I arrived in Sierra Leone during the 2014 Ebola epidemic on Oct. 22, 2014, as part of a traveling group of 5 US Public Health responders working on behalf of the Centers for Disease Control and Prevention and joining a larger field team spread throughout the country. This was the first time I had been called to an outbreak, and I knew 2 things: I would be assigned to the infection prevention control team covering the maternity hospital isolation unit, and I should be ready for “rough conditions.” The short commute from the hotel took an hour during afternoon traffic. We pulled into the hospital gates to a courtyard crowded with people. Because we had not been screened on entry to the hospital grounds, I suspected they hadn’t been either. I stood the recommended arm and a half length away from people in the crowded hospital courtyard, knowing this would be the first of many long hours spent at the maternity hospital. My colleague gave me a tour of the facility: the isolation unit for women with suspected or confirmed Ebola virus disease (EVD), hospital wards, screening areas, morgue, laboratory, pharmacy, patient waiting areas, and the incinerator. Little did I know how accustomed I would grow to the smell, smoke, and eye-burning effects of the incinerator. I walked awkwardly behind her trying not to get too close to anything or anyone and followed her lead as we stood to the side while men in full personal protection equipment carried bodies on stretchers past us to the morgue. No one can quite prepare for these “rough conditions.” I was shocked at the large size of the hospital compound and the throngs of people who seemed unfazed to spend an afternoon in a hospital courtyard during an EVD epidemic. There were no weekends. Staff at the isolation unit worked nonstop, 7 days a week. The head nurse of the isolation unit would become a friend. During my 35-day tenure at the hospital, I would see her mood fluctuate from an ever-present exhaustion to hope and optimism with rare bouts of sadness and hopelessness. I wished I could give her the reprieve she undoubtedly needed and worried for her health and stamina.

I was and remain awed by the magnitude of courage, strength, and optimism maintained by health care workers staffing the isolation unit. Most were nurses, lab technicians, and cleaners reassigned from their regular hospital jobs to work the isolation unit. They were now friends and had become a family.

For these isolation unit staff members, the epidemic became personal through the death of colleagues, friends, family members, and the constant death of mothers, unborn children, and infants. Yet, on the steps of the vacant building facing the isolation unit, staff members shared meals, laughed together, and monitored each other’s donning and doffing of personal protection equipment. I often arrived in the afternoon to hear stories of the events since the previous night. Sadness and despondency over the death of a mother and fetus, frustration over not being able to intervene medically to help save a woman’s life, and the mental and emotional toll of turning women away because of the unit being at capacity seemed to wear off by midafternoon, replaced by managing EVD labs and test results for new and current women to be triaged or hopefully sent home in the case of negative test results. I, on the other hand, would often become emotionally stalled and shocked at news of the death of a woman I saw admitted the day before. Nursing staff would in a matter-of-fact way assure me the woman did indeed die and suggest that we move on to discuss the current day’s EVD labs and test result statistics.

Conversations outside the isolation unit were upbeat, casual, and often about the lengthy wait for patient lab results, lunch, how hard it was to keep family and friends of women inside the isolation unit from touching them through open windows, and the recurring joke about who had to rush up to the unit to stop a woman from “getting up and walking out” of the isolation unit. The comfortable and everyday nature of these conversations often caused me to forget that we were talking about Ebola and the fact that a nurse, not donned in personal protection equipment, had to figure out how to convince a pregnant woman emerging from the isolation unit to return to her bed. This was courage and strength in action to end an epidemic. Accompanying the casual conversations among nurses and lab technicians were seemingly emotionally detached more subdued questions about whether the burial team had come to pick up bodies from the hospital morgue because evening was coming and “Bodies don’t sleep,” and “Oh, did they get the baby? Yes, babies don’t sleep either.”

Only once did I witness anger and hostility, though not by a health care provider. A well-known, prominent woman had just died in the isolation unit after a transfer there for postpartum hemorrhaging shortly after delivery. The crowds, family, and friends of the deceased woman were angry; the isolation unit nurses were upset and flustered. They had done all they could do to stop the bleeding with the sparse supplies to which they had access. My skin color became a privilege in Sierra Leone. As an African American woman, often mistaken for being Sierra Leonean, I blended in quite well. Hurrying through the hospital courtyard that day, angry glares were turned on my white colleagues. It was clear that Ebola was not immune from the perception that Westerners brought the disease with them to West Africa.

As I prepared to leave Sierra Leone, I was struck with deep sadness and some embarrassment. I was leaving. I had the power to leave. It was hard not to believe that local Sierra Leoneans with whom I had built close relationships would consider me the typical “Western helicopter researcher.” We “fly in,” do our work, and then go home. Many of the nurses were my own age and with great courage risked caring for women in the EVD isolation unit while their spouses and children were at home.

I will forever be grateful for my time spent in Sierra Leone during the Ebola epidemic. It has been a tremendous honor to work alongside such courageous and brave health care workers.