Q: If you could start by telling me where you currently work, and then where you were during the Ebola crisis.

DTS: I work at the Ministry of Health. During the Ebola outbreak, I worked at JFK [John F. Kennedy] Medical Center, as a nursing supervisor, for fifteen years. While at the hospital I heard people dying of Ebola, hospitals were shutting down, and I was in charge of the surgical ward, where we had burn cases, we had orthopedic cases, we had patients with surgical problems, and we were still on the ward. Because of the Ebola most of the nurses were staying home and most of the patients were trying to run away. Being the head of the ward, I had to stay there to encourage the patients and to encourage the staff.

JFK established an ETU just to hold a few patients. But they had the ELWA ETU. I had to come in the hospital to take care of about forty to forty-five patients, talk to the nurse aides to help me take care of patients that needed daily dressing, burn patients. There came a time when I told the administration that we had to discharge these patients that were in the hospital just for care, so they discharged a few patients, and there were only Ebola patients on the ward. I had friends in the ETU who were not taken care and most of them died. When the aides carried food to them they pushed the food under the door with their legs, because no one wanted to take care of Ebola patients. And we were not trained as Ebola heroes. We were not trained how to take all the necessary precautions. I had a doctor who was very, very passionate about his job, and he came down with Ebola. He used to work at JFK, and he used to work at the ELWA hospital. He got infected at the Catholic Hospital. He was the surgeon for my department. When I found out that he was in the ETU, and the first set of people that were in the ETU all died, I felt so bad.

One day a friend of mine came and said, “Diana, every day we come to JFK but we don’t have work to do. All the patients have been discharged, and we are sitting. They are going to recruit people to work in the ETU.” I said, “Where is it? Where is the doctor?” I said, “I want to go there to work, because I want to go and take care of him, take care of those that I worked with before.” When I got at the ETU, there was a team of Ugandans. They said everyone was standing on the line to put their names—some few nurses and PAs [physicians assistants] were standing on the line to put their names down.

Q: So people were standing in lines to put their name down.

DTS: But I didn’t know their motives. Some were thinking about working maybe because there was a lot of money in the ETU. Some thought about working in the ETU because of their passion, they didn’t want for people to die, like me. When we started working we weren’t trained. We weren’t trained on the protective equipment. We were even still writing our names to be recruited when cars were at the gate to bring patients in, a thirty-five-bed hospital for the Ebola patients. And that very day we started taking care of patients. They brought a suit, goggles, the mask, all the protective equipment. They just said, “Well, you have to wear it like this. Put it on like this. Put it on like this.”

Q: So they just taught you right there, and you went right in.

DTS: Right there. “You wear it like this, wear it like this.” We were so excited, and we brought the patients in. But I’m good at establishing IV [intravenous] lines, so when they came in–they were fifty, twenty-five in line–I took the chair, sat, and as you come to me in my suit I will just open your line. When the Ugandans saw my work and saw how passionate I was for the patients, after two weeks they decided to make me their nursing supervisor for the unit. I had a shift running with nurses.

Q: You started shifts.

DTS: Yes, I started recruiting nurses. And after two weeks, we started going for training, had the co-training, the ETU training.

Q: Where did you go for the training?

DTS: They had a hotel, the Corina Hotel. A group of Americans and other people came, the WHO [World Health Organization]. WHO trained me in ETU management. When I got back to the ETU I started to train nurses, and we started to run shifts. I used to go in the ETU with my staff. We’d spend four hours in that suit establishing IV lines, giving bed, bath, feeding patients. Sometimes when you enter the Ebola unit, you see patients lying in a pool of blood, and you have to go there, clean up the blood, ensure they have IV lines established with the fluids. We took care of these patients until after a few days, few weeks, they started being conscious. I noticed that in the ETU, once you have patients losing a lot of fluid, vomiting, passing stool, establishing an intravenous line, and giving fluid, was one of the best methods to resuscitate a patient.

Q: How did you manage with your family in these circumstances?

DTS: And even though I know family comes first, but I took an oath to save lives. I know my ability when it comes to my profession, when it comes to my career. I love nursing, whether in the dangerous part of wherever I find myself, I will apply those skills that as a nurse you should apply. There will be nothing that will stop me from doing things for people once it comes to saving their lives. Many times we have patients whose smell is offensive, and nurses will not want to touch them, not want to come closer to them. But I will go there, help them, be by them, establish their IV lines, clean their wounds. And they would say, “Thank you.” They would say, “Thank you, Diana.”

Q: Did their knowing your name help to keep you going? Was there one patient in particular?

DTS: You know, while I was in the unit I saw this one patient who every time we entered the unit, this patient, you just feel like he’s going to die today. usually when you enter the Ebola unit—we have our names written on our back, or on the forehead, so the patients will recognize us, but we wouldn’t recognize them because of their conditions.

Q: But this one knew your name.

DTS: Yes, he knew my name, and he asked, “Is this Diana, the supervisor, under these clothes?” I said, “Yes. You just came in today?” And he said, “No, I’m the one who’s been lying down, you’ve been taking care.” I said, “Wow! I’m so happy.” You know? And these things are things that make me happy, and once you see the end result of your work, yes, you see the end

Q: How long was the ETU open at JFK?

DTS: It was open at JFK for three months.

Q: And then tell me about what happened next.

DTS: We moved to the Ministry of Defense where it was better. There were systems in place. We had a well-organized structure, because with the help of the foreign team that came, and I was also trained again by them, we recruited more nurses. We set up the place, and it was so conducive for the patients. Most of the patients admitted at the Ministry of Defense, most of them walked home.

Q: Wow.

DTS: We had a life tree at the Ministry of Defense. When you get out of the unit, you put your name on the tree, tree of life. We would look at the number of names on the trees, on the tree; we would know that, yes, our effort has not gone in vain.

Q: Could you talk more about how it was different, those systems, or how—what was different about it?

DTS: It was the process of triage? We triaged patients according to priorities. We had the suspected, the probable, and the case area. At the MOD [Ministry of Defense] we had a system where we had a place for you. We even sit for observation. Most of the time we’d put patients in suspected areas and discharge them, because they weren’t Ebola patients. So that was the system that they put in place. Secondly, we had a time for medication.

Q: Like a set time.

DTS: Yes, we had a set time for medications. We had a set time for feeding, for care. So we placed the nurses in those different areas. “You are going for feeding. I’m going for medication.” Medication in terms of establishing IV lines, and inserting whatsoever. That’s medication. “You go in there for care. You’re going to do your bed bath, make sure the patient’s surrounding is very clean and conducive and comfortable.” So those are systems that we put in place where, as you enter the unit, you know what you are going to do, and not just every time on the unit everybody just doing things that they don’t even understand.

Q: So there was order and control.

DTS: So that was—yes, there was order and control in the unit. We had music, where patients could listen to music, listen to the radio. And they mounted this large sound system where you play music, and they would be listening. That was one of the reasons why they walked out of the unit. I even had a time where we would share clothes with them. Make them feel comfortable. Get towels. Get those things that they can munch on to take in the unit to them. So they were living their normal life; it’s just that they were ill, and they had to be— But they were well taken care of. It was so interesting.

Q: What do you think—what is one of the biggest things you learned from that experience?

DTS: I learned that you have to be qualified. You have to be a trained practitioner before entering such a place, otherwise you get infected. Not just anybody can work in the ETU. You have to be trained. And you have to be a real nurse, because even if you’re a nurse and you don’t have passion for your profession, you will just enter the unit, look at patients and pass by them.

Q: What are you most proud of from that time, and the work you did?

DTS: That I worked in an Ebola unit with Ebola patients. That is the pride that I have. Most people would not work there, but I’m proud that I can be counted among the nurses that worked in the Ebola unit, even if I don’t get anything, because during the whole Ebola crisis, we did not benefit anything. There wasn’t any scholarship to say, oh, these nurses did a lot. They sacrificed their lives. They worked tirelessly on those years. But at least after this whole episode, at least we must appreciate them, even if it is a training out of the country, even it is a training that will improve their lives. It should be happening for them, but it wasn’t done. Even our hazard benefits for entering the unit, for working with Ebola patients, for risking our lives, we were deprived of it.

Q: You didn’t get that.

DTS: No, not at all. We were not given anything. We were given certificates for working in the unit, but no one recognized that. No one even called us to say, “Let us give them an award.” Nurses risked their lives, but when it came to awards, they called doctors. Nurses were the ones who were doing the dirty work. Nurses were the ones who were establishing IV lines. We were not recognized. I wasn’t recognized. Because being a nursing supervisor for the largest ETU in Monrovia, and other government officials’ relatives are there, and they walked out, they went home, and no one recognizes that.

Q: Were other health professionals recognized?

DTS: In the unit, I think only one person, because he was a doctor, and he was the head for the unit, after everything. They sent him to London School of Tropical Medicine to do his master’s. And that was it. While we were here struggling to get our master’s, and he left.

Q: How does that make you feel?

DTS: Very bad. It made me feel bad, not because I took care of patients. But I needed the recognition that I did it, I was a part of it. I was a part of it. I think I should be recognized for that.

Q: You were so brave. So incredibly brave. It’s okay.

DTS: You sit. You sit home and listen to the radio, and they are recognizing doctors? It’s not fair.

Q: That’s why we’re here.

DTS: To be a nurse in Liberia, you must sacrifice, it’s just the passion. Because you know, people are saying things that are not not right in the hospitals. They don’t want to know the root cause, right? They just want to say, “Oh, nurses are not taking care of patients. Nurses are not doing this. Oh, nurses don’t have time for patients.” But they don’t want to know how nurses feel. They don’t want to know what would satisfy nurses. I can be a nurse and go in the Ebola unit. I’m not being paid for two, three months. I have my children who— But yet, and still I sacrifice, take care of patients. Well, after taking care of the patients, I go home and I hear the doctor of that unit is going to London for service, and he said nurses are not doing it. How will I do it when I don’t know it, when I’m not trained, I’m not being capacitated? How will I do it?

Q: And you did it.

DTS: Yes. You just want to leave me to where I am? You don’t want me to improve my life? Or you want to complain and say nurses are not doing this in Liberia, nurses don’t know this? When it comes to the nursing profession, nurses are very, very skillful. In other countries, before you establish IV line you need to use an ultrasound. You need to apply it to see where the vein is, or nurses will just start and apply the tourniquet and they go in, they are in. I just think that being a nurse in Liberia is a waste. That’s how I feel. And I’ve been working for fifteen years. I have worked with surgeons. I was trained by a Chinese surgeon. They want you to do the work, and they don’t recognize that, yes, you did it. So that’s why: because of my hard work, because of my dedicated job, because I’m patient, I was appointed as Deputy Chief Nursing & Midwifery Officer, and that’s where I am right now.

Q: At the Ministry.

DTS: Yes. Most of the nurses, everyone who knows me, knows that I have worked with my whole heart. But nurses need to be recognized for the job they do, and that’s the hurtful part, and that’s what kills me when it comes—that’s—it weakens my strength.

Q: Yes. What would you like—if you could say one thing to the Director of the WHO, what would you say?

DTS: I would ask him to provide some training skills to improve my capacity as a nurse, anywhere EVA [phonetic] is in Lofa, to provide our means, to improve my skills. I would ask him for that assistance, to come back in my country and train nurses who are passionate about their profession.

Q: Is there anything else you would like to put down, have recorded, understood? About you as a nurse, about the work at that time, or more generally?

DTS: Yes, I have a documentary that I gave during the Ebola crisis, and it’s documented. A day in a life of an Ebola nurse in Liberia. That is something that you need to see, how we worked during the Ebola crisis, what are some of the recommendations you will make on my behalf as a nurse. A CBS News reporter did an interview, and she followed me all the way in the unit. It’s there. You can take a look at it.

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Diana T. Sarteh was interviewed for Frontline Nurses by Susan Michaels-Strasser on August 15, 2019 in Monrovia, Liberia.

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