{"id":378,"date":"2015-02-10T20:18:02","date_gmt":"2015-02-10T20:18:02","guid":{"rendered":"http:\/\/www.mc.vanderbilt.edu\/vanderbiltmedicine\/?p=378"},"modified":"2021-08-11T19:41:41","modified_gmt":"2021-08-11T19:41:41","slug":"called-to-serve","status":"publish","type":"post","link":"https:\/\/medschool.vanderbilt.edu\/vanderbilt-medicine\/called-to-serve\/","title":{"rendered":"Called to Serve"},"content":{"rendered":"
\"Boris<\/a>
Boris Pavlin, M.D. Photo by Matej Kolakovic.<\/figcaption><\/figure>\n

Within days of arriving in Liberia in September 2014, Boris Pavlin, M.D., \u201803, cared for three patients with Ebola\u2014a mother, father and young son. It was his first face-to-face contact with the rare and deadly infectious disease that was raging through West Africa.<\/p>\n

Pavlin, an epidemiologist with the World Health Organization, was stationed in Sinoe County in southeastern Liberia for six weeks as a field coordinator. The remote area is extremely poor, with little access to health care services.<\/p>\n

He immersed himself in the county\u2019s health team, first acting as a technical adviser in how to put on and take off personal protective equipment (PPE). \u201cWe just buckled down and did the work that had to be done,\u201d he said.<\/p>\n

Once the first patients presented, he designed and set up an isolation ward, and then supervised the health care staff taking care of the patients so that the patients were cared for safely and effectively.<\/p>\n

The young boy with Ebola, who was malnourished prior to contracting the deadly virus, died several days later, and part of Pavlin\u2019s work turned to instructing teams how to bury the boy safely, effectively disinfect the family\u2019s home, and dispose of their contaminated belongings.<\/p>\n

A few weeks later the parents, now recovered, returned to visit Pavlin and his team, which included colleagues from the Ministry of Health and the Centers for Disease Control and Prevention (CDC). \u201cThey came back to be our \u2018ambassadors of hope\u2019 to the rest of the community so that people could see that Ebola isn\u2019t a death sentence,\u201d Pavlin said.<\/p>\n

\u201cI got all choked up when I was able to shake their hands, the first time I had shaken hands with another person in two months. After all, they were the only two people in Sinoe that I knew didn\u2019t have Ebola. I wanted people to see there was no reason to fear the survivors. They were just beaming. I\u2019ll never forget that.\u201d<\/p>\n

Pavlin, based in the Pacific Island nation of Papua New Guinea, has a background in hemorrhagic fevers such as Ebola. He trained as an Epidemic Intelligence Service Officer in the CDC\u2019s Special Pathogens Branch, and has always followed outbreaks closely. \u201cAfter two invitations to be deployed that I had to turn down because of other work commitments, the outbreak was declared a \u2018Grade 3\u2019 corporate-level emergency response and it became clear that responding to the outbreak was the highest priority,\u201d he said.<\/p>\n

\u201cI had been following this outbreak from the beginning, and like just about everyone else I never expected it to become as out of control as it has become. There have been many outbreaks in the past, and they all tended to either burn themselves out or they were able to be brought under control using conventional methods of meticulous case finding, contact tracing and safe burial of each case.\u201d<\/p>\n

Pavlin credits Medecins Sans Frontieres (Doctors Without Borders) for being the only voice of dissent early in the outbreak\u2014they said this outbreak was different. \u201cBut unfortunately it seems no one listened,\u201d Pavlin said.<\/p>\n

 <\/p>\n

Duty-bound<\/strong><\/p>\n

In addition to caring for patients in Liberia, Pavlin also participated in policy and planning during his 90-hour work weeks. Several times a week, he attended task force meetings at the county level, providing guidance to the various other sectors working on Ebola-related issues such as public works (roads) and education (reopening schools). He also attended town hall meetings in communities to educate them about Ebola and to answer questions.<\/p>\n

He spent countless hours in a four-wheel drive trying to negotiate what he called the worst roads of the 65 countries he\u2019s visited. \u201cIt really gave me a sense of the logistical challenges posed by the crisis.\u201d<\/p>\n

Pavlin said he was cautious when caring for Ebola patients, and not overly afraid. Standard PPE was a pair of rubber gumboots, an impermeable coverall suit, double gloves, mask and goggles. \u201cThere were a few specific times when things didn\u2019t go as well as they should have,\u201d he said. \u201cOnce when we disinfected and removed our PPE, I realized that the disinfection solution had been grossly underconcentrated. If you can\u2019t smell the chlorine in it, it\u2019s ineffective. Therefore, we were probably covered with live virus while disrobing.\u201d<\/p>\n

Pavlin said he was able to set aside his own fears because a population of patients needed help in a community unable to care for them. \u201cI felt duty-bound to do it. I feel like I can protect myself adequately, and if I hadn\u2019t been willing to go in and expose myself to care for the patients, I don\u2019t think the local health care workers would have been willing to either. Or even worse, they would have felt obligated to provide care but would have done so without adequate training or supervision and then would have become victims themselves. I couldn\u2019t live with myself if that happened.\u201d<\/p>\n

After leaving West Africa in mid-October, he remained in Switzerland, Australia and the Philippines for 21 days before returning to Papua New Guinea so he would have access to appropriate care in the event he got sick and to allay fears that he might bring Ebola into the country.<\/p>\n

Initially drawn to public health because he was inspired at Vanderbilt University School of Medicine by William Schaffner, M.D., chair of the Department of Preventive Medicine, Pavlin said that Schaffner \u201copened my eyes to the world of public health and he has continued to be a mentor to me ever since.\u201d<\/p>\n

Hopefully events like the Ebola crisis will help public health take its proper place at the forefront of medical teaching, Pavlin said. \u201cOur medical schools have placed way too much emphasis on curative services.\u201d<\/p>\n

Pavlin, who speaks five languages, returned to Sierra Leone in December and will be there until the end of February, and then on to wherever the next public health emergency takes him.<\/p>\n

\u201cMy wife met me when I was at the CDC in Special Pathogens Branch so she kind of knew what she would be getting into. She was very supportive of my going (to West Africa). She knows it\u2019s important to me, that I have a rare skill set that is very needed and that I do what I need to stay safe. Still, she\u2019s always relieved when I come home in one piece.\u201d<\/p>\n

 <\/p>\n","protected":false},"excerpt":{"rendered":"

Within days of arriving in Liberia in September 2014, Boris Pavlin, M.D., \u201803, cared for three patients with Ebola\u2014a mother, father and young son. It was his first face-to-face contact with the rare and deadly infectious disease that was raging through West Africa. Pavlin, an epidemiologist with the World Health Organization, was stationed in Sinoe…<\/p>\n","protected":false},"author":216,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2},"_links_to":"","_links_to_target":""},"categories":[20,29],"tags":[],"class_list":["post-378","post","type-post","status-publish","format-standard","hentry","category-vm-related-content","category-vm-winter-2015"],"acf":[],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"","jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/pcDnub-66","_links":{"self":[{"href":"https:\/\/medschool.vanderbilt.edu\/vanderbilt-medicine\/wp-json\/wp\/v2\/posts\/378","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medschool.vanderbilt.edu\/vanderbilt-medicine\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/medschool.vanderbilt.edu\/vanderbilt-medicine\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/medschool.vanderbilt.edu\/vanderbilt-medicine\/wp-json\/wp\/v2\/users\/216"}],"replies":[{"embeddable":true,"href":"https:\/\/medschool.vanderbilt.edu\/vanderbilt-medicine\/wp-json\/wp\/v2\/comments?post=378"}],"version-history":[{"count":1,"href":"https:\/\/medschool.vanderbilt.edu\/vanderbilt-medicine\/wp-json\/wp\/v2\/posts\/378\/revisions"}],"predecessor-version":[{"id":3168,"href":"https:\/\/medschool.vanderbilt.edu\/vanderbilt-medicine\/wp-json\/wp\/v2\/posts\/378\/revisions\/3168"}],"wp:attachment":[{"href":"https:\/\/medschool.vanderbilt.edu\/vanderbilt-medicine\/wp-json\/wp\/v2\/media?parent=378"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/medschool.vanderbilt.edu\/vanderbilt-medicine\/wp-json\/wp\/v2\/categories?post=378"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/medschool.vanderbilt.edu\/vanderbilt-medicine\/wp-json\/wp\/v2\/tags?post=378"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}