Healthy Choices

Sacramento doctor heads into heart of Ebola zone

When Dr. Hernando Garzon boards his flight to Sierra Leone this Sunday, it won’t be the first time he’s headed for disaster.

The emergency department physician in Kaiser Permanente’s Sacramento Medical Center on Morse Avenue is one of about 20 doctors from all over the world volunteering with the International Medical Corps, a global relief nonprofit, to provide much-needed aid to Sierra Leone, which has lost more than 600 people to the Ebola outbreak since it began in March.

During that time, nearly 7,000 people have been diagnosed with the virus, including a man who brought it from Liberia to Texas on Sept. 20. Officials from the Centers for Disease Control and Prevention have offered reassurances that the United States is fully equipped to prevent the virus’ spread.

That is not the case in Sierra Leone, said Garzon, whose résumé of crises includes the Oklahoma City bombing of 1995, the 2010 Haiti earthquake and political violence in Kenya and Nigeria. This week, he’ll add the front lines of Ebola to the list.

Garzon will be caring for the infected and educating the country’s health care workers at an International Medical Corps facility in Lunsar for the next month. Though it will be his first time deploying with this group, disaster relief is a type of care with which he is intimately familiar, he said.

“I’m very motivated to do this kind of work,” Garzon said. “I’ve developed a specific skill set that makes me good at working in these environments.”

The doctor called The Sacramento Bee from New York, where he’s staying until he flies out, to discuss concerns and expectations.

Medical relief agencies have noted that they’re receiving fewer volunteers for the Ebola outbreak than they have for disasters past. What makes this different?

In general I’d say this is one of the more difficult disaster relief situations I’ve been a part of. There are tangible and real risks to the health workers. But with appropriate precautions and simply following strict guidelines, I believe we can safely work in this environment.

You’ll be arriving in Sierra Leone as a foreign health worker. What do you expect your interactions with the native population to be like?

In areas where there has been significant education and coverage of the relief effort, the local population can be appreciative of the efforts being made. But I’m also very concerned about pockets or villages where that’s not the case. We’ve seen stories of people throwing stones at relief workers and myths or superstitions where they think relief workers brought in the Ebola. These rumors have turned local populations against relief staff. That makes this a difficult deployment, because you have to be careful of that perception. And when you’re there to help, you have to make sure that message is clear.

You’re also the medical director of Sacramento County Emergency Medical Services. What was it about your training or personality that steered you toward emergency work?

I feel very much a mission to help where the need seems the greatest. And the more severe the crisis, the calmer I tend to be. And that’s why I’m well suited for emergency work ... I’m able to commit and make a decision with limited information. That’s very important in crisis.

One of the key tasks in emergency management is allocating scarce resources and making a decision about how to use them – whether it’s supplies, water, anything. That’s a critical part, and it’s been a part of every disaster I’ve worked with in one way or another.

How do you handle being present at sites of so much death and destruction?

It’s always a challenge, no question. I think one of the realizations I’ve had is that even if I wasn’t there to bear witness to the suffering of people, that it would happen anyway. If I stay at home, it’s easy to avoid it. But deep down I know it’s still happening – everywhere in the world, all the time, in one crisis or another. I’ve been able to go to these events and bear witness. On a deeper level it gets very reverent. It’s almost a privilege to be there and just hold a hand.

Can you desribe a time when you’ve been afraid for your own life while treating a patient?

While working in Kenya in 2008, it was the first disaster I went to where I wasn’t just there in the aftermath like with a quake or tsunami. It was an ongoing event. And we were functioning as the ambulance service and would get called to pick up victims of trauma. So having to go into the slums to pick up injured victims and go into open gunfire was a little dicey. You have to be a bit of an optimist to do this work.

What kind of preparation are you doing for the upcoming West Africa trip?

It’s been a matter of reflecting on my past experiences and the challenges I faced there, and visualizing the current situation and what I expect to see ... I’m playing through my head what decisions I might have to make. What’s going to happen when we open the treatment center and every bed is full and we have to turn people away? What’s going to happen when we have to treat an infected health care worker? It’s one thing to read it in the news, it’s another to be the person who is there and dealing with it … You hope for the best, but you plan for the worst.