ANDREW LIMBONG, HOST:
I want to tell you about a doctor who was in Rwanda helping patients during the country's first Marburg outbreak. This was one year ago. The virus is a cousin to Ebola. It's nasty and deadly, and more than 75% of patients who got sick were doctors and nurses. NPR's Gabrielle Emanuel spoke to a doctor who was there and survived.
GABRIELLE EMANUEL, BYLINE: Tsion Firew had just finished running a first aid training when she glanced down at her phone. It was a message about a colleague. It said, pray for her. Firew was confused.
TSION FIREW: She's very young, full of energy, one of the smartest nurses I've ever worked with. When they told me all of a sudden that she's been hospitalized, for me, it was like, OK, this is a little bit concerning or what this could be.
EMANUEL: Firew is an emergency room doctor at King Faisal Hospital in Kigali, Rwanda. Later that day, Firew went to visit the nurse. She was in the intensive care unit. Peeking behind the screen, Firew was taken aback. The nurse was disoriented, eyes half closed.
FIREW: After I saw her, I was overcome with this emotion at a corner crying, and one of my colleagues came and consoled me.
EMANUEL: He gave her a hug and said they had no idea what was going on. In a bit of a daze, Firew went home to get her kids to bed. Later that night, she gets a text from the doctor who had consoled her at the hospital.
FIREW: He texted me saying, I developed a fever. I'm in the isolation unit.
EMANUEL: Soon, another text - the young nurse was dead. It was confirmed. She had died from Marburg virus.
FIREW: That's when I was like, Oh, God, like, this is real.
EMANUEL: Firew's mind was racing. She knew that Marburg was deadly. There's no approved treatment, and it's very contagious, spreading through bodily fluids, even sweat. That hug she'd gotten in the hallway, what if she'd been exposed to Marburg?
FIREW: And it was just extremely scary.
EMANUEL: What should she do about her children?
FIREW: Telling a 1-year-old and a 3-year-old, you know, stay at a corner, don't touch me, it was not going to fly, right?
EMANUEL: And her husband couldn't help. He was stuck in the U.S. He'd gone there for work, dropped in on his parents in Atlanta and gotten trapped there by Hurricane Helene.
FIREW: He couldn't even get out of his parents' house because there were trees everywhere.
EMANUEL: She realized she had no choice but to send her kids away. She put them with a cousin on a plane to Ethiopia where her parents live. All the while, her phone is lighting up with messages from colleagues who are developing symptoms.
FIREW: They would go isolate, they'll test positive, and then especially in the first three or four days, most of them died.
EMANUEL: She didn't tell her parents the whole story. She didn't want to scare them. But the day after the kids arrive, they call. It's about her 3-year-old.
FIREW: He develops a fever. Of course, I freak out.
EMANUEL: Could she have infected her son? The boy gets on the phone call.
FIREW: Mommy, I need you now. Where are you? Why are you not with me?
EMANUEL: For a moment, her emotions clouded her judgment. She bought a ticket to Ethiopia, then canceled it. The grandparents took the youngster to the hospital. Firew went to her own hospital where Rwandan health officials had already set up Marburg testing. She got tested and then put on full protective gear so she could care for Marburg patients, including the colleague who gave her a hug in the hallway.
FIREW: He was on the verge of dying. The course of the disease for me was extremely shocking. It's just like this, what I call the kiss of death, like where there's, you know, bleeding from the mouth and other orifices.
EMANUEL: Her fear carries her home. She calls up a good friend who lived through Ebola, looking for advice.
FIREW: I can't think clearly right now. All my judgment, everything is clouded. My colleagues are dying every day. Could I be next?
EMANUEL: The friend urges her to think through the practical steps. So she updates her life insurance policy. If she dies, how much will her family realistically need? It's now been five days. She's hardly slept. Alone and exhausted in her empty house, she starts hallucinating.
FIREW: I was hearing voices, the voices of my colleagues that just kept - kind of kept on repeating. So right when I'm about to doze off, oh, wake me up (ph).
EMANUEL: The most vivid voice was her colleague who'd given her the hug in the hallway. She hears him calling her name.
FIREW: It was just a complete nightmare.
EMANUEL: The next day, she gets up and heads into the hospital. Relatives had begged her not to, to leave it behind for the sake of her kids, her family. But Tsion Firew is adamant. She cannot leave. Her test had come back negative. She doesn't have Marburg, and neither, it turns out, does her son. Now it's time for her to do her part. After all, she says the Rwandan government was working hard to do things right. It had set up testing right away, same with isolation wards. It started a clinical trial for a Marburg vaccine within 10 days, and Firew had an idea to do something that had never been tried before - start people who'd been exposed on an experimental treatment even before they had symptoms.
FIREW: The idea was brought on that Tuesday. It was started on that Wednesday, and we gave it to over 150 health care workers that had high risk exposures.
EMANUEL: The research is still being done on the impact, but Rwanda did achieve the lowest death rate ever recorded for a Marburg outbreak. The virus has been known to kill up to 90% of patients. In Rwanda, it was 23%.
FIREW: Just to be part of this extraordinary response is such a big - I guess I'll say a big opportunity.
EMANUEL: Six weeks after the start of the outbreak, Firew's husband and kids were finally able to return home. She met them at the airport.
FIREW: My 3-year-old, he ran across the airport when he saw me, and it was, like, this prolonged hug. He just did not want to let go of me, which is a feeling that I've never had before.
EMANUEL: Gabrielle Emanuel, NPR News. Transcript provided by NPR, Copyright NPR.
NPR transcripts are created on a rush deadline by an NPR contractor. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.