Dr. Margaret Tandoh, a trauma surgeon, has seen her share of patients in dire situations, but spending seven weeks with people infected with Ebola took “dire” to a new level.

An assistant professor of surgery at the University of Vermont College of Medicine, Tandoh says she couldn’t check a patient’s temperature or do lab tests in the Ebola treatment unit where she first worked in Bong, Liberia. The heat and lack of resources made these basic procedures unfeasible.

“It was very difficult to see the sicker patients because there was nothing you could do,” Tandoh wrote earlier this month in an email from Brussels, Belgium, where she stayed during a quarantine period after she left Liberia. “You knew they were going to die. As a surgical intensivist, I'm trained to place large IV lines, provide intubation and all kinds of medications to save a patient's life. In this situation, you cannot offer any of those.”

Tandoh and Dr. Majid Sadigh, an infectious disease expert and UVM associate professor of medicine, worked in Liberia for seven weeks from November to December. They received Ebola-care training in Bong, then traveled to Buchanan to set up an Ebola treatment unit in that port city.

The two UVM doctors are among the “Ebola fighters” named as 2014 Persons of the Year by Time magazine.

Tandoh, a native Liberian, says she felt compelled to muster her skills against an epidemic in her home country.

“I kept reading how bad things were and kept saying to anyone who would listen that I wanted to go and help,” she says. Upon arriving in the country, she says she wondered, “Where are all the people dying of Ebola? It seemed just as normal as it was when we visited in March except for all the buckets of chlorine water at every place of business, homes, etc.”

Sadigh, director of the Global Health Center at UVM and clinical teaching partner at Danbury Hospital/Western Connecticut Health Network, says he deserves no glory for his work. Instead, he credits those fighting the disease in their home countries while losing family members and living in poverty with inadequate resources and support.

“I admire the resiliency of the West Africans,” says Sadigh. “Despite being at the epicenter of Ebola, their life continues. I learned so much from that nation.”

As of Jan. 20, the Centers for Disease Control counted 21,797 cases of Ebola in West Africa -- Liberia, Sierra Leone and Guinea -- and 8,675 deaths, plus another 35 isolated cases outside of that region. Incidence of new cases, though, is leveling off.

With their Ebola experience now in their rear view, Tandoh and Sadigh say they realize the importance of an international unified, organized and swift response to prevent the spread of such diseases.

“The world has become very small, and a crisis in one part may be coming to you sooner than you think,” Tandoh says. “So it's very crucial to send help and send help fast if you have the capacity to do so. This kind of epidemic has to be controlled and contained immediately, using all possible resources.”

Resources are the key problem in parts of West Africa plagued by poverty, Sadigh says. A lack of public health infrastructure leaves communities susceptible to outbreaks. They need medical schools, hospitals, better training for health care workers and better access to information and basic care.

About 95 percent of Liberians live without electricity, he adds, despite the fact that the country was founded by Americans.

“It belongs to us, as a nation, and they’re so poor,” Sadigh says. “It needs more of the leadership and commitment.”

He and Tandoh fear that another epidemic is almost inevitable.

“It is a very real concern for me,” says Tandoh. “You could see people becoming complacent in Liberia and not as vigilant as when we first arrived. More group gatherings, not washing hands. If we start relaxing, Ebola will be back and maybe worse.”

Back home in Connecticut in late December, Sadigh put himself into 21-day isolation. He wasn’t particularly concerned that he had contracted Ebola, he says, but he knew that his neighbors and community would fear -- despite factual evidence to the contrary -- that he would expose them to the disease.

“I knew if my neighbors saw me around, they would be frightened,” Sadigh says. He didn’t want to cause anyone discomfort during the holidays.

“Based on the science, I was almost 100 percent certain that I was not going to come down with Ebola disease,” he says of that time. “If you follow a protocol of safety in the hot zone, you should not be exposed to the virus. And we were very careful in the hot zone.”

Under that protocol, he and Tandoh worked in tandem with their medical team -- moving in and out of the Ebola treatment unit as a group. They followed a strict regimen: staying in their hotel rooms when not in the ETU; eating food only from preselected cooks; taking their temperatures at least four times a day; and enveloping themselves in protective gear in which they could only work up to 110 minutes at a time before overheating.

“I wasn’t afraid of getting Ebola, I was afraid of passing out in the suit,” Tandoh joked to a colleague on Jan. 20, -- her first day back to work at the College of Medicine. She was distributing cupcakes in recognition of the Higher Education Excellence in Diversity award recently granted to UVM, which recognized initiatives at the College’s Office of Diversity and Inclusion, where she serves as associate dean.

“I developed a routine once in PPE that I would use to calm myself,” Tandoh recalls about working in the personal protective equipment. “I could feel the sweat running down my face while getting dressed, and I wouldn't panic. I would tell myself to calm down and relax. Sometimes I thought someone was pouring water down my arm but realized that it was just sweat.”

Tandoh and Sadigh left behind much more than their sweat. The Ebola treatment unit they set up in Buchanan now has 151 national staff. It also has some of the fundamental equipment -- including blood pressure cuffs and a pulse oximeter -- that Tandoh wished for when caring for those first Ebola patients.

During a local WPTZ-TV news interview at the Burlington, Vt. airport, Tandoh summed up what she learned from the experience: “People are willing do what it takes to see their fellow human get better.”

PUBLISHED

01-27-2015