Emory after Ebola: Teachable moments

Emory NursingFebruary 4, 2015
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As Emory Healthcare's treatment of Ebola patients made international headlines and prompted a meeting with President Obama, Ebola also became a topic in classes across the university. Shown here are students in the School of Nursing's course on Complex Humanitarian Emergencies, which was revised to include a focus on the epidemic. Healthcare photos by Jack Kearse; class photos by Steve Ellwood.

When Emory students returned to campus in August for the start of the 2014-15 academic year, their arrival came only days after two historic departures: Kent Brantly and Nancy Writebol, the first patients with Ebola virus disease to be treated in the United States, had just been discharged from Emory University Hospital.

But Emory's impact on Ebola — and Ebola's impact on Emory — reaches far beyond the hospital walls.

As Emory experts continued to treat Ebola patients throughout the fall semester, they also consulted and shared protocols with health care providers around the world. Meanwhile, Ebola inspired a "teachable moment" in classes ranging from biology to business and epidemiology to ethics.

Now, six months into the university's Ebola experience, Emory is established as an international leader in clinical care and research related to the virus, while all nine schools that make up the university have joined together for an in-depth educational response.

"Emory is committed to knowledge in the service of humanity," says Sita Ranchod-Nilsson, director of Emory's Institute for Developing Nations, who is co-chairing a semester-long, multidisciplinary forum on Ebola that began Jan. 26. "Here we have an opportunity to cross disciplinary boundaries, and also boundaries that often separate professional fields, to address a health crisis in West Africa that has truly global implications for all of humanity."

From clinical care to classroom discussions, the university-wide response to Ebola "has allowed us to share who we are with the world," notes Provost Claire Sterk.

"We are a community that, yes, has the courage and expertise to respond to this epidemic across a broad range of disciplines, but more importantly, we are a community that cares."

Coming together as an intellectual community

In perhaps the broadest example of Emory's academic response to Ebola, the nine schools that make up the university are uniting this semester to offer an extensive forum to explore the impact of Ebola virus disease on public health, policy, law, ethics, government, development, religion and more. The Ebola Faculty and Community Forum runs through April 13.

"Emory has a wealth of expertise in health care but also in the liberal arts, and particularly in African studies," says Pamela Scully, director of the Center for Faculty Development and Excellence, assistant vice provost for academic innovation, and professor of African studies and women's, gender and sexuality studies.

Scully, whose scholarship includes studying Liberia, one of the countries hardest hit in the current epidemic, serves as co-chair of the forum with Ranchod-Nilsson and Deborah Bruner, Robert W. Woodruff Chair in Nursing.

"Interdisciplinary perspectives are crucial to truly understanding both the impact of Ebola in West Africa, and how it has been understood in the USA," Scully says. "The forum brings together people from different disciplines to engage in a challenging conversation about ethics, the boundaries of knowledge, and the significance of scholarship in the world."

Forum speakers include Emory faculty, experts from organizations currently working on Ebola in West Africa, and former President Jimmy Carter, University Distinguished Professor at Emory and founder of The Carter Center.

Several speakers also serve on the Emory Ebola Task Force, a group of more than 20 Emory leaders who meet regularly to advise the university on Ebola-related research, education and policy.

"Emory is being looked to for guidance in a national and global conversation about Ebola," Bruner says, noting that the idea for the forum builds on the work of Emory's Commission on the Liberal Arts, for which she served as vice chair.

"One of the recommendations from the commission was to create opportunities for something we termed 'intellectual tailgating' — the idea being to take advantage of events, work or initiatives that are unique to Emory and really build a university-wide conversation," Bruner explains.

"Following on the heels of the commission, this seemed like the perfect, unique opportunity, because Emory has done such an ethical, responsible job in treating Ebola, but not only that, in putting out information and guidelines," she says.

The April 9 session with President Carter will be free and open to all who wish to attend. For most other sessions, students, faculty and other members of the Emory community may attend the first hour, while the second part will be reserved for a group of 20-25 faculty selected through a competitive application process.

The forum is organized by the Institute of African Studies, the Institute for Developing Nations and the Nell Hodgson Woodruff School of Nursing. All schools that make up Emory University have lent their support, Bruner says.

From clinic to classrooms

While the forum is the most formal, broad-based academic response to the epidemic, Ebola became a topic of discussion in a variety of courses last semester as both professors and students sought to learn more about the virus that placed Emory in the international spotlight.

Students explored Ebola in classes across a spectrum of disciplines, including biology, epidemiology and health, but also law, ethics, religion and business.

Polly Price, professor in the School of Law, included Ebola in classes she taught on immigration law and an introductory course on legislation and regulation.

In her classes, Ebola provided an opportunity to talk about the U.S. health care system, border control, state laws governing quarantine and isolation, worker safety, and even the broad concept of federalism, the relationship between the federal and state governments, Price notes.

"It illustrated one social problem that draws upon a number of areas of law, requiring some creative thought about how the pieces fit together," says Price, who spoke on public panels about Ebola as well.

Ken Keen, associate dean for leadership development at Goizueta Business School, included Ebola in a seminar on crisis leadership for Emory's Executive MBA program. He invited as a guest speaker Carlos del Rio, Hubert Professor and chair of the Department of Global Health at the Rollins School of Public Health and an infectious diseases professor in the School of Medicine.

"It was tremendous," Keen recalls. "I was trying to use what organizations are having to deal with, whether in a hospital or the CDC."

Students in instructor Amanda Freeman's "Current Topics in Human Health" class, offered through the Center for the Study of Human Health in Emory College, not only discussed Ebola, but got to hear directly from the man leading Emory Healthcare's treatment of Ebola patients — Dr. Bruce Ribner, director of the Serious Communicable Disease Unit.

Ribner says he was willing to take time out of his packed schedule of patient care, media interviews and consultations with other health care providers around the world to talk to an undergraduate class for a simple reason: "Because it was Emory."

"We turned down many more speaking engagements than we accepted, but we obviously have an allegiance to Emory. This is our institution," Ribner says. "A number of our faculty have given talks to various groups on campus. We've had great support from Emory University and Emory Healthcare and I think it is important to repay that support."

Making connections

In addition to specific coursework, Emory professors and students sought out other opportunities to address the many issues raised by Ebola.

Members of the Student Outbreak and Response Team at Rollins sprang into action in the fall when Ryan Lash, a global geographer at the CDC, asked for their help to create detailed maps of portions of Guinea, Sierra Leone and Liberia needed by humanitarian aid workers in remote areas.

The Emory students, about 45 in all, joined a movement through OpenStreetMap — dubbed the Wikipedia of mapping — that connects volunteers around the world who use satellite and other imagery to create maps showing villages, houses, buildings and more.

Additional "map-a-thons" are planned for spring semester, according to Lance Waller, Rollins Professor and chair of the Department of Biostatistics in the School of Public Health. Participants will receive brief training on the web-browser based tools, then get to work.

"Moving from education to action is a central part of what we do," Waller says. "The map-a-thon illustrates how we can put classroom skills to immediate use without even leaving campus."

University divisions such as Emory Law and the Center for Ethics stepped forward to host public discussions of issues raised by Ebola, connecting students, faculty, staff and the community at large.

"The treatment of patients at Emory evoked both reasonable concern and unreasonable fears in the public, raised questions of who was getting care and why, and was the catalyst for larger questions of how we think about and respond to epidemics in the world today, in both developed and developing countries," says Paul Root Wolpe, Asa Griggs Candler Professor of Bioethics and director of the Center for Ethics.

Adjusting plans to offer discussions of Ebola "fit seamlessly" into the mission of both the Center and Emory as a whole, Wolpe says.

"What makes a university special is that it is a rare place where experts from a variety of disciplines can get together and cross-fertilize their thoughts," he explains. "So often on TV and other media we hear pundits from two opposing sides express contrary opinions, while at Emory we instead try to enrich conversation by synthesizing the expertise of scholars."

Inspiring students to help

Whether freshmen or new graduates, Emory students now seek to use what they have learned through classroom and campus activities to try to help in the global fight against Ebola.

Sparked by an assignment on the first day of classes in "Introduction to Biology," Emory College freshmen Rostam Zafari and Brian Goldstone set out to develop a portable, fast field-test for Ebola.

Their proposal to create Rapid Ebola Detection Strips (REDS) made headlines on campus and beyond with a crowdfunding campaign through Indigogo. The pair beat their goal of raising $14,500 to fund research into their idea.

As the new semester begins, Zafari and Goldstone continue to work on Project REDS — learning more about themselves and becoming close friends in the process.

"This project has helped me in almost every aspect of my life," Goldstone says. "It has accelerated not only my academic, but personal development."

And while neither could have imagined the impact Ebola would have on their Emory experience from the very first day, they say it confirmed both their college and career choices.

"Emory is a place where you can go as far as your vision and hard work can take you," Zafari says. "It has definitely reinforced my decision for social entrepreneurship and global humanitarian work as well as furthered my interest in infectious disease."

Goldstone agrees, noting he is now "absolutely sure" of his goal to become a physician.

"This project and all the support we have received for it from our peers and the Emory faculty has absolutely reinforced my decision to come to Emory," he says. "This would not be happening at any other university, and I have been thrilled with the response of the university to what we are trying to do."

Emory's experience with Ebola is also inspiring students reaching the end of their education here. At least four School of Nursing students — three who graduated in December and one who graduates in May — are going to West Africa to help care for patients at the epicenter of the epidemic.

Emily Headrick, who graduated from the BSN/MSN Segue program in December and will be a family nurse practitioner, will spend six weeks working as a nurse in an Ebola treatment center, most likely in Sierra Leone.

Headrick had planned a career in global health, but says she decided to go to West Africa to care for Ebola patients after hearing a nurse who had returned from the region speak during a three-day intensive "Complex Humanitarian Emergencies" course offered in the School of Nursing during the fall semester.

Led by Elizabeth Downes, associate professor of clinical nursing, the course had been planned for a year but was reframed to include a focus on Ebola. Capt. Holly Williams, a nurse anthropologist/epidemiologist from the CDC and adjunct professor at the School of Nursing, co-coordinated the course, which included guest speakers from Emory, the CDC, Doctors Without Borders, The Carter Center and CARE.

"They talked about things such as transmission of the disease, adequate protective measures, and the mental health implications of Ebola. But just having these people who lived over there and who dealt directly with the crisis was educating in itself," Downes says.

Headrick credits her Emory education for preparing her to care for Ebola patients — both academically and ethically.

"As Emory nurses, we are nurtured to be leaders not only in our field, but in the increasingly complex field of health care, which, let's face it, is wrought with social and economic inequalities," she says. "Emory has prepared me to approach this work as an expertly trained clinician, but also as someone who believes that this seems like the right thing to do."

Rebekah Stewart Schicker earned her MSN and MPH degrees from Emory in December 2014 and says she will work for six weeks as a nurse in "Liberia, Sierra Leone or both depending on the needs at the time I go."

Schicker obtained a certificate in complex humanitarian emergencies as part of her MPH from Rollins School of Public Health and notes that "learning about the work being done all over the world in emergency settings solidified my desire and resolve to use my nursing and public health background to do humanitarian work."

While she admits she was worried for her own health when she first applied to work in West Africa, she says she later "realized that I would be more nervous to not help out in a crisis when I had the skills, training and availability to do so.  

"My life is not more valuable than the lives of the people living, working and enduring this crisis in West Africa. Many of them have already given their lives to care for the sick and dying," she says. "By joining the people of West Africa in this fight, I might be a part of the solution that brings this awful epidemic to a close and that both inspires me and gives me courage."