A doctor on loan to the Iowa Department of Public Health is back in the state after a stint in Sierra Leone. The native of Nepal was there to track the ebola outbreak in West Africa.
Dr. Samir Koirala’s birthplace is home to Mount Everest and several other spectacular peaks. But he was such a studious boy he barely noticed he was growing up in one of the most physically beautiful locations in the world because he was buried in books.
“My whole childhood revolved around being in academia," he says. "Because my aim was to be a physician, which required hard work to be good at your studies.”
He spent his early career as an internist and then switched his specialty from primary care to research into infectious diseases. It was this interest that brought him to Iowa through a fellowship at the Centers for Disease Control and eventually to a volunteer job tracking Ebola in Sierra Leone.
“We were told to not be involved with any patient care, to not go into the hospitals, because that's not why we were there," he says. "We were there for preventive aspects, so our chance of being exposed to any Ebola patients was very low.”
Koirala spent 25 days in West Africa developing computer models to enable local health officials to better watch over the spread of the killer virus.
“You can see where the cases are coming from, how many were admitted, how many died, what were the age ranges, which area they were coming from,” he says.
The latest figures from the CDC show the disease has killed nearly five-thousand people, primarily in Guinea, Liberia and Sierra Leone. Koirala says he now understands why Ebola has ravaged the region.
“They didn’t have enough treatment centers throughout the country of Sierra Leone," he says. "At that time there were only two treatment centers, and they didn’t have enough beds to treat the people. They only had two labs that were capable of doing blood tests for ebola.”
In addition, he says, doctors and aides have had to battle misperceptions and mistrust among skeptical citizens.
“People were not taking Ebola as a real disease," he says. "They were thinking this was a scam by government or health-care providers. That they wanted to kill people to sell their blood or organs for money.”
Koirala says there are more myths surrounding Ebola. Many people believe an infected person, even if cured of the virus, carries it forever and is always a risk to transfer it. This has led to another crisis in Sierra Leone, a nation of nine million: homelessness.
“We have seen people who have been cured of Ebola and discharged from the hospital, who are not being accepted by the community, who are not being accepted by their family members," he says. "So they were just wandering around the streets because they didn’t have any place to stay.”
While Koirala was in Sierra Leone, cases of Ebola surfaced in all but one of the tiny nation’s 14 districts. Four cases have been confirmed in the U.S. with one death. Thirteen people in Iowa who have traveled to West Africa are being monitored; one is under self-quarantine at home. But Koirala is certain the virus will eventually be controlled.
“Ebola is a dangerous disease, but we know how to control it," he says. "One thing, it’s not transmissible through air, and not through water or food. It’s just through bodily fluids and direct contact.”
Koirala says he does not plan to return to West Africa anytime soon. Between now and next summer, he will study infectious diseases that are more common to Iowa.