containing the suspected or confirmed cases here is very helpful in avoiding spreading this epidemic.

    We know the best supportive care decreases the mortality rate of the disease very significantly. If thousands of Ebola patients appeared in Europe or other countries, where there is a well developed health system, the patients would survive.

    This is once again a disease of poverty.

    This very low survival rate here is linked to the fact that there is no health system here, these countries have been ravaged by war and poverty, with very little attention paid to developing the health structure.

    Even still, if I got sick with Ebola, I would get treated in the Emergency hospital here. Emergency has always had this philosophy: a hospital is good enough for the Africans or Iraqis when you are ready to be cared for in that hospital, when you are ready to have your family members cared for in that hospital. The locals are not class B citizens. They have been much more unlucky than we are. But they have the same dignity and the same rights.

  9. Why I lied to my family about being an Ebola doctor

    When Ebola broke out in West Africa in 2014, Franklin Umenze, a 29-year-old doctor in Lagos, Nigeria, knew it was only a matter of time before the virus arrived in his country. Sure enough, by July, a Liberian-American man named Patrick Sawyer boarded a plane in Liberia bound for Lagos. Sawyer collapsed on arrival, and died days later, infecting several others and sparking fear around the world about what would happen if the virus spread through Africa's biggest metropolis. Umenze was one of several doctors who volunteered to work on the first-ever outbreak in the country. This is his story:

    When Patrick Sawyer came to Nigeria with the virus, an urgent call was made for clinicians. I got an email and immediately decided to volunteer. I had grown up to understand that we will be remembered for the impact we made on the lives of others and not the wealth we made. I wanted to add value to mankind. Watching my fellow brothers die in other countries from Ebola made me very sick and unhappy.

    I was responsible for the clinical welfare of the patients. I was initially trained by Dr. David Brett, an American, on how to don and doff the personal protective equipment and other safety measures. The first lesson I learned from Dr. Brett was: be afraid of Ebola.

    Initially, the Ebola center was poorly structured. The wards were untidy. The changing rooms were very close to the isolation wards. It was really a mess.

    I live with my family, and I couldn't tell them what I was doing

    The first time I wore the personal protective equipment, I was so scared. It was really uncomfortable and hot. I thought of my life, my little achievements. I was praying to God to forgive all my sins should I contract the virus and die.

    One particular incident occurred while I was on a night shift. One of the patients was really sick and needed attention. The only available personal protective equipment was not my size. I wore it but had parts of my hands and face exposed. We secured an IV access, cleaned up the patient to the best of our abilities.

    I was scared to death when I came out. I thought I had the virus. I developed a phantom fever, body pains and avoided contact with people. I was always checking my temperature. It was terrible.

    The most horrifying part was my inability to tell my loved ones what I was doing for the fear of being stigmatized. I live with my family, and I couldn't tell them what I was doing. I was avoiding them as much as possible. I never disclosed what I was doing to any of my friends or my boss for fear of being stigmatized.

    You worry you might lose your job. One of the survivors working in an oil and gas company was fired here. Friends will shy away from you, church members would never visit. You would be an outcast. I was afraid I was going to lose my job, lose my friends, and bring a lot of negative attention to my family

    Looking back now, I think this period of my life was the most exciting. I felt really special knowing that I helped save some lives.

    My life is almost back to normal now. I am back at work. I have told my family I did this work but I still haven’t told my friends or my boss. My mom was proud. My siblings were glad I did not get infected.

    The first lesson I learned from Dr. Brett was: be afraid of Ebola

    Luckily this outbreak started in Lagos, where a lot of people were enlightened. It would have been a disaster had it first occurred in the northern part of Nigeria. These were Nigeria’s first Ebola cases, and we successfully contained the outbreak.

    I think Nigeria as a nation deserves to take all the credit. Immediately when the outbreak broke out, there was a massive media campaign, an informational website was developed, hotlines were made, posters and discussions on Ebola came to life. Large public gatherings were discouraged. The movement of corpses was barred. There was screening at the ports, and the immediate mobilization of the isolation unit in Lagos.

    Kudos must also go to Dr. Stella Ameyo Adadevoh, who died treating Sawyer. She stood her ground despite all the pressures she went through. We must not also forget the four other doctors that were also infected in First Consultant hospital. They were infected doing their jobs. Three of them died.

  10. How Ebola goes after children

    Lina Moses is an epidemiologist based at Tulane University in New Orleans. She has been working on and off in Sierra Leone for nearly six years — and happened to be there, at the center of the worst Ebola epidemic in history and the country's first outbreak, just as it was taking off. Here Moses talks about leaving her daughters behind to go back to Sierra Leone, and the children she found there.

    I can tell you I'm going to miss my daughters when I go back to Sierra Leone. And I think the hysteria that has been propagated in the US has made it really tough on them because they keep hearing things that are untrue about the risks of Ebola to myself as well as to others in the US. Kids are making up songs about Ebola. They are making fun of getting Ebola in Texas. There's fear of contagion. It scares them.

    I'm anxious to get back to an environment where I feel very useful and effective. But honestly, what I’ve been hearing about what’s going on in Sierra Leone across this whole outbreak is scary to me. Not scary for myself but scary for this country that I love, Sierra Leone.

    Early on in June, there were very few people responding to the Ebola outbreak. And I was one of them. I was in Sierra Leone from February until September, and I had been working on Lassa fever when Ebola showed up.

    Even the best-trained person is going to make mistakes after working 12 hours a day

    I studied hemorrhagic diseases in my training but had never seen Ebola before. We didn't quite understand how quickly this thing could explode.

    I can tell you it’s was a lot worse on the ground. It was pretty horrific. For the first couple of months, when the outbreak was in Guinea, I was working closely with the Ministry of Health in Sierra Leone and their surveillance teams. We were looking hard for Ebola. We were responding to every rumor we heard, surveying along the Guinean border. And we didn’t find it. So when it popped up in Sierra Leone at the end of May — and it clearly had been going on in Kailahun district for some time — it was pretty shocking.

    I felt completely overwhelmed. I'm nervous about feeling that way again when I go back. At this point, I have been working in Sierra Leone for nearly six years. I have people very close to me whom I have lost. I lost a lot of friends to Ebola. I haven't counted in my head how many people.

    It's very difficult to pinpoint where people are getting infected. There have been many lab technicians in Kenema Government Hospital who got infected. But they all had active Ebola transmission in their neighborhoods and communities. Whether they were exposed in hospital or at home, we can’t tell for certain.

    Even the best-trained person is going to make mistakes after working 12 hours a day. People are human. The system needs to provide the best possible environment to protect health care workers but it infuriates me when people blame people.

    No one wanted to take this boy for the 21-day incubation period

    This virus, it’s hell. It’s devastating. How it devastates the social fabric in communities, in towns and villages. It’s horrendous. This outbreak just exploded rapidly. I don’t think anyone was expecting this.

    There was a small child who came in to our hospital in the ambulance with his mother. The mother had classic Ebola symptoms, and was unconscious. The mother couldn't give us any information. The child was 16 months old. We didn't know if he had Ebola or not. Because of the contact with his mother, he was in the suspected ward. The mother died that night. What do you do with the child? We were not sure if he had Ebola or not.

    The child tested, and he was negative. But that child clearly had very close contact with someone who had Ebola. How do you place these children in foster care?

    No one wanted to take this boy for the 21-day incubation period. Basically he ended up being looked after by all the nurses and the hospital workers. We kept an eye on him for a long time during the day. At night we made sure he was sleeping. A couple of days later he started developing a fever.

    He had Ebola. He went into the treatment center and died.

    I can tell you about another four-year-old girl like this. There are countless stories about children like this.

  11. My uncle was the first person to die from Ebola in America. We still don't have his remains.

    Josephus Weeks is the nephew of Thomas Eric Duncan, the first person to be diagnosed with Ebola in America. In late September, Weeks found out that Duncan — a Liberian man who was visiting the US for the first time — had been hospitalized in Dallas. On October 8, Thomas Eric Duncan died, leaving behind two sons in America and two daughters in Africa. From his home in North Carolina, Weeks talked about the uncle he loved, how health officials here failed his family, and what it was like to suddenly be in the national spotlight because of the virus.

    On the day of my birthday I made a phone call, and all hell broke loose. It was September 29, a Monday morning.

    Eric was in the hospital in Dallas, and they weren't moving on his blood work. So I called a Centers for Disease Control and Prevention hotline. Eric had his blood work sitting at the hospital in Dallas for a whole 48 hours. I had been telling them, "You know, he's from Liberia." I don't think they knew what Ebola was before Thomas Eric Duncan came in.

    This was his first visit to America, and he didn't survive. He didn't get to see anything here. He spent most of his time in hospital. He arrived on the 20th, and by the 24th, he was sick. By the 30th, I found out through the news that he had Ebola, and then the hospital called us and told us. That's the same way I found out he died — through the news.

    This was his first visit to America, and he didn't survive

    When he was in the hospital, he asked me, "Josephus, how long does this thing stay in your body?" I said, "Well, based on what I had seen with the other two other patients transported from Liberia, both survived — Dr. Kent Brantly and Nancy Writebol." I told him, "In three weeks, you'll be okay."

    He kept saying he was in pain. He was trembling; he was cold all the time. He had diarrhea. He was nauseated. He was having trouble breathing. But mostly he complained about the pain.

    The bleeding stuff I didn't hear much about, except for one time while he was in the hospital. I heard they were trying to give him an IV and they missed, and there was blood everywhere.

    On that Friday morning before he died, he was on the oxygen mask. Through the phone, I could hear the oxygen tanks hissing. We told him to go to sleep, that we'd call him that afternoon. And we never talked again.

    What bothers me is the lack of attention and lack of humanity about his death. Still today, President Obama has not called on my grandmother to say, "My condolences." He sent prayers to Amber Vinson and Nina Pham, the other nurses who got infected. But he never gave prayers to Thomas Eric Duncan's family.

    The media attention was painful. Here's my brother on the bed, fighting for his life. Every time I turned around, my grandma had to turn on TV and see him in that green shirt. I was at the airport trying to take a flight to Chicago and we were standing here, and he came up on the screen big as the Brooklyn Bridge. I wanted to say, "Please stop showing his picture." It was hard for us to deal with. As a family, we are praying people. We just keep praying, and supporting each other.

    There's a human being out there, but you can't give him a burial.

    We don't have Eric's remains. We don't know where they are. It's a big old mess. The indignity he faced in death is really upsetting to me. We should have had his remains and figured out if we were going to take them to Liberia and find a decent place to bury this man.

    He still doesn't have a place to rest. There's a human being out there, but you can't give him a burial.

    People think Eric came here with malicious intent, and that's not the case. I always refer to Dr. Craig Spencer. He was a doctor who knew better, but he arrived in New York, went around the city, and then got sick. Eric was a regular old civilian. He came here and was just living his life. He got sick, and it turned out to be Ebola.

  12. Ebola and the power of film: How my students and I saved lives by making movies

    Divine Anderson runs Liberia's first and only film school, the Liberia Film Institute. The 37-year-old started making movies in 1996 and has stuck to the medium because he thinks it's the best way to reach his fellow Liberians, many of whom can't read. When the Ebola outbreak was peaking last fall, he turned his attention to creating public-health awareness films that he spread through a mobile cinema — essentially a motorcycle retrofitted with a cart that carried him, his students, and a TV. We talked to Anderson in March — just before what appeared to be Liberia's last Ebola patient was released from the hospital — about how these films saved lives.

    I teach students how to make low-budget or no-budget movies. You just make do with what you have. You use your smartphone. You make sure you don't use professionals, because you have to pay them. You look to your friends for help.

    We started doing the Ebola films because it was a way for students to learn how to engage their community with films. Only 60 percent of the population can read and write.

    Ebola was frightening. It was the unseen enemy. Eventually the government shut down the schools, so our film school was also shut down.

    By November, there was a drop in the death rate. We now understood Ebola properly. It was not as deadly as the media made us believe. Ebola is simple. Obey the rules, and you don't get infected. We took all the precautions —wash hands, use sanitizers — and we were fine. People were still moving around, going to the market, entering public transportation, and nothing happened to them. So in October and November, we called a couple of the students we knew very well and invited them over.

    The fear of Ebola probably killed more people than the virus

    Together we made educational films about Ebola, to engage the community. Our health messages were based on the rules the Centers for Disease Control came up with, some basic rules for the "Ebola Must Go" campaign. There were five key public-health messages: Don't touch the sick, don't touch the dead, don't shake hands, report sick persons, and contact tracing (when health officials seek out all the people who have potentially been exposed to the virus and quarantine them if they become sick).

    We saw it as our responsibility to create a film that would carry those five key messages, that would help the people who cannot read and write to understand Ebola. That's exactly what we did. We also had a Christmas film about keeping families home during the season.

    We retrofitted three motorcycles to travel around and show the films. We would leave at 6 in morning and just keep going from street to street to show people the films. We did it 10 hours a day for several weeks, all over Monrovia. At the end of the day, we would spend one hour collecting reports and feedback from people. Then we would go to bed. The next morning, we would take off again.

    More than 50,000 people saw these movies. Monrovia alone has more than 900,000 people, and it gets more crowded during the Christmas season, which is when we screened these movies street to street, market to market, and in the most crowded places.

    We had mixed reactions at different points and from different communities. To some, it was was timely and educating. Some were happy. Some asked to know more about Ebola and the Ebola survivors' stigma. Some people thought we were sponsored by government and didn't listen to us. When we explained that we are an NGO, they accepted us and listened to us.

    People understand Ebola better now. The films we made, this is just a starting point.

    When you understand how Ebola works, you will no longer be afraid of it. Fear killed a lot of people, because they didn't understand what Ebola was. People were afraid of helping even when they could, because they didn't understand the virus. I lost my sister-in-law. She was three months pregnant. She had low blood pressure, and for three days we were trying to get her medical assistance. Her own hospital couldn't admit her, and she eventually died. Because of the fear of Ebola. The fear of Ebola probably killed more people than the virus.

    Now Ebola is going but not gone. People are no longer afraid of Ebola. People understand it better. The films we made, this is just a starting point. I would love to do more.

  13. I was a journalist covering Ebola in Liberia. Then I caught the virus.

    Ashoka Mukpo was the only American journalist to contract Ebola during this epidemic. The 33-year-old had been working in Liberia as a freelance reporter and cameraman for various media outlets when he suspected he was sick. He was diagnosed in Monrovia at the beginning of October, and by the end of that month he was released from the Nebraska Medical Center, virus-free. Here's what he had to say about coming down with the disease in Liberia, getting treated in the US, and recovering physically and emotionally.

    I have the dubious distinction of being the only American reporter to catch Ebola. I can definitely think of things on my resume I'm more proud of.

    I have no idea how I got it. I think there was a dirty surface somewhere, or someone bumped into me. But there were journalists who did far more risky things than me — some went into treatment wards, some really got quite close — so I was very surprised when I got sick.

    When I first suspected I had something, I stuck a thermometer in my mouth, and the temperature jumped up to 101.3. There was instantaneous recognition on my part — the chances of that being something that wasn't a big deal were small. The first thing I did was quarantine myself. I went into a room in the place where I was staying and wiped down all the doorknobs. I worried about infecting my roommate. I isolated myself and started making phone calls. My father is a doctor, so I called him. He was able to locate colleagues of his volunteering with the World Health Organization in Liberia. They gave me a call and started to work out a game plan: to go to Doctors Without Borders the next day and get a test.

    The thought crossed my mind that I needed to start preparing for my death

    I woke up the next day and felt sick. The night before it was only a fever. The next day, I had other symptoms. I couldn't eat. I started to develop a mild headache. My body felt strung out. I felt tired and a little bit foggy. I started to get sicker. I got a ride to the treatment center.

    When I arrived, the man checking me in looked at me and said, "What are your symptoms?" I started to list them off: joint pain, tiredness, I don't want to eat. The look on his face said it all.

    I went over to the suspected ward. It takes five or six hours to get the results. So I waited.

    It was very emotional to be in that space and realize the barrier that had existed between me and the Ebola patients I had been covering for the last month had broken down and now I was in that situation with them. At that point, my whole mentality was, "Let's get a confirmed diagnosis and see what comes next."

    The hours passed, and two doctors wearing full protective outfits came up to me, stood there, and paused. They said, "The results of your test came back. You've been confirmed as carrying the Ebola virus."

    I knew this was coming, but to get it in those clear terms was shattering — sad, frightening, lonely.

    The needs in the moment were so pressing. The thought crossed my mind that I needed to start preparing for my death. I might not survive this. I called my girlfriend and started to talk to her about the need to prepare herself. I realized most of her money was in my bank account. Did I need to make a phone call to the bank? Get her added as a beneficiary to the account?

    I'd spent three nights and four days sick in Liberia when the US State Department got involved. They have the ability to get one of the very few planes that exist in the world to carry you back for medical treatment if you're a US citizen. It costs $150,000. They don't ask you for that up front. And I very foolishly didn't check if my insurance covers Ebola. It turns out it didn't.

    To get into the medevac, I had to put on a suit. I was really sick at this point. I was very weak. I had these recurring bad headaches and couldn't walk very well. I had to get up, get out of bed, and put on the whole Ebola outfit — gloves, boots, mask, goggles — and they put me in back of an ambulance. We drove 40 minutes to the airport, where there was a giant gray jet sitting on the tarmac, and that was my ticket home. It was air-conditioned, with a comfortable bed. I wouldn't say it was the Ritz-Carlton. But compared to the gym mat I had been sleeping on at the Doctors Without Borders facility, it felt like a whole new world.

    It took about 18 hours to get to Nebraska, and I slept most of the time, running a fever of 104 degrees. When we arrived in the US, my symptoms got worse. I started to vomit. I had diarrhea, a classic symptom associated with contracting Ebola. I was having muscle pains. My eyes were really red. I felt really foggy. My head was swimming. I was very short of breath, and it was hard to talk. I still didn't know if I was going to live or die. I asked the doctor, and he said, "I don't know."

    It was a frightening experience but also a gift: I got to see what I really care about

    I had 40 nurses tending to me. I always had someone there in the room. Every day, a doctor did a full-body examination to ask me about my symptoms. One day, I got a nosebleed — partly because the climate had changed so much since I left Liberia. But I got afraid that it was the beginning of crazy hemorrhagic symptoms. Thankfully, that was it. I didn't eat for a full three days. They fed me through a line in my neck.

    I don't know what helped me and what got me through this. I got a blood plasma transfusion from Kent Brantly, the American doctor who survived Ebola after contracting the disease earlier in 2014. When I was at my sickest — that was a really tough day. I felt like the blood transfusion was making things worse. I felt cold. The next day I woke up and felt much better.

    When you have a brush with your own mortality, you see what's important to you boiled down to the bare essentials. It was a frightening experience but also a gift: I got to see what I really care about, what I'm most afraid of losing. The whole experience has been so overwhelming and such a major life break. It provided me with an opportunity to evaluate what I want to accomplish and use my time wisely, because it can be so brief.

    My recovery has been much milder than I thought it would be. I was concerned it would take years to get my strength and health back. There are lasting effects: I have joint pain, muscle aches come and go, it's easy for me to pull a muscle, and if I sit in the wrong position I can experience pain. I still have fatigue. I used to be able to run four or five miles, no problem. Now it feels good to get to a mile.

    NBC has agreed to help me pay the debt from my treatment and take care of me as someone who is working with them. That is such overwhelming good fortune, to not be saddled with this unpayable debt for the rest of my life.

    People said I recovered a bit quicker than some of the other survivors. I have no memory loss. It could have been a lot worse.