Not a typical deployment, part 6

by Disease Detective, posted in APHA IH Section
Homecoming

After I came home, I began to process and tell the story of what had happened to me. My husband was sick with an upper respiratory infection, so I went to the pharmacy and the grocery store to get cough medicine and Gatorade. What should have been a quick run for supplies in a setting I had been in hundreds of times before triggered a panic attack. Initially confused and alarmed, I quickly learned that grocery stores are one of the most common triggers for anxiety and panic attacks. I spoke to my father and another close friend, both combat veterans, who were able to relate to my experience.

It took me several days to collect the mental strength to unpack my suitcases. I separated clean from dirty clothes, put away my shoes, and carefully hung up all the silk scarves I had taken with me to cover my neck from mosquitoes. I showed my husband the black feather I had kept from my visit to the church near the hotel, and he played Blackbird by the Beatles for me. I still have that feather on a bookshelf of mementos in my front hallway.

I also began to realize the scale of what had happened to my USAID colleagues who had been evacuated with me as Elon Musk and DOGE worked with Pete Marocco to feed the agency “into the woodchipper.” As difficult as it was to make myself sit down and write, I summoned the willpower to describe my airport companion’s story in a letter to my Congressional representative. I wrote the following letter on February 2.
I want to start off by saying how deeply I appreciate what the Congressman is doing today to try to help USAID. While I was studying for my PhD…I worked as a TA and had a student who now works at USAID as a foreign service officer. As you might imagine, she is beside herself with grief and rage. We are both sick over this whole situation. I hope that the Congressman and his allies in the Senate are able to put a stop to this in the short term. However, I wanted to share an account of something I recently experienced alongside a USAID contractor, which demonstrates that this rushed dismantling at the agency literally put American lives at risk overseas.

You may be aware of the fact that the U.S. embassy in the Democratic Republic of the Congo evacuated all non-emergency personnel under Chief of Mission (COM) authority in Kinshasa last week. I was there on TDY with CDC to assist with the agency’s country mpox response, so I was evacuated with everyone else. As a CDC employee, the process, though somewhat harrowing, was pretty straightforward. State Department personnel were incredibly professional and kept us all safe and informed. However, I met a USAID contractor for whom the process was not nearly as smooth.

She arrived on Sunday (26 January), the departure was ordered on Tuesday (28 January), and then she was furloughed by her employer in response to the freeze on foreign aid. At that point, things started to go off the rails for her and another colleague with her: because she was furloughed, she was told that (1) she was not allowed to use her government-furnished equipment (which is where the State Department instructions for evacuation were coming) and (2) they were not sure whether she was still under COM authority and thus eligible to be evacuated with USG personnel and their dependents. Her employer tried to tell her to get to the Kinshasa airport to take a commercial flight out after the RSO had specifically said that the airport (and the road to it) was not safe, AND after multiple news reports that commercial airlines were canceling service to Kinshasa. She did manage to get on the charter flight that got us all back to DC, but only after she reached out to her own Congressman.

I am reaching out to pass on this story in the hope that the Congressman can use it to raise awareness among fellow members of the consequences of this “move fast and break shit” mentality that the federal government is being subjected to by (unelected) Elon Musk. I have no doubt that USAID could have benefited from reform. However, government moves slowly for a reason. If this woman had not had the courage that she did, she and her colleague very well could have been left stranded in the middle of a country in upheaval, with no way out and no one to help them. It is America’s responsibility to take care of personnel who are working on behalf of the American people overseas. This attack on USAID put these American women at risk. There are very serious consequences to what Elon Musk is doing. If he is not stopped, I fear CDC may be next.
This is the first time I have read that message since writing it. I had no idea how right I would be about CDC.

This is the final installment of a multi-part series on a Section member’s deployment to, and evacuation from, the Democratic Republic of the Congo while on an emergency response assignment with the CDC. All views expressed here are the author’s own personal perspective and do not reflect the position of their employer or the U.S. government.

Not a typical deployment, part 5

by Disease Detective, posted in APHA IH Section, Emergency Preparedness and Response

Exodus

I woke up early on Wednesday morning, ate breakfast, and then brought my suitcases down to the lobby to check out. I was surprised to see a large group of Americans there for the same reason. Besides my fellow deployers, there was a group of a dozen or so with a distinctly ex-military look: large muscles, shaved heads, camouflage duffel bags. One guy had a ball cap with the Marine insignia that read SEMPER FI. I approached them, smiled, and said good morning. Are you all with CDC? No, they answered, we work at the embassy. When I asked what they did there, one man answered curtly that they were IT contractors. I suppressed a laugh.

I checked out of the hotel and got my statement, and then checked my full-sized suitcase with the concierge. I sent the luggage tag and photos of the bag to the CDC country team.

1349: We will continue evacuations tomorrow. Departing personnel should be ready for pick-up beginning at 4:00 am on Thursday morning. We are going to move very quickly, so please be ready to go when your residence is called on the radio. Remain beside your radio and your phone.

We all groaned and lined up to check back into the hotel. I joked in French with the hotel concierge, trying to take the edge off what was undoubtedly a stressful situation. We had another accountability drill. Disease Detective, Safe, Hilton.

I went back up to my room and set my laptop up on the desk again to continue monitoring emails. I was forwarded an email chain between senior agency leadership, who were clarifying whom we were allowed to communicate with for outbreak response overseas, amid the flurry of executive orders. “WHO remains a red light…One related question that has come up is how we view PAHO. For now, we consider them as tantamount to WHO, so the restriction on engagement applies as to [sic] PAHO, as well.” Not a single one of the senior leaders on that email chain still works at CDC today.

I started awake on Thursday morning at my 0330 alarm clock. I rolled out of bed, changed into my selected travel clothes, stuffed my pajamas into my go-bag, and made my way down to the lobby.

0415: Evacuation will start at approximately 04:30hrs (04:30am) today. All personal [sic] should be sheltering-in-place until the motorcade arrives to pick up their residence. SAFEAlerts and radio broadcasts on E&E R will announce collection zone and residence pickups. All supervisors who have TDY employees staying at any of these locations are responsible for forwarding SAFEAlerts and sharing radio broadcast messages. Personnel will be transported to the DCMR for consolidation and then to the embassy boats for evacuation to Brazzaville.

0423: No movements are permitted. Requests for exceptions must be approved by RSO. LE staff designated as essential staff performing critical duties are permitted essential movements. There will be no airport movements until further notice.

We all checked out of the hotel again. The CDC country director waited with us in the lobby, making sure that everyone was accounted for. I sent text updates to friends and called my husband to check in, listening to him explain the conspiracy theories being traded about the plane crash that had happened the day before at Washington Reagan National Airport. Like me, he was not sleeping.

We milled around the lobby as we waited for pickup. Our hotel, along with one other, was the final collection zone. We were the last ones.

0525: Collection Zone 4 HOTELS – Be Ready. Monitor Channel E&E R for further motorcade arrival updates. For TDY Personnel, sponsoring sections are responsible for ensuring they are kept updated on all SAFE alerts and applicable radio announcements. IF YOU ARE IN CZ1, CZ2, or CZ3 AND HAVE NOT YET BEEN PICKED UP: Contact Post One.

We received an email to take our suitcases back from the concierge and bring them with us. Then, at 0545: “The motorcade is there – please go to the ground floor.”

They took us in vans to the DCMR (Deputy Chief of Mission Residence), a walled compound with a spacious house and a manicured yard. I walked into the house and was immediately overwhelmed by the chatter of hundreds of people. A table in the foyer had been set with beautiful china coffee cups, but there was no coffee. Children were darting from room to room. Parents were trying to comfort screaming babies and toddlers. The DCM called for attention, and the room went quiet as she told us all that it was not safe for the children to play outside. “There is a construction site on the next block, and yesterday there were men climbing up to look over the compound walls. We do not want them to know that we have 300 people sheltering here. Please do not let your children go outside.” She went on to explain that embassy staff were working to get authorization for us to leave from the DRC government, and for those of us who needed them (including me) to get visas to enter the Republic of the Congo (ROC), so we could be evacuated to Brazzaville.

I wandered around the mansion in a sleep-deprived haze. The coffee was replenished, so I poured some into one of the lovely gold-rimmed demitasses and looked for a quiet corner. After hiding in the kitchen for a bit and washing the dishes in the sink, I found a spot looking out of a door by the laundry machines. The sound of the rain brought some comfort.

After a few hours, we received notice that we had clearance to leave. The DCM was handing out trash bags for people to wear as makeshift raincoats for when they were ferried across the river. I scrambled to find my suitcase and pulled my hardshell out. We were handed our passports as we climbed into the vans to take us to the riverbank. We drove to the “beach” as it was called and loaded onto covered ferries, 20 at a time. Even after looking out over the river from the hotel, I did not realize how large, or how fast, the Congo river was until I was on it. Huge chunks of dirt and grass swirled by us as we powered across the rapids. I should be nervous, I realized, but I’m not. I was too tired.

We arrived on the opposite riverbank and sat down in a holding area. While our passports were checked, a diplomat from the ROC embassy welcomed us. “Things are a lot quieter over here,” he joked. He explained that we would go to a hotel “to relax for a few hours.” That evening we would be taken to the Brazzaville airport, which had been closed to everyone but us, for our charter flight back to DC. I went to the Pefaco Hotel Maya Maya, which was quaint if a bit outdated. I took a shower and stumbled down to the restaurant for a 4 p.m. lunch. I went back upstairs and tried to sleep. At around 7 p.m. the front desk called to let me know that the motorcade was leaving. I ran down the stairs and out to the van. I was the last one.

The Brazzaville airport is a blur in my memory. I stood in line with families with children, including one with a hamster, and a young woman who had just been fired from her contractor position at USAID. We joked about trauma-bonding and fanned ourselves to try to stay cool, as there was no air conditioning. I went through the exit screening and made my way to the airport gate. I sat in a daze as we waited to board the flight, struggling to stay awake so I would not be left behind. I would not realize until later that the bright lights and noise of the grocery store would trigger that memory, and a panic attack to go with it. Finally, the jet bridge opened and we filed onto the plane. I sat down in the aisle seat of a row in front of the lavatory and prayed that no one would sit next to me. I dozed in my seat as we waited for the flight manifest to be approved at Dulles.

Finally, at 2 a.m., the plane took off. Once we reached cruising altitude, I laid down across the seats in my row and pulled a blanket over my head. For the rest of the 18-hour trip, I drifted in and out of sleep. There was a newborn who spent most of the flight screaming, his father trying to comfort him while pacing up and down the aisles. If I ate, I don’t remember it. We stopped in Dakar to refuel.

We crossed the Atlantic and touched down at Dulles. As the plane braked on the runway, the passengers around me burst into applause. I began to laugh, and then to cry, pressing my airplane blanket into my face to muffle the sound as I sobbed. It was over, I told myself. I had no idea that it was only the beginning.

This is the fifth installment of a multi-part series on a Section member’s deployment to, and evacuation from, the Democratic Republic of the Congo while on an emergency response assignment with the CDC. All views expressed here are the author’s own personal perspective and do not reflect the position of their employer or the U.S. government.

Not a typical deployment, part 4

by Disease Detective, posted in Emergency Preparedness and Response

Ordered departure

The embassy security alerts began hitting my inbox before 7 a.m.

0643: Do [sic] to a changing security situation and local contacts expecting protests today, ALL personnel, except for essential LE Staff as designated by their supervisor, should remain at home today…If you have already departed for the facility, please arrive by 0730.

0705: If you have already arrived at a facility, you are required to stay. DO NOT leave a facility to return home. No further movements of any kind are authorized without RSO approval. If you are driving to work now, immediately go to either an embassy facility or your residence, whichever is closer. TASOK school buses are returning children to their residences. Children should not be at school today.

I looked out over the city from the south-facing window of my hotel room and saw smoke rising in the distance. I snapped a photo of a fire in front of the Chancery a few blocks away. I accepted a calendar invite for “Meeting_Touch Base_USDH” at 1435 that afternoon. My colleagues stateside asked me to confirm that I would practice my CROI presentation at an upcoming division meeting. I just got an email saying my travel to CROI has been canceled, I responded. Are we really still doing these presentations?

0958: Large protests are occurring at the Chancery and JAO. Protests are expected throughout the day at Embassy compounds and throughout the city. All personnel must REMAIN in their current locations (in their residential compound or Embassy compound) with NO movements permitted.

We had another accountability drill shortly after lunch. Disease Detective, Safe, Hilton. “Meeting_Touch Base_USDH” was a State Department call with the ambassador, who explained that multiple embassies had been attacked that day and that the U.S. government was preparing for a formal ordered departure of all non-essential staff. She explained that we would be evacuated in tranches according to residence, that we would be taken with a go-bag to a safe house, and from there transported to Brazzaville across the Congo River. She emphasized that people should only pack essentials, and that each family member would have an allowance of one go-bag. Pets could replace a person’s go-bag if necessary. When she warned that any pets beyond that allowance would have to be left behind, I started to cry.

While I was safe in my hotel room, USAID foreign service officers and their families grappled with the possibility that the US government might abandon them:

One foreign service officer…said he feared for his and his family’s safety amid widespread protests in Kinshasa, including at the US embassy and outside his home on January 28.

He detailed challenges he and other staff faced – including one colleague whose house was set on fire and “lost all their belongings to looting” – and recounted being told that “any spending not directly approved” by the agency’s acting administrator could be considered defying the administration’s orders.

“I began to feel an intense sense of panic that my government might fully abandon Americans working for USAID in Kinshasa,” [he] said.
[…]
Another foreign service officer…detailed…“the trauma” of exiting Kinshasa in the middle of the night with three young children and having to leave his dog.

Half an hour after the call with the ambassador, the CDC country team held a call. The country director summarized the call with the ambassador and took questions, but then he had to drop off for another meeting. He tried to pass it to his deputy. “I can’t talk,” she shouted. “We are sheltering in a room in the back of the JAO with about 75 other people. There are protestors out front.” The call ended abruptly. I sat at the desk in my hotel room with the realization that my deployment was over. I was about to be evacuated.

1626: Local staff are now authorized to depart the Chancery and JAO compounds. U.S. Direct Hires will be returned to their residences by Motor Pool armored vehicles. Please wait for more information on timing. The shelter-in-place is still in effect. All personnel must remain in their residential compounds. Please prepare and pack your go-bags. Reach out to Post One in case of an emergency.

I laid a towel across the bed, pulled my full-sized suitcase and my roller carry-on onto it, and spent the rest of the afternoon packing. Dirty gym clothes in the big suitcase. Silk scarves in the go-bag. Shoes in the big suitcase. Underwear in the go-bag. For every one of my possessions, I had to ask myself how I would feel if I never saw it again. My inbox was inundated. “What action should we take to support the departure of our two Mpox deployers, or does the Embassy coordinate all return travel at this point?” “The charter from Brazzaville will head to DC. For those who prefer to arrange their own flight from Brazzaville, please confirm to me urgently and in the next 10 mns and I will send the information on behalf of CDC.” One deployer was not getting the embassy alerts. I got an automated email notifying me that my boss had submitted my 2025 performance plan on my behalf. I confirmed that I would be on the charter flight to DC. I finished packing, dressed comfortably for a potential evacuation, and flopped down on the bed. On a whim, I took a selfie to capture the moment. I was shocked at how visible my gray hairs were.

I joined a call, which had been scheduled the week prior, with a colleague working on the response from CDC’s Atlanta headquarters. She was shocked to learn that my deployment was being cut short due to the ordered departure. “That’s so scary!” she exclaimed. “Have you ever deployed overseas before?” Nope, I said wryly, and laughed. This is my first international assignment. “I am so sorry to hear that,” she replied. “This is not a typical deployment!”

2058: We are moving to an Ordered Departure status for Mission DRC. Stay at home and prepare to evacuate via boat to Brazzaville. We will be evacuating in tranches across the Congo River, starting tonight around 2am. We may pause during the day, and then resume again at a similar hour the following day. Everyone who has not been told by their section or agency that they are staying as part of emergency staffing should be prepared to evacuate tonight. The first tranche will find out if you’re leaving by 10 pm—it will be organized by residence.

I called my husband and explained what was happening. He peppered me with questions I had no answers for, panic rising in his voice. I texted my teammates and a few friends. Cross-talking emails kept hitting my inbox, as other deployers changed travel plans and my team lead scrambled to find a flight to Atlanta in time for his son’s high school graduation. I paced back and forth in my room, waiting for the notice to evacuate.

The evacuation instructions for that night went out at 2238, listing mostly residential complexes. Our hotel was not on the list. I emailed the deputy country director. If Hotel Hilton is not on the list, does that mean we can sleep? “Yes,” she replied. The fear of falling asleep and being left behind had crept in. I would not sleep soundly for the next three days.

This is the fourth installment of a multi-part series on a Section member’s deployment to, and evacuation from, the Democratic Republic of the Congo while on an emergency response assignment with the CDC. All views expressed here are the author’s own personal perspective and do not reflect the position of their employer or the U.S. government.

Not a typical deployment, part 3

by Disease Detective, posted in Emergency Preparedness and Response

Trauma
The inauguration was on a Monday, and the onslaught began soon after. This is what I wrote in my journal the following Sunday:

And just like that, the new administration has robbed me of the joy and excitement of this experience.
We have been bombarded nonstop. With executive orders, memos, OPM emails that look like phishing. With news stories. And rumors. So many rumors.
The executive order ending remote work came down Tuesday night. Some say it (and all the others) were written using AI. I cried in my hotel room and spiraled and cried some more. I cried to [my husband] and to my mother…I wrote a text essentially telling [my boss] goodbye and thanking him for hiring me, and cried some more.

I got an email from CDC’s responder resiliency program. “Please reach out to us if you or someone you know may benefit from meeting with one of our mental health clinicians.” I wanted to reach out but was afraid my emails were being monitored, and that requesting a meeting might result in me being pulled back. On Thursday, we found out that travel for the people who had been rostered to backfill us had been canceled, and that we would not be replaced. My team lead was scheduled to fly back the following Tuesday. I would be the only response team member in country.

I got an email saying that my travel to San Francisco for the Conference on Retroviruses and Opportunistic Infections (CROI), the premier conference for HIV research in the U.S., had been canceled due to the administration’s pause in funding. I called my mother in tears to tell her that we could no longer meet up there.

On Sunday, the embassy sent out a security alert advising us to work from home the next day. “We are aware of calls for protests tomorrow at the U.S. Embassy and other foreign embassies.” CDC’s DRC country team canceled their planned retreat and returned to the city. We had an accountability drill the next morning. “Please respond immediately with the following: Name, Status (safe, etc), Location.” Disease Detective, Safe, Hilton, I replied. The embassy asked me to find my team lead and have him respond as well. I was pulled into a meeting to develop a justification for my work so that my deployment would not be cut short. “They are only approving deployments related to the imminent protection of life, safety or public property related to the Mpox outbreak response,” wrote the response deputy chief of staff. “Please send us a statement that describes how each of these deployments meets these criteria.” I was asked if I had any “WHO engagements,” as we had been told that we could no longer collaborate with them. I explained that there were personnel from WHO on every single team and in every single meeting of the response. No one could tell me what to do. “Response can draft the statement about the critical nature of your deployment,” my contact told me. I imagined packing up a month’s worth of clothes and shoes and tea and supplies, leaving the work I had yearned to do my entire career. I wondered what else the administration would take from me.

When the embassy gave the all-clear that afternoon, I left the hotel to walk two blocks to a nearby Catholic church. As I made my way down the broken sidewalks, I tried to ignore the stares from the people all around me. Of course people are going to stare, I reasoned. I am clearly a foreigner, and a type they do not see often at all. I myself had never seen a white person walking around at any point driving through town. The church complex was beautiful, if a bit run down, and blessedly empty of people save for a few contractors and a vendor stall. I walked over to ask the price of an offertory candle. “You need to be careful with everything going on,” the woman warned me. “You should not be here.” I nodded and thanked her, confused. I would not understand until the next day the fervor of the anti-Western sentiment among the people in response to the invading M23 militia, a paramilitary group funded by the Rwandan government. I had been so overwhelmed with what was happening in the response that I could not see what was happening in front of my eyes. I wandered the grounds and, on a whim, picked up a black feather from the ground.

This is the third installment of a multi-part series on a Section member’s deployment to, and evacuation from, the Democratic Republic of the Congo while on an emergency response assignment with the CDC. All views expressed here are the author’s own personal perspective and do not reflect the position of their employer or the U.S. government.

Not a typical deployment, part 2

by Disease Detective, posted in Emergency Preparedness and Response

Arrival

After two days of travel, I arrived at the hotel in Kinshasa just before midnight. The next day I slept in until noon, missing multiple emails from my team lead. I scrambled to get dressed and get to the emergency operations center, where I was hastily introduced to the country team, which was in the middle of a working meeting. I sat off to the side, trying to follow the conversation on an empty stomach. Someone brought shwarma for lunch around 2 p.m. On the way back to the hotel, we stopped at a fried chicken place. I tried to stay focused on my team lead, with many years of experience working on deployments and multi-year global health assignments, as my mind reeled from the juxtaposition of chaotic city streets with a Western-style fast food restaurant.

My in-country security briefing with the embassy Regional Security Officer was the following week. Until then, I had been operating under the assumption that most capital cities in the world had a baseline level of infrastructure and emergency services. My top question walking into the briefing was what the DRC version of 911 was, to call in case of an emergency. I learned immediately that there was no 911. We were strongly discouraged from driving and explicitly told NOT to exit the vehicle in case of a car accident. If the police arrived, we were instructed to drive away. I was given a laminated card to show through the car window explaining that I was a diplomat going to the embassy. The hospitals were poorly equipped to handle health emergencies; “Health conditions that are manageable in other places can be fatal in the DRC,” one slide warned. The UN handled fire response but often took several hours to arrive. We were explicitly prohibited from going anywhere outside the green zone. “If you have any kind of problem at all,” the RSO warned, “call Post One.” The embassy was our only emergency response.

I was in Kinshasa for two weeks. I worked six days per week, and the days were long: response work during business hours plus emails and calls in the evening with stateside colleagues on Eastern time. All communication was done through WhatsApp. The schedule was always fluid: meetings started late and ran long, and we often had last-minute invites to other meetings we had not even been aware of the previous day. I quickly realized that the work would not look anything like how I imagined, but that somehow all those years on the periphery of the global health profession had not been wasted. Let the local professionals take the lead. Listen more than you talk. Practice cultural humility. I kept a running list of technical terms and their French translations in a Notepad document: file, folder, update, sample, collection. I was relieved to see an Albanian colleague from WHO with a Google translate tab open in her browser. I learned that you can use WhatsApp in a browser, that DRC does not have its own government web domain, and that it is considered rude to bring your own food to eat without sharing. I reached out to colleagues who had deployed before me to learn about the response history, and to my father-in-law, who had worked as a doctor in Zimbabwe, to learn about cultural norms.

I stayed at the Hilton, a five-star hotel by the Congo River. I figured out after a few days that the alarm clock was not reliable, because frequent power outages reset the time several times per day. On weekdays, I ate breakfast at the hotel buffet and brought Ziplock bags down to store food for my lunch as well, per advice from a previous deployer. Dinner was usually room service, though half the items on the menu were unavailable. Sundays were off days. I wandered the hotel to check out the amenities and journaled while sitting by the rooftop pool. I boiled water in my hotel room, let it cool, and stored it in my Nalgenes and used plastic water bottles that I hoarded like a lemur. I washed my laundry in the shower with shampoo and hung it up all over the room to dry. After I had the “Do Not Disturb” doorknob tag on for several days, I got a call from the manager of guest services. Was my stay satisfactory? Did I need anything from the hotel? Was I alright? He explained that the hotel had a policy of checking on guests who asked not to be disturbed for more than three consecutive days – to verify that they were not being held hostage. There had been incidents in other hotels, he explained. “We take security very seriously.”

But still, despite the newness and the strangeness and the loneliness, I started to gain my footing. I found myself able to follow the conversations between my colleagues more easily. I scribbled notes about the history and evolution of the response, the structure and schedule, who was in charge, who knew what was actually going on, who understood the data and could answer questions. I came to understand that my primary responsibility was to serve as the eyes and ears of the agency. I got to know people and contributed where I could. A future in which I might do this work began to take shape. I could do this.

This is the second installment of a multi-part series on a Section member’s deployment to, and evacuation from, the Democratic Republic of the Congo while on an emergency response assignment with the CDC. All views expressed here are the author’s own personal perspective and do not reflect the position of their employer or the U.S. government.