Q: Can we go back in time, and can you describe where you were working during the Ebola outbreak?

PCT: Okay. During the Ebola outbreak, 2014, I was first assigned to the Clara Town Health Center in Clara Town. I reported to the Health Supervisor. I’m a midwife and a nurse, and was the supervisor for the facility when it came to mother and child health. When Ebola entered the country, I was still working in the labor room. Women were coming for delivery, but people were also shying away. Health workers were shying away too, fearing the unseen, anything we couldn’t see.

Q: They were shying away because they had heard about it?

PCT: They had never seen Ebola, even though we learned about it in school. It was completely strange. Our health system wasn’t that strong, even though the community was trying. We still had a shortage of supplies.

Q: What kinds of supplies, specific supplies, were in short supply?

PCT: IPC supplies, the infection prevention control supplies. We also talked about the state of mind you had to have to be safe to serve.

Q: What about training?

PCT: There was no training. Health workers were embedded into the services just like that. We weren’t prepared to handle a case when it came to supplies–gloves, the gowns, the masks, the shields, the boots and other things, that we have now because of the Ebola crisis. So people started to die.

Q: What was the reaction in the community?

PCT: The community never trusted us because they felt we were lying, that we brought the disease, and were killing the people. We felt trapped.

Q: You felt trapped.

PCT: Yes, trapped. I have lost relevance in my community. Now, I’m at the facility level. People wanted to burn the facilities because they couldn’t trust the health system anymore. They felt they were part of the disease. They were blaming the government. I said the only thing I can do is go into the fight. People were starting to come to Liberia, bringing supplies, training us how to use them, how to treat, how to be confident of ourselves. So I say I think this is the savviest place.

Q: The savviest place. So people were coming together?

PCT: People were coming together now to see how to fight. I decided to go into the fight. I discussed it with my husband. My husband said you don’t want to go in the fight. Ebola isn’t easy, nurses are dying, and nurses are the conduit of disease to their family, because they are the frontliners. If they come in contact with the disease, they take it back to their family, and then the children, especially the children are closer to their mothers, so he seemed unhappy, didn’t want me to go. So then I kept quiet. I just kept quiet. Something was just telling me to go. I don’t know what was, just that internal drive.

Q: You weren’t afraid?

PCT: The nurses couldn’t contend with the overload of patients. People were all on the street laying down. But seeing the other nurses made me want to get into the fight, that we had to do it.

Q: Later, you became a manager.

PCT: Yes. From that point in time, I started to manage the ETU. I managed over 500 staff.

Q: Five-hundred staff?

PCT: Staff! I had doctors, I had nurses. I was working with the team from Uganda, Dr. Atta and her team. They said don’t be afraid. You will make it.

Q: So you coordinated—

PCT: Coordinated everything. Supplies. Make sure there’s food, clothing, water, drugs, fluids, that everything is in place. Make sure my staff is paid on good time. Make sure the payrolls are clean. Make sure I submit my payroll on time. Meetings. But I’m a nurse also.

Yes, I’m a nurse. That’s the common denominator we all have. I’m a caregiver, so I have to go and see. And then you lead by example.

By September, October, November, we had to leave JFK ETU because the infection was growing. The pay was so tight, and we had a pile of debt, pile of medical waste that people couldn’t just take, and we still had patients being treated, and the staff—

Q: It just was too many—

PCT: Just too many patients. Medical waste had not been evacuated, so the infection began to grow among the staff, some of my staff started coming down with the virus. At the ETU, I lost three of my staff at JFK, two security—four. One doctor and one laboratory technician. I lost two hygienists.

Q: Ah, okay. You lost a lot.

PCT: We had to divide the staff into two. In Liberia, I’m the first female manager. Because I went, other females came, so I was a motivating force.

Q: You became a mentor for other nurses.

PCT: Yes, we were also mentoring other ETUs about the secrets of care. We’re using IV fluids, we’re using everything to fight back. Some would die, but by the grace of God, we had a lot of survivors in a short period of time.

Q: But why do you think there wasn’t enough recognition for all that you accomplished?

PCT: People like to take the glory all by themselves, not recognizing we were all on a team and forgetting that we were women, the first to get into the fight.

Q: What was your home life like?

PCT: I go until two, three in the morning, I don’t sleep at night, my children cannot be played with because I have the Ebola care, I’m in the ETU. My husband and I couldn’t have intimacy.

Q: But still, you were a team in the fight.

PCT: I’m a nurse, yes, but we separate our rooms. When I come from work at night, I go and take a bath outside while people are sleeping, use my chlorine, go into my room quietly, and I tell my husband good morning neighbor. We called each other neighbor. My children wanted to come and hug me. It wasn’t easy. My little son at that time, he was four. He couldn’t understand.

Q: Sure. That must have felt very lonely.

PCT: Yes, you just stay away to yourself.

Q: What helped you to keep going?

PCT: At some point in time, I really wanted to leave the ETU, but how? People saw me. That why they came. People were dying. The whole team was broken down, so I couldn’t leave.

Q: You were seen as the manager.

PCT: I was tasked to show by example that we keep going and fighting. As people die, still talk to them. We bury them. We talk to the family. They would cry. Got to keep moving. Got to keep moving. We held hands together and prayed.

Q: That was helpful?

PCT: Yes. What we were able to do for each other was to create a survivor tree, an artificial tree with ribbons tied on to it. Black for death, but there was only one black ribbon. Those who survive get pink. The heroes get white. Then we carved the names on the box, each and every one of them is there.

Q: So your name is carved on the box.

PCT: Carved on the box. With a white ribbon. It’s in the museum [National Museum of Liberia] . If you go, you ask for the ETU survival tree from the MOD.

Q: Beautiful.

PCT: Yes, just to remember us because we want to be recognized. There was no certification, there was no time queue.

Q: So you did it for yourself.

PCT: We did it for ourselves. So today or tomorrow, when you go there, you’ll see the names, the names are there for the children to see. Everybody, those that died, you’ll see staff with something that can be recognized, that more the children, children, children, children, children, children to see it.

Q: The history.

PCT: The history, history, yes.

We overcame Ebola. And we still have those skills.

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Patience D. Cooper Tokpah was interviewed for Frontline Nurses by Susan Michaels-Strasser on August 16, 2019 in Monrovia, Liberia.

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