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A Navy Microbiologist on the Ebola Front, Pt. I

by svanderwerff | 23 December 2014

by svanderwerff | 23 December 2014

By Cmdr.?Guillermo Pimentel, MSC, Naval Medical Research Center

[caption id="attachment_7734" align="aligncenter" width="656"]Header The Navy is the only service that has mobile laboratory?s that can deploy quickly to detect infectious disease agents, by commercial or military air.

Editor?s Note.? ?On September 28, ?2014, Navy Microbiologist Cmdr. Guillermo Pimentel, MSC, and advanced laboratory technician HMC Jerrold Diederich travelled to the front lines of the Ebola outbreak ?in Liberia where they established two mobile laboratories for detecting the virus. ?The importance of these labs in Montserrado and Bong Counties cannot be understated. For many hundreds of men, women and children the Navy mobile labs have been the difference between life and death.? Within four hours, lab personnel can determine if blood samples contains Ebola, ultimately ensuring that patients receive immediate medical attention.? The Office of Medical History had the great pleasure of speaking with Cmdr. Pimentel as part of their oral history project. The following narrative is an excerpt.

When Ebola broke out the CDC was already on the ground in West Africa and ?the U.S. Army Medical Research Institute of Infectious Diseases(USAMRIID) was researching Lassa Fever in Sierra Leone [1]When Liberia?s outbreak went out of control they set up operations at the Liberian Institute for Biomedical Research. Some are surprised to learn that the Navy is the only service that has mobile laboratory?s that can deploy quickly to detect infectious disease agents, by commercial or military air. We?re the only ?team in the DoD that can deploy a full detection laboratory globally within 24 hours. At BDRD[2] we?ve been doing this for 12 to 13 years. Our labs deployed when we invaded Iraq, and to New York City after September 11. My teams train thru the year in multiple scenarios, and multiple environments. [caption id="attachment_7735" align="aligncenter" width="466"] Our labs deployed when we invaded Iraq, and to New York City after September 11. In late August, CDC, DTRA-CBEP[3] and other DoD personnel visited NMRC to see our mobile labs, saying our labs were what they needed. At the time the international community was vocal bout how they thought the U.S. needed to play a bigger role. At first we planned on leaving Sept. 8, but were unable to depart until the 25th, the reason being, because the DoD was now involved AFRICOM[4] had to submit a Request For Forces (RFF) and then be approved by the Joint Chiefs of Staff, which made the WHO very unhappy. In the meantime, Liberia?s Ebola crisis was out of control. They need our labs. Thank God the European Union was able to send an Italian laboratory to Lofa County[5], to provide much needed assistance. Late Friday afternoon, Sept. 19 we got our RFF document. My chief[6] and I ?boarded ?a plane the following Monday with a goal of exploring the sites and assess prospective homes for my mobile labs. [caption id="attachment_7736" align="aligncenter" width="465"]15444627806_a308abaf66_z Lt. Cmdr. Benjamin Espinosa, Naval Medical Research Center, dicusses lab operations with Col. Sazzad, commander of the Bangladesh contingent of the United Nations military forces in Liberia. The first thing I noticed when I arrived in Monrovia was that no one shook hands. There was no body contact. If you greeted somebody you put your hands to your heart or you touched elbows. It was my first time to this very poor country and obvious years of civil war had taken its toll.[7]? My most dreadful experience was driving from the airport to the hotel, there was no power, and no power grid; everything was based on electric generators. Most shocking was seeing containers of bleach in front of buildings for washing hands. Before going into a building you must wash your hands in the bleach solution as a precaution. That first morning I didn?t see any dead bodies; there wasn?t a feeling the world was coming to an end, and no zombies were walking the streets. It seemed like business as usual, people going about their affairs as they normally would. In September with the assistance of WHO, CDC, MSF and NGOS, the government had a better grasp of the crisis, and had been working a strategy for implementing control. By then the bad things seen on Youtube and CNN were gone. Yes, there was an outbreak, but the government had done a good job with a huge educational Ebola campaign. Signs everywhere said ?Ebola is real?. ?Songs playing on the radio informed people of the threat. [caption id="attachment_7738" align="aligncenter" width="426"]15444538746_5d56ce2b79_z We got the RFF on the 19th and by the following week, we had boots on the ground, ready to receive the labs. Fourteen days to become operational was unheard of. Some people thought the government was using Ebola as a way to control them; different tribes, different cultures, different villages had different beliefs. Their burial practices are very complex and involve touching of the body, washing,, kissing and such. Informing people of the dangers of these practices was a way to prevent transmission. Our first mission was to make sure our labs would be ready to be received at the chosen locations. We attended a meeting hosted by the Minister of Health with all of the international partners, NGOs, etc. at the Ebola Response Center, I met the Ambassador,[8] General Rodriguez[9] and Major General Williams,[10], in charge of the operation unit at the time. When informed that our Navy?s labs were under way they couldn?t believe how we got the RFF on the 19th and by the following week, we had boots on the ground, ready to receive the labs. Fourteen days to become operational was unheard of. They couldn?t believe how fast we moved. [1]Lassa hemorrhagic fever (LHF) is an acute viral hemorrhagic fever caused by the Lassa virus and first described in 1969 in the town of Lassa, Nigeria. [1]Biological Defense Research Directorate (BRD), Fort Detrick, MD [1]DTRA-CBEP?Defense Threat Reduction Agency -Cooperative? Biological Engagement Program (CBEP). [1] United States Africa Command (AFRICOM) is one of six of the U.S. Defense Department's geographic combatant commands and is responsible to the Secretary of Defense for military relations with African nations, the African Union, and African regional security organizations. A full-spectrum combatant command, U.S. AFRICOM is responsible for all U.S. Department of Defense operations, exercises, and security cooperation on the African continent, its island nations, and surrounding waters. AFRICOM began initial operations on Oct. 1, 2007, and officially became an independent command on Oct. 1, 2008. (source: www.africom.mil).     P

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