By Dr. Ronald Hernández
Dr. Ronald Hernández (left) and colleague on arrival in Liberia.
Our words were “spoken” via Facebook, which for several weeks has hosted e pictures and comments from this doctor who might do well as a journalist himself one day….
Here is the story…
Hello. I hope we can meet. Till then, take care of yourself.
Ronald: Hello. I’m here!
Hello again. I wanted to ask you a few questions, not only because the work you do is amazing but also because you’ve become the face of the group of our health professionals fighting Ebola in Africa. At least on Facebook there are Cubans searching for you to get information on how things are going over there. By the way, I am a journalist for the “Venceremos” local paper, and also a blogger in Guantánamo Province.
Ronald: I don’t think of myself as the face of our group of the Cuban collaborators…in fact, in many of the pictures I post, you see their faces, not mine. I try to keep it like that, so most of the time I’m the one taking the photos. And what I do like is keeping people updated on what’s going on in Liberia.
There’s a lot of misinformation about what’s going on here. Also, it’s a real boost to receive thanks from friends and relatives who I’m about to provide news about.
Exactly. That’s why I wanted to interview you. Is it possible?
Ronald: Sure, you’re already doing it!
So, here’s the first question. Who are you? Where were you born? What did you study? How old are you? What’s your job in Cuba?
Ronald: I’m just an ordinary 45-years-old Cuban guy. I’m a specialist in family medicine. I have two children, three brothers. My parents are still alive, thank God. I am from Banes in the province of Holguin but I’ve always worked in Sagua de Tánamo. Right now, I live in Las Tunas Province and I work in the primary care section of the provincial health department.
I was born in Tacajo on May 4, 1969. I went to s school like any Cuban and graduated from medical school in Holguin in 1992.
I worked as a family doctor for two years as part of the Plan Turquino in Sagua (a program for rural and mountainous areas —Eds.) Three years later, I finished my residency in family medicine. Since then I’ve also headed teams at different levels, in Cuba and in both stints I did abroad: in Honduras and Venezuela.
Are you a leader of the team in Liberia?
Ronald: Here, I’m just a doctor.
Do you hold a degree in epidemiology? Do you have any experience in epidemiological situations requiring such a high level of care and training?
Ronald: I was the deputy director and director of the Municipal Hygiene Unit in Sagua over four years. I’ve taken courses in tropical diseases, medical emergencies and management.
As for experience, I’ve worked in emergencies involving cholera, dengue, malaria and TB. But nothing like Ebola.
How did you make it into the brigade? What was that process? I guess you know that some media are saying it was ‘mandatory’, that you were forced to go…
Ronald: Our disposition to go was the first thing required. Over here, we are just a portion of the ones who wanted to come. There were many more getting ready to do so. But there weren’t enough spaces, which frustrated a lot of the ones left behind. There is nothing ‘mandatory’ about it. I offered to come from the start. My boss didn’t let me go in the first group but I got lucky and he let me come in the second one.
I just said ‘Yes’. I filled out the form and made it to Havana with the rest of the doctors from Las Tunas for a month of training. Then we left for Africa. A lot was explained to us in Cuba before we left.
Did anybody drop out at the last minute?
Ronald: We all had to have a thorough medical check-up—tests of all kinds at the Hermanos Ameijeiras Hospital, and some people turned out not fit to go. The only dropouts in my group were due to medical conditions, by decision of the medical commission.
Rumor has it that you were told that if you got infected with Ebola you couldn’t return to Cuba in five years and in case of death, your bodies wouldn’t be brought back home. Is that true?
Ronald: Look, the fact is that a cadaver infected with Ebola is the most contagious element. Contact with cadavers explains many of the deaths here, too. But, first of all, we’re not going to die here. And second of all, if that were ‘my destiny’, then my body shouldn’t be transported back home to infect you all. That’s the way I think.
My apologies for talking about death. I know a doctor always works surrounded by it, but this time you have it closer than ever. Aren’t you afraid?
Ronald: No, I’m not. For over three months, I’ve been conscientiously preparing myself. Besides, there are situations that remind me that I’m a health professional and I must act as one and save lives. Yesterday, in the ward of confirmed Ebola cases, there was a 10-year-old girl who had lost her entire family to Ebola… and I mean the whole family… looking at her makes you feel like crying. But our job is not to cry; our job is to save her. That’s what we came here for.
Ronald: Living it is harder, a lot harder…
It must be heartbreaking to see the Ebola patients…
Ronald: It’s the hardest thing…and I’ve seen quite a few. First, the fever, the headache, muscle and joint pains; abdominal pain, diarrhea, vomiting, dehydration and bleeding at every possible level.
Nobody doubts the Cubans’ courage. But taking a look at the images, the number of deaths… many people here on the island look up to you but at the same time think you’re all ‘crazy’… in a good sense… but ‘crazy’ after all.
Ronald: We are crazy–about doing our job. Thinking we’re not going to do it? Now that would be really crazy…
I think people think that way because they wouldn’t have done what you all did, were they in your place. In the beginning you said you were just an ordinary guy but, actually an ordinary person wouldn’t go to another country to save lives putting his own at risk.
Ronald: There’s nothing extraordinary about it. We’re common and ordinary people who’ve been educated based on principles of humanism, altruism and internationalism. That’s our ‘destiny,’ and to fulfill it, we have to do it right.
How did your family take it?
Ronald: Hard. At the beginning it was a mess, no one understood my decision, especially my youngest boy. Then little by little, they grew used to the idea and now they’re more accepting. However, my mom’s birthday was last week and they couldn’t even make a cake for her: she said there’ll be no party until I get back home.
J: I guess that cake will deserve a Guinness Record Award by then…
Ronald: That’s right, maybe so.
How often do you communicate with your family and how does it go when you do?
Ronald: Through email, several times a day. We exchange messages and I call them on the phone. No problems in that sense.
Do you feel safe?
Ronald: Very safe. We have good living conditions, nutrition and protection gear.
What is the work like that you do in Liberia?
Ronald: I already shared that on Facebook, so I’ll copy the text from there and paste it here, not to abuse my fingers that are already hurting, since I’m writing on a cell phone…
It goes like this:
To answer questions I’ve received from a number of people, I’ll explain how the biosafety procedures work, essential for maintaining the good health of all personnel working here. First, the suits are impermeable. As you can see, they cover the whole body including the head that gets covered with a hood that it is part of the suit. We wear rubber boots, masks, glasses and two pairs of gloves.
In between patients we must wash our hands with hypochlorite at 0.5% and change the gloves. We always work in pairs or trios, making sure that each others’ suits are perfectly fit. Not one bit of the skin can be exposed.
The hospitalization of patients is subdivided into three groups: suspected, presumed and confirmed cases. The rounds start with patient one and continue until all have been seen. The flux is always in one direction; there is no coming back to the previous case.
During rounds, there is no use of personal items of any sort, not even pens. Everything is written on an information board: treatments, vital signs, temperature and pulse.
The most important thing is choosing a suit with the accurate size. And the greatest danger comes when you take off the suit, which might be contaminated with fluids or vomit from the patients.
On our way out, we get help from the epidemiologists. They are the soul of this mission. They guide us through all the steps for taking off the suits. They also give us psychological support, because after wearing the suit for two hours straight, we’re anxious to take it off and drink water, but we have to keep calm.
First, we get showered with hypochlorite at 0.5% all over the body and then slowly, we start shedding our protection…washing our hands… Anyway, it is a long, complicated and highly professional process that keeps problems from arising.
Another thing–if someone is working in the “red area” [where confirmed cases are hospitalized//Eds.] and starts feeling bad, becomes too thirsty or requires relief from a physiological need, the work stops right there and then, and the person is guided outside by their partner. After this is done, the person then gets supplied with oral rehydration salts and water.
We have set times to rest. The work is carried out in six-hour shifts, but we work in the “red area” for only two hours.
I hope this answers your question.
From a cell phone? My apologies. Just two more questions. How were you received by people in Liberia? Have you received encouragement through social networks? What do they say, the people who contact you?
Ronald: These are almost two questions… hahhaha. We never thought we would be received with so much public affection. The people who work with us every day are even speaking some Spanish. Every now and then, they tell us how grateful they that we’re here. It’s become like a second home to us.
Well… two questions, three questions… I know you have spent just a short time there, but I’m sure you already dream about coming back to the things you love. Your return to Cuba–because I’m sure you’ll come back–how do you imagine it?
Ronald: When I get back to Cuba, the first thing I want to do is see my family. Then, have a nice Cuban meal and then go back to work, which is my thing.
If you ever decide to leave medicine, you’d sure do well in journalism. You write well and clearly… anyway, thanks so much for sharing with me some of your Sunday time.
Ronald: A pleasure, my friend… and thanks but I would rather stay doing my thing. Abrazos to all.