Aliabadi Deployment Transcript

Aliabadi Deployment Transcript

Q: Was contact tracing something you'd had experience in before?

ALIABADI: No.

Q: What was that like then--just starting to pick that up?

ALIABADI: It's a pretty straightforward concept, but it's not necessarily easy to execute because, again, there's people letting you talk to them, people being suspicious, and all that stuff plays into it. The theory is simple, but the execution isn't. I always, just for me, especially with that first appointment, when we'd be out talking to people in the field it would just be really hard for me not to immediately try to assume a doctor-patient relationship with people just because that's my training and where I'd been from. It's hard to push that away and not want to examine someone or like--you know.

There was an incident in that first deployment as well when I was with the same WHO person who was doing contact tracing with me where he was like oh, there's been a death in a prison and it's unexplained and we need to go investigate. We went up to the prison, and this was not in Conakry, this was in the next prefecture a couple of hours away. We go there, and talking to the prison warden or whatever they're called, I'm like, who did the person share a cell with? Can we examine them--or I wasn't asking, can we examine them. I'm like, "Who's the doctor or the nurse here?" They brought that person in, and I'm like, "Tell me the symptoms, give me some history that I can say yeah, this person probably had Ebola versus they didn't." The story was all over the place. It was hard to understand what really had happened, but I was like, "Did you examine the people around this person?" He was like no, they hadn't. My instinct at that moment was like, bring them in. Someone needs to examine them. I want to do it, but we're not supposed to do that. They told us no exceptions, we're not supposed to handle patients and touch patients and care for them in a clinical way. That was hard for me to let go of. But when I saw that it wasn't being done, it was just frustrating. What ended up happening is we just called MSF and were like, just please come, somebody needs to actually lay hands on these patients. [laughs] Not lay hands, but look at them, observe them, examine them. They did, and it ended up being fine.

Q: But when you look back, how do you feel about that? The prohibition on having that more doctor-patient relationship?

ALIABADI: I think it's probably appropriate. We're there as epidemiologists, not as physicians. I think if there was a mechanism for us to have been able to provide direct care, I think a lot of us--some of the EIS officers that I know I'm sure would've taken on that role. But I can also understand that CDC wouldn't want to get involved in potential exposure of its staff to Ebola. I can understand.