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World

Remembering The Fall Of One Of The World's Great Ebola Experts

ARUN RATH, HOST:

One year ago, Dr. Sheik Umar Khan died of Ebola. At just 39, Dr. Khan was Sierra Leone's top Ebola expert. He had been leading the effort at Kenema Hospital, the epicenter of the epidemic in this country. Shortly before he got sick, a local journalist asked him if he was afraid.

(SOUNDBITE OF INTERVIEW)

SHEIK UMAR KHAN: Yes, of course I'm afraid of my life, mostly because I cherish my life. And if you afraid of thing, then you take the maximum precautions, which I'm doing.

RATH: After Dr. Khan, the next doctor to get sick at Kenema Hospital was an American physician named Ian Crozier, and now he's back in Sierra Leone for the first time. Ian Crozier, welcome to the program.

IAN CROZIER: Good evening, Arun. It's a pleasure to be here.

RATH: So it must have been terrifying there with the medical community, in particular, that this doctor who knows so much about Ebola fell to the disease.

CROZIER: Well, I think, you know, the more we crunch the calculus from this outbreak, that happened again and again. He left a huge swath when he died. He was quite a remarkable man, and, in a sense, Sierra Leone lost a national hero just before I arrived. But the staff at that hospital really stepped into a significant gap, and as that happened, people became infected and died. Ultimately, I was one of those who became infected and then was medevaced soon after that.

RATH: Now, after you came down with symptoms, as you mentioned, you were evacuated. You were airlifted to Emory Hospital in Atlanta, but you were extremely ill with the virus. Can you explain about your medical care - how you survived?

CROZIER: Yeah. Well, I - in my first week at Emory, I rapidly developed what we call multi-system organ failure. My lungs failed, and I required a mechanical ventilator. My kidneys failed, and I required dialysis. My brain failed, in a sense. And my Emory team, as they cared for me when I couldn't care for myself, really changed the game. They are - I think prior to my case, that level of critical care had not been offered with any success. In many ways, I should not have survived the illness.

RATH: So talk about the lessons the medical community there in Sierra Leone can learn from your experience.

CROZIER: Well, I think, in general, you know, there really are two simple goals for Ebola treatment units. The first is to take those who are infected and, in a sense, segregate them from the community and protect the uninfected. The second is once they're in those walls of the Ebola treatment unit, how can we change the natural history of that disease? And I think over the last 30 or 40 years, often the latter has lagged behind the former, and that's all changed during this outbreak.

RATH: The critical care that you got in the United States was very expensive. Is there any way to replicate that on a larger scale for a country with a poorer health system?

CROZIER: Yes, I think one of the issues is I don't think all patients require medevacuation and critical care. One of the key drivers of the illness in this disease is the very early, profound gastrointestinal fluid losses, for example, in vomiting and diarrhea. And I think most of use who've taken care of patients on the ground believe that if we can prevent the severe dehydration, we could do a great deal to decrease the case fatality rates that we see. And some of those things are not rocket science, Arun.

RATH: What does the health care system look like in Sierra Leone now, as opposed to last year? And what are you hoping to do?

CROZIER: Well, I think there's a great sort of emergency within an emergency to pay attention to the complications that are developing in survivors. And in one sense, this is a microcosm of some broader systems strengthening that really needs to happen so that we don't find ourselves back in the same position. Of course, the outbreak is not completely over. We hope it's winding down, but one case is still an outbreak. So we expect and hope that in the next months, we'll see the end of the active cases and then continue to rebuild the vitality and the health of countries that in many ways have also suffered. Almost everyone in Sierra Leone or Liberia or Guinea is, in some way, an Ebola survivor.

RATH: Dr. Ian Crozier nearly died of Ebola last year. He's back in Sierra Leone for the first time. Dr. Crozier - Ian, thank you very much. It's been great speaking with you.

CROZIER: It's such a pleasure to speak with you, as well. Thank you. Transcript provided by NPR, Copyright NPR.