Kaci Hickox spent her last night in Sierra Leone trying to save the life of a young girl suffering from Ebola.
The next morning, the girl was dead.
“I don’t remember her exact age. I think she was 10, but to watch a 10-year-old die alone, in a tent and know there wasn’t anything you could do … it’s hard,” she said, her eyes tearing up.
Hickox said she never kept track of how many patients died during her month-long stint at the health care center in Bo, Sierra Leone’s second largest city, where she cared for Ebola patients. But the day she left, she did look at the number of patients who had recovered and left the hospital. A total of 39 Ebola patients treated there survived the disease, and each time one walked out there was a big party.
“Those are the faces I try to remember,” she said Saturday afternoon during a wide-ranging interview with the Maine Sunday Telegram in her Fort Kent living room. It was the first in-person interview Hickox has granted since returning to the United States more than a week ago.
Since then, the 33-year-old nurse has been the focal point in a national debate about how to handle the hysteria over a disease that most Americans know little about, and how to balance the rights of health workers with the rights of the public.
Media have been camped for the past week outside the home in Fort Kent that she and her boyfriend, Ted Wilbur, moved into in August. Hickox, who has shown no symptoms of infection and has tested negative for the virus, has defied attempts by Gov. Paul LePage to keep her quarantined at home during the illness’s 21-day incubation period, which for her ends Nov. 10. But despite a judge’s refusal last week to grant the state’s request to impose a quarantine, she and her boyfriend say they will respect the wishes of town residents and avoid going into town during that time.
“I didn’t mean to bring this media storm onto this community, either, but I think unfortunately sometimes, especially when up against governors, you don’t always have an option,” she said. “I don’t feel like I was given an option.”
Hickox has been criticized by some Fort Kent residents and people across the country who feel she has failed to consider the public’s well-being by not volunteering to quarantine herself. In response, she has said she was trying to fight for something bigger than herself – the rights of other American health workers trying to stem the deadly disease in West Africa who will return home themselves at some point. Hickox said she feels her actions were right and justified.
“Sometimes we fight for our rights, but it doesn’t mean we have to act on them,” she said, paraphrasing something her lawyer has said.
“I hope in six months aid workers returning back can be unnoticed,” she continued. “They won’t be in the media like I was, I hope. And they can walk into a grocery store and maybe no one even knows they were working in a country with Ebola, but one day I hope everyone can know and still smile at them in the grocery store. I know that won’t happen today.”
Frustration marked much of her time in Bo.
She was frustrated because the protective gear she had to wear – “this sort of space suit” – made it hard to connect with patients, and the high temperatures inside meant she could only spend an hour at a time in the high-risk tent, which didn’t leave much time to provide care for the 30 or so patients in her care.
“As a nurse and health care provider, we like to be able to look our patient in the eye and hold their hand and to explain to them that we’re there for them,” Hickox said.
HER ROAD TO SIERRA LEONE
Kaci Hickox grew up in the small town of Rio Vista, Texas (current population: 909), just south of Fort Worth. When she was young – maybe 13 years old, she thinks – she remembers reading in a newspaper that children in Africa were dying of a disease she had never heard of called malaria.
“And it got me thinking,” she said. “What is this disease and why are kids dying from it?”
It would be convenient to think it was at that moment she decided to become a nurse and dedicate her life to fighting disease, but that’s not what happened. She tucked away that memory, though, and it resurfaced during her senior year of high school. She considers herself a “practical thinker” and knew she wanted to work overseas, work with people and find a job that provided some useful skills and job security. So she became a nurse.
She attended the University of Texas at Arlington and graduated with a nursing degree in 2002. After stints in the emergency departments of a few hospitals in Texas, Hickox pursued her desire to work overseas, traveling to Indonesia after the tsunami ravaged communities along the coastline there in 2004.
She never returned to Texas.
What followed was years spent traveling to other nations to fight infectious diseases and providing health care for some of the world’s poorest people. She spent two years in Burma, a few months in the Darfur region of Sudan, and later was in northern Nigeria fighting a measles outbreak.
It was while working in Nigeria that she heard from her sister that she had been accepted at Johns Hopkins University.
“I held back as much as I could, but I’m sure I made a little squealing noise as I sat there and read that message,” she said.
She moved to Baltimore while she completed the year and a half program and graduated with dual masters degrees in public health and nursing. After that, she moved to Las Vegas for a public health fellowship with the Centers for Disease Control, which lasted two years. It was there that she met her boyfriend.
Ted Wilbur had already been accepted to the nursing program at the University of Maine Fort Kent, so when Hickox’s CDC fellowship ended in July, the couple drove across country and rented the house on Violette Settlement Road.
After the Ebola outbreak struck West Africa, Hickox received several texts from friends asking when she would be heading to West Africa to help.
When she received a personal email from Doctors Without Borders, the organization she had worked for in Burma, Sudan and Nigeria, asking for volunteers, she knew she had to go.
NOT THE WELCOME SHE EXPECTED
She left Sierra Leone feeling proud of the work she had done, but she received a shock when she returned to the United States and landed in Newark, New Jersey, on Oct. 24. She was immediately forced into a quarantine tent outside a hospital, where she stayed for three days, despite showing no symptoms and a blood test that came back negative for Ebola.
At some point during her time in the isolation tent she realized she had been thrust into a battle about something much bigger than herself.
“I don’t think I question authority for questioning’s sake,” she said, “but I believe in doing things right and treating people well and I expect to be treated with the same respect and compassion I would treat people with and that is definitely not how I felt when I returned … both at the airport and unfortunately here in Maine as well.”
Many of her friends from Johns Hopkins have provided her support through her ordeal. The dean of the school of public health even wrote a letter to Gov. Chris Christie asking him to release her from the involuntary isolation at the Newark hospital.
She says she soon realized that if she was being treated this way, then other nurses and health care workers like her might be treated the same when they returned from West Africa.
“I’ve sort of seen the ripple effects of some of these policies – especially by outspoken governors like Christie and LePage – that have been put into place, and it’s scary,” she said.