Atlanta is home to the CDC (Centers for Disease Control and Prevention), an organization with a mission to “protect America from health, safety and security threats, both foreign and in the U.S. Whether diseases start at home or abroad, are chronic or acute, curable or preventable, human error or deliberate attack”. This purpose means many of the world’s leading medical experts and scientists live in Atlanta or use CDC headquarters as a home base for deployments on health crisis around the world. Over the years, I have had the opportunity to work with CDC professionals on fundraising or awareness initiatives, and I am always impressed.
I first became interested in Ebola via the 1995 novel The Hot Zone, a true story about the emergence and containment of the Ebola Virus, a Biosafety Level 4 virus for which there is no cure. I found the book fascinating and horrifying. In the book, Richard Preston relates the true story of an Ebola outbreak, with details on how a pathogen such as Ebola travels globally and the devastation and commotion surrounding such an occurrence can cause in the circles of world health. The book also followed the plan and actions used to contain the virus, with an inside look at the team working behind the scenes to do so. For me, the most interesting part of the story was the detail surrounding research and containment by the scientist in the lab and field. These characters (non-fictional) were medical detectives, fearlessly tracking down the origin and spread of one of the most deadly viruses in the world, all to protect global public health. Talk about a heroic activity. At the time, I remember thinking how brave these individuals were, admiring their relentless pursuit of this evasive and deadly virus.
John Saindon is one such expert leading the containment efforts of Ebola in Liberia and also happens to be a good friend of mine. I recently sat down with John before he headed back to the front lines to get a better understanding of the CDC’s mission in Liberia, how Ebola and the outbreak of contagions in other parts of the world may affect us, and why we should care about and support the work being done by the CDC. I also wanted to know how a how John, a gay man from Kansas, ended up fighting for the health of a country where punishment for homosexuality is imprisonment for up to one year and a fine (if not worse).
Q&A: John M. Saindon, GS601 Health Scientist, CDC, U.S. Army Medical Service Corp
In his words.
Q: How did you, a gay man from Kansas, end up on the front lines fighting Ebola in Liberia, a country where punishment for homosexuality is prison?
Simply put, I volunteered. Since I was in high school, I have had this calling to do something greater than one’s self regardless of my sexual orientation. If I was going to allow my sexual orientation to offset set my progress of life I would’ve never joined the Boy Scouts of America and attained the rank of Eagle Scout, I would’ve never joined the US Armed Forces at a time when “Don’t ask don’t tell” was being enforced, I would’ve never been able to donate lifesaving stem cells to a leukemia patient; who happens to be alive 10 years later due to this donation, and most importantly I would’ve never been able to serve in Liberia in the time of their most need of support and solidarity. I have also been very proactive in life by attaining a clinical degree in Laboratory Technology, a masters and doctorate in health science and took on the challenging assignments when most would turn away.
Q: Have you ever felt threatened?
I personally have never felt threatened, but I make every attempt to mitigate being put into a threatening situation. This includes being aware of my immediate surroundings and not discussing topics that may make individuals from the host nation uncomfortable or angry. As representatives from the United States and international community, we all have a duty to promote partnerships anywhere we go.
Q: What is your mission/objective in Liberia?
I am currently on my 4th Deployment into Liberia for the Ebola response. Each deployment has entailed different objectives with the overall mission to support Global Health Security Agenda (GHSA). GHSA is a growing coalition of nations, joined with a common interest to prepare, prevent, and respond to disease outbreaks. During my first deployment in November 2014-January 2015, there were issues will Ebola specimens reaching the laboratories in a timely or consistent manner. At times, it would take up to two weeks for a sample to reach a lab and be tested. This delay added to the influx of Ebola cases because the delay inpatient intervention, contact tracing, and overall response. Within one month being on the ground in Liberia, I was able to coordinate with international and US sponsored partners to develop and implement a sample transport system that could be used to carry samples to laboratories throughout Liberia. This has evolved into a sustainable laboratory transport system supported by a team of over 50 motorbikes services all regions of Liberia.
The second deployment to Liberia June 2015 was to support the initial development of a strategic mapping guideline. This document would be the basis for partners to conceptualize and incorporate resources and support over the next five years. Also, emerging technologies to include Rapid Diagnostic Ebola Tests (30 minute Ebola screening tests) were being validated in Liberia and I led a team to implement this from phase 2 to phase 4 of 4 of validation requirements. Today these RDT kits are being used on daily basis and making an impact in Liberia.
The 3rd deployment to Liberia was to solve the issue of a major Ebola sample backlog occurring throughout the country. At the time, there was enhanced screening being required for all patients, thus most Liberians seeking medical care, were being required to have an Ebola test conducted to role our Ebola. This caused the sample volume to increase exponentially thus burdening the laboratories with more samples than they could process in a day. The other consequence was the increased volume was depleting the laboratory reagents and consumables at three times the rate as previous periods. My role was to coordinate with the laboratories, international partners and other related entities to mitigate the increased demand and to catch up with the 1000 plus backlogged samples. From a surveillance perspective, this backlog created great heartache, because a potential positive sample could be buried in the pile of samples needing to be tested, thus it could be up to 3 weeks before results of a new case would be identified. Within six weeks of being on the ground of Liberia, our laboratory team successfully cleared the backlog and was able to maintain day to day operations with existing sample volumes. Less than two weeks after clearing the backlog, our laboratory system was able to identify new cases of Ebola within 18 hours upon collection of the sample. If the backlog hadn’t been cleared, the Ebola virus would’ve had the opportunity to continue to spread thus a large scale outbreak could’ve developed. Instead the cases with limited to just three persons within the same household.
My current deployment in Liberia (ongoing for the next two years) is to continue to building a sustainable laboratory system that over the next five years, can be fully transitioned to the people of Liberia and sustained for many years to come.
Q: Why is Ebola in Africa an issue of concern to the CDC and the rest of the world?
Ebola is concerning to the United States and the world because of the knowns and unknowns. This is a virus that many researchers never would’ve thought or predicted to be a large scale thought. Also, the media coverage of the Ebola virus required lawmakers and agencies within the United States to respond with a barrage of humanitarian resources to include militarily, vaccine development, prevention, and clinical care practices. The CDC has some of the world’s leading expert’s related to hemorrhagic viruses and also was resourced (appropriated) to support the Ebola response in conjunction with multiple other United States partners and international partners.
Q: What are the next steps now that the virus is contained?
Now that the virus is considered contained, we still need to ensure sustainable laboratory services are maintained in the event of another outbreak rather it be Ebola or non-Ebola. Before Ebola struck the region, specifically Liberia, minimal capacity for any public health testing existed. Part of the GHSA goals and outcomes is to prevent this from happening again.
Q: How can people help you and your mission?
There have been many donor organizations that have directly supported our efforts while I’ve been in Liberia responding to Liberia. Here is a list.
John M. Saidon served as the Lead Laboratory Advisor and Deputy Team Lead during the Ebola outbreak in Liberia. Responsible for the coordination of personnel, resources, and day to day operations of all laboratory efforts in Liberia. Supported the GOL Ministry of Health sentinel pathogen surveillance and diagnostic planning initiatives to include the development of a nationwide IDSR Framework. Conducted baseline and follow-up assessments to identify public health gaps and recommended guidance to support GHS requirements. Developed and implemented sustainable public health laboratory models during and post Ebola in Liberia in conjunction with the GOL Ministry of Health and partners. Experience with developing and reviewing CDC and funding partner (WHO/World Bank) cooperative agreements, memorandum of agreements, data sharing agreements, and supplemental funding awards related to emergencypublichealthresponse. Also,ledemergencyresponse strategy efforts, provided technical assistance, and developed partnerships with USG and International partners to include; U.S. DOD, DOS, GOL/MOH, USAID, OFDA-DART, UN (UNMIL, UNICEF, UNMER, UNOPS, WHO), Save the Children, Global Communities, Riders for Health, U.S. Affiliated Academic Institutes, IRC, IOM, and others.