As Ebola-stricken Charlotte missionary Nancy Writebol prepares for evacuation from Liberia to Emory Hospital in Atlanta, two other missionaries who served in the West African nation are being housed temporarily at the Charlotte campus of SIM – the Christian missionary group that sent Writebol and husband David to Liberia.
The two missionaries, along with their six children, returned to the United States on Sunday, SIM said, and are now living in an RV park on the SIM campus.
In a Monday interview, SIM USA President Bruce Johnson said the returnees are all healthy and will stay as long as they need to relax after the long plane flight and steer clear of the media limelight.
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“The issue is privacy, it’s not quarantine,” Johnson said.
In Liberia, he said, the two adults now in Charlotte were part of SIM’s missionary staff. Asked about their duties and whether they worked at the the SIM-run hospital or Ebola clinic, Johnson said, “When you’re in that situation, it’s ‘what needs to be done.’ They were helping out in whatever way they can. But they’re nonmedical personnel.”
To protect their privacy, SIM officials would not release their names or hometowns, but said they are not local. They are from “Kansas or California,” SIM spokesman Palmer Holt said.
Johnson said the missionaries and children were cleared to fly on commercial flights after on-site doctors in Monrovia, Liberia’s capital, consulted with SIM’s medical director in Charlotte. Then, once they had arrived at the SIM campus in Charlotte, they all received medical assessments, Johnson said.
In its statement to the media, SIM said it is “following strict personal and public health safety protocols established by the (Centers for Disease Control and Prevention) and the World Health Organization regarding its personnel. No returning SIM staff members are ill or showing symptoms of infection. SIM medical staff, in cooperation with area healthcare professionals, will continue to monitor their health .”
Dr. Marcus Plescia, director of the Mecklenburg County Health Department, said he was notified Friday by state health officials that SIM would be bringing missionaries from Liberia to the county. SIM officials had also contacted Dr. Stephen Keener, the county health department’s medical director.
“It sounded like they were being extremely responsible,” Plescia said of SIM officials.
Although the missionaries and their children are on the SIM campus, there is no requirement that they stay, Plescia said. “They don’t necessarily have to treat these folks any differently unless they develop symptoms. It’s not until people are symptomatic that they’re infectious.”
The incubation period for Ebola virus is 21 days, which means it can take that long after exposure for symptoms to appear.
Johnson said that SIM has also been coordinating with Carolinas Medical Center, the North Carolina Division of Public Health and York County public health officials. The SIM campus is near the South Carolina border.
Even though there’s only a “very slim chance” that any of them will show symptoms of Ebola, Johnson said, “we wanted to really go beyond that and be a good citizen. We reviewed our protocols with them and they said, ‘You’re going above and beyond.’ ”
Johnson said SIM, which has a medical director and two nurses on staff in Charlotte, brought in a third nurse, one who had served in Liberia, in anticipation of the arrival of the missionaries and their children.
Twenty to 30 of SIM’s 100 staffers in Charlotte are also serving the returnees, bringing them food and buying them clothes.
“They came back with backpacks. That was it,” Johnson said.
Johnson said he also went to the RV park Monday morning to visit the returnees and had a “hugfest” with the kids – partly to allay any fears by staffers and others.
Though the missionaries and children who came from Liberia are the only ones using the RV park now, Johnson said it’s routinely used to help returning missionaries recover from international travel.
To Charlotteans who may be alarmed by the presence of missionaries and children so recently in Liberia – a country where Ebola has killed more than 200 – Johnson said he would say this: “I hugged them, I held their hands. Because they are healthy, and they are not on our campus in quarantine. They are on our campus because this is regularly what we do.”
SIM declined an Observer request to interview the two adult missionaries.
‘We are ready’
Dr. Katie Passaretti, medical director for infection prevention at Carolinas Medical Center, said SIM officials are “monitoring vigilantly for symptoms. They’re watching everyone closely.”
But she added that if someone should become symptomatic, the first step would be to determine if the symptoms are related to Ebola or something else. Last week, for example, a patient with a fever showed up in the CMC emergency room after traveling from Liberia. Considering the potential for Ebola, the hospital closed off a corridor in the ER to make sure there was no risk of transmission until the patient could be diagnosed. It turned out the patient had malaria, which is transmitted by mosquitoes and not person to person.
Since then, Passaretti said medical personnel have held meetings to go over emergency protocols. “We were prepared before that, but that definitely kicked things up even higher,” she said. “We are ready if it happens.”
There is no known cure for the virus, which causes raging fever, vomiting, diarrhea and uncontrolled bleeding. Treatment amounts to “supportive care,” including IV fluids and nutrition to keep patients hydrated and maintain energy so their immune systems can fight the infection. If patients start to have internal or external bleeding, they can receive blood platelets and clotting factors.
“The type of isolation you need for Ebola is a variation of what we do for a number of other pathogens,” Passaretti said. “What happened last week could have turned out different. We’d be silly not to be prepared.”
Officials at SIM have been “very good partners,” said Jennifer MacFarquhar, an epidemiologist with the North Carolina Division of Public Health. She said the returning missionaries and their children had been monitoring their health before they left Liberia and continue to be checked at least twice a day.
“What’s important is that these people are healthy. And they will be in communication with us if anything changes,” she said. “There is no cause at the moment for concern.”
Doctor’s condition is improving
The 59-year-old Writebol will be taken to an isolation unit at Emory Hospital in Atlanta that was set up in collaboration with the nearby U.S. Centers for Disease Control and Prevention.
She’ll be the second Ebola-stricken patient to be taken from Liberia to Emory for treatment. Dr. Kent Brantly, a physician working with Boone-based Samaritan’s Purse, arrived at the hospital Saturday.
Brantly’s condition “is improving,” according to a statement Monday from Samaritan’s Purse, which also disclosed that he received a dose of an experimental serum before leaving Liberia.
Writebol and Brantly both worked at a hospital and clinic in Monrovia, Liberia’s capital. Writebol also received a dose of the experimental serum.
David Writebol, who has shown no symptoms of the disease, is also expected to fly to Atlanta to be with his wife. The couple has two grown sons.
At the ELWA (Eternal Love Winning Africa) Hospital in Monrovia, which is run by SIM, Nancy Writebol has worked as a personnel coordinator. More recently, she was working as a hygienist, spraying protective suits worn by health care workers who were treating Ebola patients.
David Writebol has been the ELWA services manager, responsible for managing electricity, water and sanitation services for the 130-acre campus. The couple, who married in 1974 and moved to Charlotte in the 1990s, joined SIM in 2013 after 14 years of service to orphans in Zambia and Ecuador.
“They are quiet and unassuming – not people who seek the spotlight,” Senior Pastor at Charlotte’s Calvary Church John Munro has said of the couple. “They’re following Christ. The Gospels tell us to follow him, irrespective of the costs. They took it literally, and we’re very proud of them.”