LSHTM in the time of Ebola: reflections from the Ebola Student Response

MSc Public Health in Developing Countries student Rachel Thompson explains how the Ebola Student Response, set up by students at the School, has supported the work of the School and the World Health Organization during the Ebola outbreak in West Africa:

I was actually in East Africa when the Ebola epidemic began. As I left Kenya in August, tensions were already high and I was receiving messages from the FCO and other security forums on a daily basis. Alarming reports from West Africa were making it into the mainstream media and there was definitely the uncomfortable feeling that this epidemic was not going to disappear in a hurry.

Arriving at the School, I soon started to understand more about the virus and implications for the countries affected. It was incredible to be studying epidemiology in ‘real-time’; applying new concepts I was learning in lectures to news reports I was reading at home. But with this new knowledge I soon found myself asking more and more critical questions: How had this situation been allowed to get so out of control? Who was to blame? What can be done?

I was also all too aware of the human tragedy unfolding, which can sometimes be masked behind fancy statistical models and epi curves. The ‘humanitarian impulse’ that had previously led me to join the Red Cross and work in Somalia was burning again, and there were many days I was tempted to quit my MSc and jump on a plane to West Africa. However, (fortunately) before I had the chance to do anything too drastic, I became involved in the Ebola Student Response (ESR).  You can read more about how this initiative started and what we have been doing in Remy’s blog.

For me, the ESR provided a way to channel my energy and concerns about the crisis, as well an opportunity to get to know likeminded students from across the School. Over the weeks, Remy and I became a team, throwing ourselves into organisation, promotion of events, meeting with staff and trying to keep up to date as the epidemic and issues evolved. Although this meant that I had less time to spend in the library, it felt important and helped me developed other skills that I know will come in handy in the future; for example, team management, leadership and organisation. These skills, as well as my commitment, were to be tested to the limit during the last weeks of 2014, when the ESR’s help was requested to undertake a crucial and massive data cleaning task for the WHO.

As the last week of term before Christmas approached everyone was, in a word, exhausted! We were all mentally winding down, dreaming about the holidays, mulled wine and some well earned time off. However, this was not to be the case for myself and the team of dedicated students, who gave up precious hours of their revision time and holiday to laboriously clean datasets of Ebola cases and their locations. Working to what seemed like an impossibly tight deadline, we spent many hours locked in a stuffy computer lab, using incomplete lists and maps and random online sources to try and locate thousands of Ebola cases and their contacts to the nearest village; a seriously tall order by anyone’s standards! Indeed, apart from the importance to the Ebola outbreak, this was the first time anything like this had been tried at the School. Learning together as we went, I gradually became more confident in my knowledge of Sierra Leone’s geography and place names, which way round longitude and latitude are, and the art of motivating tired volunteers (FYI chocolate definitely helps!)

Working intensely in MS Excel, it was easy to disconnect from the data, to become so involved in the minutia of the task that I forgot what the numbers and words meant in reality. Yet there were moments when I was overcome by emotion too. Googling a village name that didn’t appear on any official list, suddenly I was presented with hundreds of media reports: a whole household wiped out, their neighbours too. And suddenly the numbers and codes were more than just numbers and codes; they were people and families. People whose suffering – thanks to this work we were doing – would be recorded in a permanent database; their cases immortalised, part of a bigger story now.

As a social scientist by training, my previous experience has been mainly with qualitative data. I am an anthropologist, used to dealing with individuals rather than anonymous datasets. In Somalia I collected qualitative data from people affected by crises in order to tell their stories, which was always a deeply moving experience. However, I cannot say that I had ever had an emotional experience with quantitative data before. But something in this data really moved me. And feeling this emotion helped keep me motivated, and able to motivate the other students I was coordinating.

I left the School at 5pm on Christmas Eve, just as the staff we were working with prepared to send the clean data files of Guinea’s cases to the WHO.  We had met the deadline and could relax at last! Well for a few days at least… then it was straight on to the Sierra Leone dataset. Once again, I was blown away by students’ dedication: working over Christmas and New Year to clean messy data, students demonstrated patience and commitment to persevere through lines and lines of Excel spreadsheets.

Our hard work did not go unnoticed and was applauded internally and externally. In January I received a message that I had a delivery of chocolates from the WHO in Geneva! The Guinea data we worked on was analysed by staff in support of the Guinea vaccine trial, which is now in progress. We also found out that the WHO and the software company they employed had put six months effort into cleaning the same data and trying to find cases, using a mixture of manual time and automated algorithms. Yet we managed to find more locations, with less knowledge of the area and considerable less resources…Go LSHTM students!

Although this year the requirements of term two modules reduced the ESR’s activities, Remy and I have been lucky enough to attend the monthly Ebola Task Force meetings with School staff. Hearing returned volunteers’ stories, the planning and challenges behind the vaccine trials, and future research plans continues to inspire me. The School’s seminar series has also provided us the chance to learn about Ebola related topics in detail and pose critical questions to experts from inside and outside the School. In March, the ESR invited a team of WASH experts from Brighton University to talk about their knowledge of ‘Ebola poo’ and experience developing WASH guidelines for this Ebola outbreak. This month, we hope to have a final seminar with a researcher from Cambridge University to talk about his work with Prof Martin McKee on The International Monetary Fund’s role in the Ebola outbreak.

Meanwhile, I am busy planning my summer project in Sierra Leone. After so many months, reading, discussing, planning, it will be daunting but amazing to finally be on the ground, to see with my own eyes Ebola and its impacts.

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