On Friday, Dr. Richard Sacra got his yellow fever vaccination.
On Monday, he began taking pills to prevent malaria.
Next, he will pack about 300 pounds of medicine, supplies, gowns, and laboratory equipment into his luggage as the last step before he returns to Liberia, where he contracted the often-lethal Ebola virus in August.
"I'm less nervous about this trip because I know what I'm getting into a little more," Sacra said Monday at a press conference at the University of Massachusetts Medical School in Worcester, where he is an assistant professor. "And also because the thing I was afraid of last time — I've had it. And thank God, I'm through it."
With his wife, Debbie, by his side, Sacra, 52, announced his plans to head to Liberia on Thursday to work in ELWA Hospital outside the capital, Monrovia, for almost a month.
Sacra was working in that hospital's obstetric ward in August when he fell ill with Ebola. He was flown to the University of Nebraska Medical Center in Omaha to be treated. Sacra said his health is good now; physical therapy has helped him regain his strength, and the only trace of his struggle against the virus is a slight cloudiness in his left eye that he says is nearly gone.
Sacra said he does not expect to work in the Ebola treatment unit when he returns to Liberia. Instead, he will care for patients with general health problems, such as malaria or diabetes, and attempt to give doctors a bit of rest after working around the clock at the hospital.
In an interview after his public remarks, Sacra said the hardest thing about returning to Liberia is the sadness he feels about friends and colleagues who have died from the virus or had family members claimed by it. About 8,000 people have died during the Ebola outbreak that swept Liberia and two other West African nations, Guinea and Sierra Leone.
"Just knowing that I'm going to see people who've lost loved ones. I've lost a few friends myself directly and many of my friends have lost loved ones — and there are going to be some heavy moments as I get to see them for the first time and express my sympathy," Sacra said.
Sacra has immunity to the strain of the Ebola virus he contracted, but will still wear full protective equipment when necessary. Although he will not directly care for Ebola patients, he anticipates he will come into contact with infected people while providing care in the clinic. The hospital screens patients' medical history and temperature, and Sacra hopes that his presence may provide comfort to people facing the illness.
"I hope it'll help me when I'm talking with people who we've decided need to go over to the Ebola treatment unit," Sacra said. "I can tell them, 'I've been in there and I'm out — and here I am, so have cour-age.' "
Sacra noted that efforts to contain and control the outbreak seem to be having success in Liberia. He recalled that at one time, there were 80 people in the Ebola treatment unit his hospital used, some on mattresses in corners or hallways because there weren't enough beds. According to the latest numbers from the World Health Organization, the Ebola outbreak in Liberia is diminishing, with just 70 cases over the last three weeks.
He hopes that trend continues, but added that much work remains to be done to revive the country's health care infrastructure.
Liberia's only medical school is shut because some of the faculty contracted Ebola and died, and others fled the country, he said. There aren't many places open to get health care, and some of the centers that are open have limited staff, meaning patients may arrive seeking medical care and find no doctor that day. Other health concerns have been neglected in recent months, meaning that chronic diseases, such as high blood pressure or diabetes, may have flared out of control.
Sacra has long-running connections to Liberia. Between 1995 and 2010, he and his family spent long periods of time in the country while he worked as a missionary doctor.
Debbie Sacra said there was little question about whether her husband would return.
"That's just part of our relationship and our calling from the Lord," she said. "We know that there's a need; we know that he has a big contribution to make. We're happy that he's only going for a few weeks."
Carolyn Y. Johnson can be reached at firstname.lastname@example.org.