Two months to help

UQ PhD candidate Kei Owada took a two-month break in her studies in infectious disease epidemiology to help respond to the Ebola outbreak in Sierra Leone

In 2014 Kei Owada took a two-month interruption from her studies from the UQ School of Medicine to assist the World Health Organisation (WHO) respond to the Ebola outbreak in Sierra Leone. Here she shares her stories and personal connection to the West African country.

When news broke of the Ebola virus disease outbreak in Sierra Leone, I knew in my heart I needed to help.

I’d worked in that beautiful country during a cholera epidemic just two years earlier and felt I had left a piece of my heart behind when I returned to Australia. With the faces of those I had met flashing through my mind, I knew what I had to do when WHO proposed my deployment in 2014.

That decision was still one of the most difficult of my life because of the fear of the unknown with the Ebola virus. I didn’t quite know what I was getting involved with because I was not sure what exactly was happening in the field. All I knew was that the case numbers were rising in Sierra Leone and that it would be near impossible to convince some of my close friends and family that I would be safe.

A bed in one of the primary health care facilities in rural Sierra Leone

A bed in one of the primary health care facilities in rural Sierra Leone

The decision was still one of the most difficult of my life

Some people told me it was too dangerous, too risky, and that I shouldn’t go. I was told by one of my close mentors that helping others was a noble thing, but self-preservation should come first; that dead I would be no value to anyone, and that would be a great loss to the world.

Their words meant so much, but my decision had already been made. I’d been through similar circumstances before when my hometown in Japan was consumed by an earthquake and tsunami.

Not being able to speak to my family for days was the scariest time of my life (thankfully, they were all fine); however, the fear of losing people in Sierra Leone brought back those same emotions and I knew I had to go.

I realised how serious the outbreak was very quickly. I still remember one staff member close to me saying, with tears in his eyes, “the Ebola outbreak has changed everything; life is not the same as before, it’s so very hard now.”

Death became so constant during my time in Sierra Leone that my mind would become numb from learning of new cases every day. Burial teams were struggling to keep up as calls were coming in at a rapid rate. As an epidemiologist in the field each day, it was a battle against exhaustion, chaos and trying to keep calm.

One of the refrigerators used to store vaccines

I was particularly anxious about visiting hot spots after I heard that a couple of our colleagues had become ill with suspected cases of Ebola. Ultimately it was confirmed that they had Malaria (the symptoms are very similar), so I knew that all I could do was ensure I took every precaution and preventative measure available, and just continue my work.

Dealing with so much death and being highly aware of my own risk (needing to wash my hands with chlorine water and taking my temperature multiple times a day) was taxing. Also, as if the volume of work wasn’t intense enough, when I arrived it was still rainy season, so we were dealing with thousands of Nairobi flies (which the locals called ‘Champions’) which would surround us. The flies wouldn’t bite or sting but they contained a toxic chemical called pederin, so if you swatted them away they could release a very dangerous acid, giving nasty burn-like lesions. Something so small added an extra layer of stress.

Even in such bleak conditions there were moments of light. I formed close bonds with my colleagues and I remember working late on Thanksgiving and coming back to the accommodation to find the team had prepared a Thanksgiving meal. We sat around a table and each of us shared what we were thankful for. I remember smiling and saying how thankful I was for being able to meet such an amazing group of people. Not only did I get to meet and work with incredibly dedicated and determined individuals, I was also blessed to meet an Ebola survivor, which is a moment I will never forget.

Since my return I’ve written a paper with three WHO colleagues, whom I worked alongside during the outbreak, which was published in Frontiers in Public Health. This publication isn’t just academic work for me, it is filled with memories of often challenging and painful times in the field. It is another way for me to give support to the local Ministry of Health and Sanitation members, with recommendations we hope will help build better future responses in Sierra Leone, particularly regarding data management in the field.

To my knowledge, our published paper is the only article that provides an in-depth description of epidemiological data management issues during the peak of Ebola incidence in Sierra Leone.

While it is an academic paper, it is also a nod to the heroic efforts by local health workers, and the strength of the people living with the Ebola outbreak who experienced horrible grief.

Appreciating the challenges of Ebola outbreak and recommendations for future response:

Fast forward to the present and I’m completing my dissertation on the role of soil-transmitted helminth, malnutrition and malaria on developmental morbidity in children in the Philippines and Africa (under supervision of Dr Ricardo Soares Magalhaes (UQ), Dr Colleen Lau (ANU), Associate Professor Mark Nielsen (UQ), Professor Archie Clements (ANU) and Dr Laith Yakob (LSTMH)).

While I am currently studying from the comfort of UQ in Brisbane, I often think about how very different my life was working in the field in Sierra Leone — it’s almost haunting. Before the Ebola outbreak and the commencement of my PhD, I’d been passionate about infectious disease epidemiology for several years, but now I understand first-hand how these deadly disease outbreaks affect communities and health workers.

Kei Owada is a student of infectious disease epidemiology

Kei Owada is a student of infectious disease epidemiology

I hope our research will assist those working in Sierra Leone now and in the future. While I can’t be in the field right now, I know one day I will return to Sierra Leone, the place my heart belongs.

Read more about Kei's work and findings in her peer-reviewed journal article here.