Rhode Islanders of the Year
These people helped make the world a better place this year.
(page 2 of 6)
A week after the World Health Organization designated the outbreak of Ebola in West Africa a public health emergency, Dr. Adam Levine was on a plane heading to Liberia.
The assistant professor at Brown’s medical school and emergency medicine doctor at Rhode Island Hospital also volunteers for the International Medical Corps’ emergency response team. He’s worked in flash points around the world, including Haiti and South Sudan.
This time, Levine was tasked with setting up the organization’s first Ebola Treatment Unit in Liberia.
But as the number of infections and deaths mounted, health care workers struggled with how to treat the highly infectious disease while maintaining their own safety.
“Everyone was trying everything, but no one really knew,” Levine says. “There wasn’t any evidence or prior research to tell us what really worked.”
Now Levine is passionate about making sure the next time there’s an outbreak, the medical community is better equipped to handle it.
“If we went through this whole epidemic with 23,000 infections and 11,000 deaths and we didn’t learn anything about how to care for Ebola patients in the future, then that would be a really horrible tragedy,” he says.
The recent outbreak started in Guinea and smoldered there for several months, then spread to Liberia and Sierra Leone, where the number of cases increased rapidly in the summer of 2014.
Levine arrived in Bong County, Liberia, in August and spent his first weeks learning how to treat patients with the disease, hiring and training local staff and getting supplies. The unit opened on September 15. The group went on to open another clinic in Liberia and three in Sierra Leone.
When the pace of the epidemic slowed in early 2015, Levine and his colleagues realized they had treated nearly 2,000 patients over the course of a year at the five clinics. “It was a tremendous opportunity to learn as much as we could from that experience and from the data that was collected,” Levine says.
The first thing they developed from the information was the Ebola Prediction Score, which was published in the medical journal Annals of Emergency Medicine. Levine and his colleagues devised a tool to help clinicians figure out whether people are at high risk for Ebola by looking at whether they had six symptoms: they had come into contact with a sick person, experienced diarrhea, loss of appetite, muscle pain, difficulty swallowing, but didn’t have stomach pain.
They are also using the numbers to analyze which future patients are more likely to survive or die, based on their symptoms, demographics and the treatments they received, such as medications, fluids and nutritional supplements. Levine and his colleagues are also working with the World Health Organization to pool their statistics with other aid groups that were also part of the response, so they can have a larger picture of the epidemic.
The research is critical because Levine says it’s almost certain there will be another outbreak of the virus, which continues to live in the forest of sub-Saharan Africa and will likely cross over into the human population again.
“The question is how do we prepare ourselves to make sure that we have the best tools and the best trained people available to respond the next time.”
Omar Bah came to the United States in some ways a fortunate man. As a journalist in Gambia, he had been kidnapped and tortured for his work. He had to leave his wife of two months behind. But when he arrived in Rhode Island as a refugee in 2007, he was educated and already spoke English.
As Bah worked to build a life in the United States, he received help from refugee resettlement services for a limited time.
“But I still had a lot of problems and a lot of difficulties navigating the system,” Bah says. “So for someone who for instance does not speak any English, it is just impossible to settle down and be self-sufficient within eight months or a year.”
In March, Bah started a nonprofit in Providence called the Refugee Dream Center, to assist in providing a second level of resettlement services to the refugee community. One of the first things he wants to help people understand is that they are not migrants or immigrants.
“We are refugees,” he says. “And the reason we are refugees is that we are displaced because of natural disaster and conflict.”
They have their papers to legally work and after five years can apply for citizenship. About 180 refugees from countries including Liberia, Congo, Somalia, Iraq, Burma and Iran are resettled in Rhode Island each year, Bah says.
“But people don’t even know they exist because it’s just immigrants we think about,” he says.
The Dream Center is providing English as a second language and job readiness training and basic computer lessons so that the recent arrivals can build on skills they’ve already learned in their native countries.
Several refugees from Somalia had worked as traders, for example, Bah says.
“Okay, you were a trader,” he says. “Now with basic computer skills, you have the opportunity to sell online or work as a cashier.”
The center also received a grant from the Rhode Island Department of Health to go door to door and educate refugees about the health care system and mental health.
In many other parts of the world, people don’t seek medical care until they are very sick, Bah says. “So we tell them no, here we go to the hospital, when you have a problem, you go, that it’s better to prevent.”
Bah and other members of the center also talk about the dangers of sharing medications and dole out dietary advice.
“When somebody comes here, they are healthy,” Bah says. “Within a year, they are overweight because of the food.” They warn that consuming too much sugar can cause diabetes.
And they also broach the sensitive issue of mental health. In most of the refugees’ native cultures, Bah says there’s one word associated with mental health: crazy. He’s now a therapist himself and hoping to break the stigma.
Anxiety, depression and domestic abuse are common and through the outreach work, Bah and his colleagues are teaching the newcomers ways to cope with stress such as deep breathing, spirituality and finding a supportive community. He’s also got a program for youth, who can find it hard to adjust to high school and drop out.
The goal is to help the refugee community stay healthy so they can work, take care of their families and become independent.
“The ultimate objective is to achieve the American Dream,” Bah says.