Clearance
Just over one year ago, I was evacuated from the Democratic Republic of the Congo. I deployed there as part of the U.S. government’s global mpox emergency response. It was my first international assignment as an epidemiologist, something that I had been striving and preparing for over the course of my entire career. I was supposed to be there for one month but wound up having to leave after just 15 days. What happened to me was stressful, but not unheard of – crises happen, whether natural or manmade, and diplomatic and emergency response personnel are evacuated in ordered departures all over the world. Simply being evacuated does not make my experience unique, nor is that fact of particular interest to members of the APHA International Health Section or to the global health and development professional community writ large. Rather, what makes my experience relevant was the fact that it occurred in tandem with the dismantling of USAID, as well as the sustained assault on CDC.
I accepted the assignment and was rostered at the beginning of October, with my arrival scheduled for early January. Initially I assumed that this would be plenty of time, but simply getting clearance to travel with CDC was a massive undertaking that I was not prepared for. I had to do a French language assessment to demonstrate my fluency. I had to complete a battery of trainings unlike anything I had ever experienced. I watched videos on how to crawl out of a burning building, how to shelter from gunfire, how to ram a car. I did battle with CVS to fill prescriptions for antimalarials, antiparasitics, and antibiotics for traveler’s diarrhea. I could not book a flight until I had a visa, and I could not get a visa without proof of yellow fever vaccination, and I could not get vaccinated for yellow fever until 28 days until after I had gotten a varicella booster, because I did not know that you cannot receive a live vaccine within 28 days of a previous one. I had a phone call with a CDC medical officer who told me I could not drink any water that had not been boiled or any food that had not been cooked. I learned that there are typhoid vaccine pills. I got a varicella titer from Labcorp, at which point I realized that I did not even need the varicella booster, because my titer had been measured as part of the battery of tests my doctor ordered after my third miscarriage in 2022. I had to resubmit the global travel request four separate times, because I screwed up something different on each attempt.
All of this was done against the backdrop of the 2024 election. Donald Trump would be returning to the White House. While everyone around me at work wondered what this would mean for the federal workforce and HIV prevention work, I felt the urgency to get my travel approved morph into a sense of panic. I knew that if I waited until the administration turned over, I would lose my chance to do overseas work. I knew I had to be on the ground before the inauguration. My flight was rescheduled from January 6 to the 13th and then again to the 15th due to delays caused by a winter storm in the DC area. But finally I had everything I needed. I boarded a flight to Paris on January 15, feeling triumphant. I could do this. Finally, a lifelong dream was about to come true.
This is the first 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.
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