The harsh yet inspiring reality of working on the frontlines of the Ebola epidemic was laid bare Monday at the American Society of Tropical Medicine and Hygiene (ASTMH) annual meeting when a Tulane University professor recounted in detail,  her experience combating the deadly disease.

Speaking to a packed and attentive audience that spilled out into the hallway, Frederique Jacquerioz Bausch, Assistant Professor of Clinical Tropical Medicine at Tulane, described working in Guinea and the situation in all three affected countries as what seemed, at first, like a manageable challenge quickly morphed into a global public health crisis.

“In the first phase, we thought it was just another outbreak, but then everything got out of control,” she said.

Dr. Jacquerioz described the many ways health care professionals improvised on the spot each day as they were confronted with a series of crises within the crisis.

She showed pictures of the low orange fencing that was used to keep patients isolated but still visible and able to talk to their loved ones. The goal was to separate the patients but also put to rest, rumours that they were being killed rather than being treated. A balky monitoring device that wasn’t functioning well in the heat was sometimes encased in ice. A white board was set up for cleaning staff to help physicians keep track of patients’ fluid loss, the replacement of which was essential to saving lives.

She also talked about the complicated dance between patients being artfully vague about their symptoms for fear of quarantine and the medical professionals who urgently needed to establish the epidemiological links that are critical to stopping the epidemic.

“They learned very quickly not to say certain things…and we had to balance the risk of not letting someone go back into the community with Ebola versus putting someone inside unnecessarily,” Dr. Jacquerioz said.

While she showed a graphic picture of a patient in the late stages of an infection, Dr. Jacquerioz said that what is more remarkable—and challenging—about Ebola is that for most of the course of the disease, it presents only with symptoms like fever, headache, vomiting and diarrhoea “that could be common for many illnesses.”

She described how intensely healthcare teams focused on safety.

They established low- and high-risk zones and prescribed different types of equipment that had to be worn for each. They also practiced getting in and out of their gear repeatedly, and staff always attended to a patient in pairs. “If anything happens inside, that person helps you get out,” she said.

Hospital staff also had to come up with systems for dealing with all of the contaminated clothing, bedding, and medical waste generated by Ebola patients— and with their bodies if they died. She said the hospitals adopted a simple rule: “everything that can be burned is burned.”

Dr. Jacquerioz closed with a message of hope. She showed a picture of a group of smiling, energetic young boys who had survived their encounter with Ebola.

“The little guy in front…his name is Courage and the one in the back is named Success. These kids should inspire us.”