Dr Joel Montgomery interview and PDF transcript

[00:00:00] Current role: Branch Chief, Epidemiology Informatics Surveillance and Laboratory branch, overseeing ten country offices focused on infectious disease capacity building. Recently returned to U.S. after nine years abroad. Previous postings: Kenya (2011–2015), Director Global Health Protection; Peru (five years), led Emerging Infections Program with U.S. Navy. [00:02:00] Pre-2014 focus: Diarrhoeal and respiratory diseases in East Africa, especially children under five. Work on RSV, typhoid fever, Cryptosporidium, influenza vaccine policy. Occasional involvement with Rift Valley Fever. Ebola ranked low for public health impact, diarrhoeal and respiratory diseases much higher. [00:04:40] Ebola involvement: First deployed April 2014 after cases appeared in Guinea and Liberia. Training background in haemorrhagic fevers (Epidemic Intelligence Service, 2002). Initial mission: assess situation, coordinate with Ministry of Health, World Health Organisation. Early conditions: chaotic coordination among agencies; few cases, all outside Monrovia in Lofa County and Firestone unit. [00:08:40] Travel to Lofa: Used Samaritan’s Purse helicopters and vehicles due to poor roads. Situation: panic, distrust, low awareness of Ebola; reliance on translators and community volunteers for messaging. Focus on healthcare workers and community engagement. Infection control at Foya-Borma hospital inadequate—no PPE, water, soap. [00:15:30] Describes case from Guéckédou misdiagnosed as cholera, later suspected Lassa; spread to patients and staff. Lack of diagnostics and sample transport contributed to outbreak spread. Movement by motorcycle taxis from Lofa to Monrovia. [00:19:45] Second deployment: August 2014 as team lead. Situation worsened—large case surge, overwhelmed treatment units. ELWA 1 closed; ELWA 2 opened, ELWA 3 under construction; MSF units over capacity. Compares to other experiences he’s seen before. [00:25:00] Discussions with Liberian Ministry of Health emphasized need for more isolation facilities, contact tracing, safe burial. Quarantine of West Point caused civil unrest; later lifted. Community engagement critical for compliance and reintegration of discharged patients. Mobile labs increased diagnostic capacity. Combined efforts—treatment units, labs, safe burial, community involvement—turned outbreak curve earlier in Liberia than Sierra Leone. [00:31:40] Third deployment: October 2014. Cases declined, hotspots in rural areas. U.S. Department of Defence ramped up presence, from dozens to 3,000 personnel to build treatment units and labs. Transition to traditional Ebola response: field teams identifying cases, tracing contacts. Improved control and community engagement. [00:35:00] Reflects on personal risk, his concerns were more around fear and mistrust from the community. [00:38:00] Urban outbreak dynamics unprecedented; habitat disturbance and deforestation likely factors. Key findings: viral shedding duration, sexual transmission risk, persistence of infection. Future outbreaks likely; improved infrastructure and rapid response essential. [00:44:23] End of interview. This content summary was created from the interview transcript in November 2025 using M365 Copilot Chat. The content summary was then reviewed against the audio by the cataloguer.

27/10/2015

448 MB 1 WAV file, 1 transcript

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PDF transcript created by archivist for preservation and access reasons. See OH3/38/2 for original Microsoft Word format version of transcript.

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