A Liberian Doctor Comes Up With His Own Ebola Regimen

Oct 10, 2014
Originally published on October 10, 2014 6:43 pm

Dr. Gabriel Logan is a bundle of energy. Wearing a yellow dress shirt untucked from his slacks, he races around the Liberian government hospital compound in Tubmanburg, north of the capital, Monrovia.

He also moves fast on the medical front, experimenting with his own idea of treatment for Ebola patients.

Back in July this hospital, which was the main medical facility for the region, was closed after 10 of the staffers got sick with Ebola.

"We sent them to Monrovia," he says. Of the 10, only one survived.

When the hospital reopened in August, Logan at first tried to refer any suspected Ebola cases to Monrovia. Clinics in the capital had no room for them.

"Everywhere is filled, so I said to myself, 'Well then, as a doctor I have to do something to save some of the people's lives,' " Logan says.

So Logan set up a bare-bones Ebola isolation ward in a small building behind the hospital. He also started wondering whether any of the drugs in his pharmacy might work against the virus.

That's when he decided to try lamivudine, an antiviral medicine used to treat hepatitis B and HIV, on Ebola patients.

There's no approved medicine on the market to treat Ebola, and lamivudine is not even on the list of the World Health Organization's experimental prospects.

But Logan says he needs to do what he can now: "We need to save some of the lives of our people."

Of the 15 patients he treated with lamivudine, he says, 13 survived. Logan acknowledges that this is far too small a sample to prove whether lamivudine is effective. But that's not slowing him down.

"Do you expect me to wait until the bigger study is over?" he asks. "Then most of my patients would be finished. They would be dead."

Ebola hasn't just brought treatment challenges to Logan's hospital. He's also dealing with issues concerning the dead bodies. Body collectors are refusing to dig graves, saying it's not their job. And new cemetery space needs to be found because the current plot is full.

In addition, Logan has to organize care for 24 orphans whose parents died of Ebola.

And if that wasn't enough, he also has to combat fear of the hospital. Logan and his staff also treat people with illnesses other than Ebola, but patients are staying away. Just the word "Ebola" scares them.

"So we are out there talking to [the community], telling them there is hope," Logan says. "If you are sick you need to come."

The county has organized regular community meetings to handle questions about the outbreak. At a recent one, Logan tries to quash rumors that Ebola survivors are still infectious.

He's confrontational with the crowd, but in a good-natured way. Logan is affectionately known as "G-Lo" around the hospital — a mashup of his first initial and Logan.

Logan insists that survivors provide inspiration to Ebola patients and should get jobs at the new treatment unit being built by U.S. troops on the hospital grounds. He assures a grumbling audience that survivors will just be doing ordinary housekeeping. "They will not be serving medication," he says. "But they will be members of the team."

Currently Logan has just six Ebola patients in his ward, but he expects he'll need the full 100 beds in the facility being built by the Americans as this epidemic grows.

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Transcript

MELISSA BLOCK, HOST:

The Ebola outbreak in Liberia has crippled hospitals and clinics to the point that many have had to shut down. One such struggling facility is in rural Tubmanburg, outside the capital. The U.S. plans a new treatment center there, but completion is some time off.

NPR's Jason Beaubien has this profile of the chief government doctor in Tubmanburg who is experimenting with using an HIV drug to treat Ebola patients.

JASON BEAUBIEN, BYLINE: Dr. Gabriel Logan is a bundle of energy. Wearing a yellow dress shirt untucked from his slacks, he races around the Liberian government hospital compound in Tubmanburg, north of the capital of Monrovia.

GABRIEL LOGAN: All right. So let's start from the outpatient department.

BEAUBIEN: Logan moves quickly through the entry to the outpatient department. Currently, all patients, including those who might have Ebola, are mixed together in the hospital's poorly lit waiting room.

LOGAN: Everyone come to the hospital but following triage those that are related to Ebola will go to the Ebola center. Those that are non-Ebola will remain in the hospital for treatment.

BEAUBIEN: Back in July, this hospital - the main medical facility for the region - was closed after 10 of the staff got sick with Ebola.

LOGAN: They were confirmed. And following that confirmation, we sent them to Monrovia. So we sent 10 persons there. All of the 10 persons that was sent, only one person survive.

BEAUBIEN: When the hospital re-opened in August, Logan had first tried to send any suspected Ebola cases to Monrovia. But health facilities in the capital refused to take them, saying they were already full.

LOGAN: Everywhere is filled. So I said to myself, well, then as a doctor, I have to do something to save some of the people live.

BEAUBIEN: So Logan set up a bare-bones Ebola isolation ward in a small building behind the hospital. He also started wondering whether any of the drugs in his pharmacy might work against the virus. That's when he decided to try using Lamivudine, an antiviral medicine used to treat Hepatitis B and HIV, and use it on Ebola patients. There's no approved medicine on the market to treat Ebola. And Lamivudine is not one of the World Health Organization's top experimental prospects. It's not even on the list of prospects.

LOGAN: What can we do now, Jason, we faced with an epidemic. We need to save some of the life of our people. We can't watch all these people to die.

BEAUBIEN: Of the 15 people he treated with Lamivudine, he says 13 of them survived. He acknowledges that this is far too small a sample to prove whether Lamivudine is effective, but that's not slowing him down.

LOGAN: Do you expect me to wait until the bigger study is over? Then most of my patients will be finished. They will be dead. I need to save some of them. So I have to do whatever I can do now to help them.

BEAUBIEN: Ebola hasn't just brought treatment challenges to Dr. Logan's hospital. He also is dealing with issues concerning the bodies of the dead. Body collectors are refusing to dig graves, saying it's not their job. And new cemetery space needs to be found because the current plot is full. In addition, Logan has to organize care for 24 Ebola orphans. And as if that wasn't enough, he has to combat local fear of the hospital.

LOGAN: We have to treat people for other illnesses other than Ebola. So the hospital is open. Why it is true that because of the name Ebola is so fearful, so some of the patients are also not coming to hospital. So we out there talking to them. There is hope. If you are sick, you need to come to the hospital. But we're still talking to them.

BEAUBIEN: The county has organized regular community meetings to handle questions about the outbreak. At a recent meeting, Dr. Logan tries to quash rumors that Ebola survivors are still infectious.

LOGAN: One of my survivor told me that you people in the community saying she will not come and help to work. Why would you people do that? OK. Yeah, go ahead.

BEAUBIEN: He's confrontational with the crowd but in a good-natured way. He's affectionately known as G-lo around the hospital, a sort of hip-hop mash-up of his first initial and Logan. Logan insists that survivors provide inspiration to Ebola patients and should get jobs at the new treatment unit being built by U.S. troops on hospital grounds.

LOGAN: So what they like to be doing is like ordinary housekeeping job, which, you know, anyone can be trained to do. They will not be serving medication, no. But they are member of the team.

BEAUBIEN: Currently, he has just six Ebola patients in his ward. But he expects he'll need the full 100 beds in the facility being built by the Americans as this epidemic grows. Jason Beaubien, NPR News, Tubmanburg, Liberia. Transcript provided by NPR, Copyright NPR.