CCU professor fighting spread of Ebola virus

Oct. 04--The mother looked to be in her early 20s.

She sat on the doorstep of a house in a Sierra Leone village, her infant cradled in her arms.

"Can you tell me what that sign says that's on your wall?" asked Fredanna M'Cormack, an associate professor of health promotion at Coastal Carolina University, recalling the conversation. "She looked at it and she's like, 'Oh, it's about Ebola.' I said, 'OK, great. So can you tell me what it says?' She couldn't read it."

The exchange proved to be common in M'Cormack's home country, where she spent three months this summer researching Sierra Leone's fledgling health care system. While she was there, the Ebola virus swept through West Africa. The death toll recently surpassed 3,400, including more than 600 in Sierra Leone. This week, the Centers for Disease Control and Prevention reported the first Ebola case in the United States.

Often fatal, Ebola typically spreads through direct contact with bodily fluids. The disease was first discovered in 1976 and Africa has seen periodic outbreaks since then, though none as extensive as this one.

Despite the seriousness of the virus, health officials say the risk of a major Ebola outbreak in the U.S. remains low. The African nations that have suffered the most from the outbreak are poor countries with limited medical facilities.

That's what drew M'Cormack to Sierra Leone this summer and it's why she's helping fight the spread of the virus there.

Returning home

M'Cormack was born in Sierra Leone, a rural country of about 6 million. When she was two, her father's job in the insurance industry allowed them to move to Nigeria. At age 5, her family moved again to Kenya, which is where she lived until she went to college in the U.S.

Global health is one of her research interests, and she's made regular trips to her home country, particularly after Sierra Leone overhauled its health care system in 2010. Officials had hoped the changes would provide health care access to more people, but there have been numerous hurdles.

"The question is whether or not the clinics, the systems that are in place actually have the resources to provide the free health care," M'Cormack said. "Are there enough drugs? Are there enough free health care facilities and clinics? Are there enough health workers, trained health workers? Now those are the challenges that exist."

She traveled to Sierra Leone in May. A veteran researcher, M'Cormack received a grant to study the impact of the new healthcare policy on pregnant women and young mothers.

But just weeks after her arrival, Ebola spread to Sierra Leone. As the problem metastasized, the professor's role changed. She was no longer simply interviewing women for a study. She found herself speaking to groups about Ebola prevention, urging people to wash their hands, limit physical contact and to avoid eating sick or dying animals. She explained how the disease could be contracted, that it wasn't part of a government conspiracy, that they could help themselves.

"She was instrumental in helping with some of the initial education efforts for locals," said John Yannessa, chairman of Coastal's health sciences department. "She would do a lot of teaching."

Yannessa said he stayed in touch with M'Cormack throughout her trip, but he knew she'd avoid putting herself in harm's way.

"She is a seasoned international traveler," he said. "She is a health professional with decades of experience. As a public health practitioner, we certainly had full confidence that she would protect herself the best she could."

The outbreak didn't scare M'Cormack, either. She never spoke to Ebola patients.

"I cannot get myself sick," she said. "I cannot put myself in a situation where I will be sick and the like. It was very important."

In a culture that embraces physical contact, that was difficult.

"One of the things I was very cognizant about was that touching actually does become an issue and a problem," she said. "Sierra Leoneians are very touchy feely: holding hands, give a kiss on the cheek thing. ... That was probably one of the most difficult things that they had to deal with. We couldn't shake hands. ... Everybody's like, 'Uh oh, Ebola.'"

An educational mission

But many people in Sierra Leone didn't understand all the things they must do to avoid the virus.

M'Cormack remembers arguing with a man who considered finding a sick animal divine providence.

"God must have given that to me," he told her.

She also warned against eating bats, which can serve as hosts for the disease.

"The guy was like, 'But the bats taste so delicious in the soup. What are you talking about? How can you tell me not to eat bats anymore?'" M'Cormack recalled. "Those are the challenges. You say one thing, but you have to understand that, culturally, it may be something that is indigenous to the community."

Many in Sierra Leone, however, did come to grasp the severity of the situation after the death of Dr. Sheik Humarr Khan in July. He had been battling the spread of Ebola.

"He was like pretty much the spearhead," M'Cormack said. "When he died, I think the country sat up and took it very seriously."

Although she didn't know Khan, M'Cormack did lose friends to Ebola. Some of her research has focused on the impact of the 2010 law on Sierra Leone's health care workers, and the disease has claimed two nurses and a health outreach coordinator she knew. The spread of Ebola is hitting the local medical community hard.

"There's a lot of fear," M'Cormack said. "But you also have a lot of individuals who are trying to fight this fight and realizing that they are at the highest risk because they are on the front line. And as an individual looking, I'm like, 'I would not blame them for not wanting to go to work the next day. But these individuals get up and they go to work. And they get up, and they go and treat. And they get up and they put themselves in harm's way."

An effort to help

Throughout the Sierra Leone countryside, there are few clinics.

It's not uncommon, M'Cormack said, for a single facility to serve three or four villages. Some people walk as far as 10 miles to reach one, and once they get there they receive rudimentary care. A clinic typically consists of some benches and an examination room.

A lone health care worker cannot perform surgeries and offers only headache medicine or anti-malarial drugs.

Before M'Cormack left for Sierra Leone, one of her students brought her gloves, masks and other supplies for the health workers there.

Danielle DeTrude, now a senior, said she spent the summer of 2013 in the country and saw the struggles of the health care system firsthand. She also watched a documentary about Ebola before her professor left in May and wanted to send supplies, which she knew many locals wouldn't have.

"I was thinking that would be really helpful in case anything ever did happen like that to send medical masks to start with," she said. "Then all of a sudden, [Ebola] was reaching Sierra Leone."

In many ways, the Ebola crisis highlights the existing healthcare and poverty problems in Sierra Leone. And because of those challenges, DeTrude and M'Cormack are setting up a nonprofit organization, Social Workers Sierra Leone, to educate and provide assistance to the country's impoverished people.

DeTrude said the home organization is already operating in the Sierra Leone city of Freetown. She and M'Cormack are setting up a 501(c)3 in Myrtle Beach to raise money for the group's efforts, which are focused on teaching the people there about Ebola and how to avoid the disease. Some of those involved in the organization also helped M'Cormack with her Ebola forums this summer.

"I am a big believer, as most public healthers are, in preventative methods," DeTrude said. "There is a lack of access to education in a lot of developing countries, as most people know, and I am really passionate about providing education for individuals who either lack it or want to know more about the subject."

M'Cormack, who returned to the United States from Sierra Leone in August, acknowledges the challenges in her home country are vast and only exacerbated by Ebola, but she remains undeterred.

"We do make small differences," she said, "in some people's lives."

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