St. Marys doctor worked in Ebola-ravaged Liberia

ST. MARYS - "Satan's playground" is how Dr. Cheryl Kuck describes the country of Liberia where more than 2,000 people have died this year from the Ebola virus.

"It's isolated, there's poverty, death, fear ... you can't touch people. There's no hugging in that country," said the St. Marys pediatrician, who in late July spent a week in the West African country on a medical missionary trip.

Witnessing the dead and dying in a country with minimal government aid and poor medical care was overwhelming, Kuck said. However, so was the support she received from back home.

"I was so thankful for all the prayers. It made more of an impact than people will ever know," said Kuck, who kept in contact during the mission with her pastor, Jon Kraner of Wayne Street United Methodist Church in St. Marys.

According to the Centers for Disease Control and Prevention, more than 8,000 cases of Ebola are suspected or have been confirmed in Liberia, Guinea and Sierra Leone since the outbreak began. As of Friday, 4,033 people have died from the virus; 2,316 of those deaths occurred in Liberia alone.

The first travel-associated death from Ebola in the U.S. occurred this week when a man in Dallas died after arriving from Liberia.

Kuck and other missionaries for North Carolina-based Samaritan's Purse follow strict protocol such as wearing multiple layers of protective clothing and gear when treating the sick, she said. Each is instructed not to touch suspected patients, or worse, those who have died from the unrelenting virus.

Kuck was not directly exposed to anyone with the Ebola virus during her trip and no one in her group has become ill, she said.

"We follow protocols set by Doctors Without Borders, and in 40 years no one has ever gotten sick," she said.

Kuck said there are many reasons the Ebola virus is so widespread in Liberia. One is the culture; people in the region traditionally bathe the bodies of the dead.

"But when the people get sick and come to the centers for help and later die, we can't give the (infected) bodies back to the families. They want to know what we did with them. They want the bodies back and we can't do that. They immediately get angry and don't trust us," she said.

Kuck said the mentality of the people, lack of education and basic resources such as electricity also hamper efforts. But the problem doesn't stop there, she said.

"In the 1990s, there was this faction of warlords who enlisted children, kids 6 to 16 years old, to kill, rape ... Now these young people are in their 30s and they don't trust anyone," she said. "This was a setting for things to fall apart and they have."

Kuck, who has volunteered her services with Samaritan's Purse for 10 years in places such as Haiti, was first called in April to be on standby as part of the Disaster Assistance Relief Team to treat those infected with Ebola.

She was with the first Samaritan's Purse group from the U.S. to be sent to Liberia, she said.

"When I arrived on (July) 26th, my driver told me he had just spent 20 minutes trying to convince some people that Ebola was real," she said.

On the first day, her group was told they would have to spend three weeks in quarantine in Kenya after their two-week mission was complete. She and others expressed concern about leaving their medical practices for such an extended amount of time.

During her first 24 hours in the country, a group of medical workers from Liberia attempting to retrieve ill and dead people in nearby Foya was attacked by hammer-wielding residents, she said.

"The next day we thought we'd be leaving. But we found out the Liberian Ministry of Health hadn't shown up at the Case Management Center as promised to care for the sick so the six of us went," she said.

The first two workers to go inside the center were disturbed by the sight, Kuck said. Eleven people were dead including one man who died in a doorway; workers had to step over him until a team arrived to pick up the bodies. The temperature outside was 85 degrees, she recalled.

Sick people needed food and medication, beds were dirty and the morgue - with a capacity for six - was full, she added. And more people were lining up to get in, Kuck said.

"There were children in there, whole families walking around in there," Kuck said. "It was horrendous."

Her director, one of the first to enter, came outside after less than two hours and declared the center unsafe to enter, she said. The sick and their families were angry and at one point an ill man tried unsuccessfully to bypass guards and run to where Kuck and others were standing, she said.

"These people are desperate," she added.

Other groups such as Doctors Without Borders and the Peace Corps left Liberia the next day.

"It just all started to implode," Kuck said.

By mid-week, she and other Samaritan's Purse volunteers headed to Kenya for quarantine but found out en route the government planned to "detain" them, so they returned to Liberia.

The group spent the rest of the week providing indirect care for American aid workers Dr. Kent Brantley, 33, and Nancy Writebol, 59, who became infected with Ebola and eventually were flown to Atlanta, Ga., where they recovered after receiving the experimental drug Zmapp.

Kuck said her group's flight home was supposed to make a stop in Amsterdam but out of fear of being detained because they had departed from an Ebola-stricken region, their plane instead landed in Ghana.

"The U.S. Embassy and William Graham (Samaritan's Purse leader) arranged it so our passports were stamped to show our point of departure was Ghana, not Liberia," she said.

They were instructed before the flight not to converse as a group or display anything that would identify them as Samaritan's Purse volunteers and were told not to mention the word Ebola, she said.

Kuck believes an Ebola outbreak is very unlikely in the U.S. Although the death rate in West Africa is 50 to 60 percent of those infected, it is because they have no "significant care."

She doesn't plan to return to Liberia in the near future because of her duty to her private practice but she doesn't regret her time there.

"I have a faith that tells me I need to go, so I go," she said. "The Lord never promised it would be easy. He said he would be there with me. I'm just very thankful to the community here for their prayers."

Health official offers advice:

Editor's note: The following is a message on Ebola from Auglaize County Health Commissioner Oliver Fisher:

The Ebola epidemic is the largest in history. Tragically the Centers for Disease Control and Prevention has confirmed the first travel-associated death of Ebola in the United States occurred in Texas.

You may be at risk if you have traveled to an area with an Ebola outbreak or have had close contact with a person sick with Ebola. If exposed or at risk, you should check for signs and symptoms for 21 days. Monitor your temperature and check for other symptoms of Ebola or contact your doctor for evaluation of exposure level.

Symptoms of Ebola include fever of 101.5 degrees or higher, severe headache, muscle pain, vomiting, diarrhea, stomach pain or unexplained bleeding or bruising.

Ebola is spread only through direct contact with blood, bodily fluids or items that have been contaminated by an infected person. Bodily fluids include urine, feces, saliva, vomit, semen and sweat. Ebola is not spread through the air, water or food.

To protect yourself, wash your hands often with soap and water or use an alcohol-based hand sanitizer. Do not touch blood, bodily fluids or items such as clothes, bedding or medical equipment that may have been contaminated by a person sick with Ebola. Currently, there is not a vaccine for Ebola, but experimental treatments and vaccines are being researched.

Perhaps the greatest prevention measure is the limitation of travel to infected areas. The risk of contracting the disease must be weighed against the purpose for the travel, which should be only essential.

If you experience Ebola symptoms after traveling to an area with an Ebola outbreak or you have been in contact with someone who recently returned from such an area, seek medical attention right away. Make sure you contact your doctor or medical-care provider before you go to the office. This will allow the medical provider to better care for you and protect other people who may be in the facility.

The Auglaize County Health Department, with combined efforts from surrounding entities, will continue to monitor all updates and activity to keep the public informed and current.

For more information, please visit the CDC website at www.cdc.gov or contact the Auglaize County Health Department at 419-738-3410.

Residents in Mercer County can call the health department at 419-586-3251.