During the 13 days she spent covering the Ebola epidemic in Sierra Leone, Guardian newspaper journalist Monica Mark took every precaution. She checked her temperature every morning, every night and at any moment she felt the slightest twinge or ache. She hired a driver to avoid a taxi that could have been contaminated with someone exposed to the virus. In-person interviews were conducted at a distance. Washing her hands and boots with chlorine became second nature. So did wearing long johns and long-sleeved shirts in West Africa’s blazing heat. Wiping sweat off her brow was out of the question.
“But it’s impossible not to touch people sometimes,” she said, remembering the day she was at Princess Christian Maternity Hospital in Freetown when a complete stranger wrapped her arms around her.
Mark was standing in a hallway of one of the wards when an older woman approached her. “I heard a woman yell, ‘Jessica!’” Mark, who is black, said describing the incident. The woman had clearly mistaken Mark for someone else, but before she could explain the mix-up, the woman gave her a massive hug.
“She kept saying, ‘I’m so excited you came. You must see my daughter,’” Mark said. At that point Mark knew if she had contracted the virus it was too late to do anything about it. She followed the woman to a room where she met the woman’s daughter who had just given birth.
“That moment captured what Ebola does,” she said. “This woman obviously had family and no one wanted to come to the hospital.”
Mark is among dozens of journalists who have traveled to West Africa to report on the Ebola outbreak that has killed thousands and continues to threaten the lives of health workers, family members and children. But the job has put journalists in the crosshairs of a virus that has a 70 percent mortality rate. NBC News freelancer Ashoka Mukpo reminded the world of this when he was diagnosed with the deadly virus on Oct. 2 while covering the outbreak in Liberia.
Chlorine and hazmat suits
For news producers the decision to send a colleague to these dangerous hot zones is not taken lightly. David Sweeney, NPR managing editor of news operations, says all assignments to West Africa are voluntary. NPR reporters are told to take their temperatures regularly, use a chlorine solution to wash their hands and boots, to not shake hands, enter isolation units, and to avoid large gatherings and demonstrations.
“Before an assignment begins, we hold a briefing for the team about to depart – participating are those most recently returned from the region, along with other producers and reporters who reported from the affected countries as well as senior editors and managers,” Sweeney said. “It’s an information-sharing exercise, and an opportunity to ask and answer questions.”
Vice had three reporters -- two from the U.S. and a freelancer in Liberia -- to produce a 30-minute documentary from the center of the epidemic. The news organization has sent reporters to dangerous regions, but unlike a war zone where bullets, shrapnel and hostage situations are the norm, the Ebola epidemic is unique in that everything you touch has the potential to kill you.
Ahead of their departure, Vice consulted with multiple infectious disease specialists, security advisers on what kind of personal protective equipment protocol to follow, and spoke with journalists and medical professionals already on the ground to devise the best set of precautions for its crew. They were given hazmat suits, rubber gloves, goggles, face masks and thick rubber boots.
While the crew was reporting in Liberia, they had to take their temperature twice a day and check in with office staff regularly. They had to avoid all physical contact with others while in Monrovia. Their crew was told to turn down reporting opportunities from Ebola treatment units. Before returning to the U.S., their crew was told to dispose of their clothing, nonessential gear and wipe everything else -- cameras and lenses -- with highly concentrated chlorine wipes. Once they were back, they debriefed with the Centers for Disease Control and Prevention, and were instructed to remain in a private residence for the mandatory 21-day quarantine. Both U.S. reporters have since cleared the quarantine.
The Associated Press is taking similar precautions. Reporters are told not to sit down or touch anything while in affected neighborhoods. Interviews should be conducted at a “greater-than-normal physical distance” and outside. All meals are eaten at their respective hotels.
“AP staffers are having their temperatures monitored through the day. They’re avoiding taxi cabs or unknown drivers and carrying bottles of bleach spray to clean their shoes and gear every time before they enter the vehicle arranged for them by the owner of their hotel. They require the driver to have hand sanitizer, bleach and protective footwear,” AP spokesman Paul Colford said.
Geoffrey York, a journalist for the The Globe and Mail, spent two weeks in Liberia reporting on the outbreak. “The main precaution is to avoid any physical contact with anyone who might have Ebola, and with any surfaces, fences, gates, floors, etc, that might have the virus,” he told International Business Times in an email. “Along with that, a lot of hand-washing in chlorine solutions, hand sanitizers, disinfectants on shoes and boots, temperature monitoring, etc.”
While he brought safety equipment, York said it was safer to not use hazmat and gloves suits unless he was in high-risk areas because the suits can lend a false sense of security. “These days, experienced people on the ground are advising journalists against the use of protective clothing unless you are inside the high-risk wards,” he wrote in a first-person account of his time spent in Liberia. “[Gloves and suits] can lead to risky behavior and – unless you are highly trained and carefully supervised – you can easily contaminate yourself with the Ebola virus while you are removing the gloves or suit.”
ABC News correspondents in Liberia are using the buddy system to minimize the potential for mistakes. “If either of us saw each other doing something risky we would call each other on it," said Dr. Richard Besser, ABC News' chief health and medical editor, who has been to Liberia twice since the outbreak began.
And Besser only used his hazmat suit once. He was in an Ebola isolation unit and even then he was dressed and undressed by a trained team. “It creates a false sense of security,” Besser said about his decision not to wear the hazmat suits regularly. “It’s like a man who makes your sandwich at the deli counter and then takes your money at the cash register,” he said.
Images of the bright yellow hazmat suits with goggles, masks and gloves might appear to be a safe bet in an environment where every object is at risk of contamination -- but removing protective gear is a 31-step process that requires the supervision of a trained specialist. One must be disinfected and washed every step of the way. A Spanish nursing assistant who has Ebola said she touched her face during this process. In Dallas, two nurses who cared for Thomas Duncan, the Liberian national who died on Oct. 8, have been diagnosed with Ebola. While the state health agency is still looking to confirm how these health workers became infected, many are pointing to the absence of safety protocols as a cause.
Ebola up close
Monica Mark brought a hazmat suit and protective gear to Sierra Leone but immediately realized she would not be using it. Besides the difficulty of putting the suit on and off, it also impeded her work.
“It’s really difficult to get someone to open up to when you’re wearing it,” Mark said. She already had to conduct interviews several feet away from the people she was speaking to. Wearing a brightly colored alien-like hazmat suit wouldn’t help.
Hazmat suits have become associated in Sierra Leone with burial teams, which have been attacked in some communities by villagers confused as to why their loved ones are suddenly taken away.
“They didn’t understand these strange people coming in suits, coming into their community,” Mark said describing how villagers perceive the Ebola burial teams. “It’s a pretty horrible, undignified way of seeing someone you love die,” Mark said. And then “for someone to place them in a body bag and go off with them” only perpetuates the trauma.
Ultimately, Mark said surviving in the field came down to blind faith. Her driver Nixon was terrified of the disease. He wore a facemask everyday as a precaution. But she didn’t know where his car went at the end of the day or who was in it. Her trust in him stemmed from something Nixon once told her: “I don’t want my son to be left fatherless.”