Joint Forces Command – United Assistance to transition critical health care worker training to partners on January 1st, 2015

Written by Sgt. 1st Class Nathan Hoskins
Headquarters, 101st Airborne Division (Air Assault)

Monrovia, Liberia – The U.S. Department of Defense Ebola Treatment Training Team, the joint-service team tasked by the DoD to train health care workers to staff Ebola treatment units, is scheduled to transition its critical mission for the Joint Forces Command – United Assistance, January 1st, 2015.

Initially split between the DET-3 and the World Health Organization, the training mission will be transferred back to the WHO, who provides the course for the Liberian Ministry of Health, the ETU health care workers who were trained as trainers, and PAE, a contracting company.

Since the start of their mission, October 27th, 2014, the DET-3, comprised of service members from the Army, Navy and Air Force, has trained more than 1,500 between the course offered at the National Police Training Academy facility and the mobile training teams, which reached out to the remote regions of Liberia.

“The mission here is to train workers who will go into an Ebola treatment unit to be prepared to take care of the patients, said Col. Laura Favand, the chief of training, DET-3. “Whether they’re a clinician, a nurse, a doctor or [physician assistant], or whether they’re on the hygienist side where they’re cleaning and doing maintenance – it’s to ensure that they’re safe for themselves and that they’re actually doing the patient care that’s required for them to recover.”

The DET-3 executed their mission without the advanced technology found in the U.S., where patients were seen being encapsulated in pressurized rooms, receiving state of the art medical care.

Favand’s team and the WHO found that this disease is controllable through low-tech methods in austere environments with the right training. It’s the procedures that are important – not the technology available, said Favand.

Here, the DET-3 started from scratch, working for the U.S. Agency for International Development, with the government of Liberia, the WHO, the Armed Forces of Liberia as well as numerous nongovernmental and intergovernmental agencies.

Though the WHO started conducting the training, it was necessary that the JFC-UA DET-3 arrived to help support this mission, said Foday Kanneh, a physician assistant working as the training coordinator for the Ebola Case Management Unit under the Clinton Health Access Initiative, a non-profit organization initially set up to help save the lives of people living with AIDS and HIV in the developing world. The focus of CHAI shifted in Liberia when the Ebola endemic hit.

Since March 2014, Kanneh has been assisting the Liberian Ministry of Health facilitate all aspects of the training and support to partners – such as the WHO and DoD – in their work to fight this deadly virus.

When the DET-3 arrived, they were able to fine tune the program and focus the training plans, said Kanneh.

They were also able to help grow the program throughout the country, reaching more health care workers than previously possible with mobile training teams, which conducted classes in Voinjama, Zwedru, Ganta, Zorzor and other remote locations.

The training mission was and is critical, as it is one of the primary objectives, along with the construction of ETUs, as part of Operation United Assistance. And it didn’t matter what level of training the health care workers already had, Favand said.

This class is required for even the most seasoned physician because of how deadly and infectious the Ebola virus is, she said. Basic use of personal protective equipment – such as goggles and latex gloves – can be the difference between life and death.

Without the necessary training, health care workers ended up becoming patients instead of treating them, said Favand.

When health care workers first started trying to treat Ebola patients, many of them became infected with Ebola, said Kanneh, a native of Liberia. If health care workers are ill and fighting to survive, who will care for the patients?

“[The DET-3] was important because there was a need in training health workers in the country,” said Kanneh.

Health care workers were dying; they had no idea how to fight the virus. The very fact that they should have been the ones caring for infected people, but instead, were the ones getting infected and dying of the virus, was proof enough.

Along with proper procedures and the use of PPE, health care workers are taught to work as a team, providing the patient the utmost attention and care while looking out for each other.

“It’s the team concepts. It’s learning how to work as partners. It’s the safety of having a buddy system,” said Favand. “You don’t do something independently based on your own knowledge. It’s having the whole team having the same mindset going into it.”

The DET-3 also focuses on patient care. They ensure the patient feels like human being and not a disease – a feeling which can be difficult to communicate through a mask, goggles and gloves.

“Patients still need that contact; they still need to feel like they’re a human being,” said Favand. “And when we’re in these moon suits, it’s hard for them to get that feeling of comfort. So it’s important that we not only train the skills but, we train the cultural aspect of the care.”

That’s where the expert patient trainers came into play, said Favand. An expert patient trainer is a survivor who role plays as a patient in one of the numerous scenarios conducted during the training. These personnel have first-hand knowledge of the disease and what it’s like to go through treatment in an ETU, making their feedback invaluable to the trainees.

“They know how well or poorly they were treated in an ETU,” said Favand. “They help the health care workers focus on the patient and not the disease.”

The WHO will continue the training as 2015 begins and the DET-3’s mission ends – successfully, said Favand.

“The reason we feel that we’ve accomplished our mission is because after each class we get feedback, and sometimes it’s from the NGOs; sometimes it’s from U.S. citizens who came over here to work in ETUs; sometimes it’s the Liberians,” said Favand. “And every one of them – even if they’ve already had experience in an ETU – they all say how valuable this training is, and how it helps them be safe, how it helps them know what they need to do to work in an ETU.”

“We got that daily feedback from day one about how important our job was,” she said. “We definitely feel that we’ve had an impact.”

Kanneh has his own feedback about the DET-3’s mission and presence.

“Their presence also brought more hope and motivation to me, Liberians and the Ministry of health,” said Kanneh.

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