Background: This qualitative study was designed to assess health care volunteers’ experiences and psychosocial impacts associated with deployment to the West Africa Ebola epidemic.Methods: In 2015, using snowball sampling, 16 US health care volunteers who had recently returned from West Africa were recruited for this study. Semi-structured interviews were conducted to collect information associated with each phase of deployment (pre, peri, and post).Results: Participants reported that they were motivated to volunteer because of a sense of responsibility and feelings of empathy and altruism. Immediately prior to deployment, most reported fear of contagion and death, as well as doubts regarding the adequacy of their training. Family members and close friends expressed high levels of concern regarding participants’ decisions to volunteer. During the deployment, participants were fearful of exposure and reported feeling emotionally and physically exhausted. They also reported feeling frustrated by extreme resource limitations, poor management of the mission, lack of clearly defined roles and responsibilities, and inability to provide high quality care. Upon return home, participants felt a sense of isolation, depression, stigmatization, interpersonal difficulties, and extreme stress.Conclusion: Preparedness of volunteers was suboptimal at each stage of deployment. All stakeholders, including volunteers, sponsoring organizations, government agencies, and professional organizations have a shared responsibility in ensuring that volunteers to medical missions are adequately prepared. This is especially critical for high risk deployments. Effective policies and practices need to be developed and implemented in order to protect the health and well-being of health care volunteers to the fullest extent possible.
existing capacity to respond. Operational capability scores ranged from 33% (death care industry) to 77% (offices of emergency management). Resource sharing capability analysis indicated that only 42% of possible reciprocal relationships between resource-sharing partners were present. The overall cross-sector composite score was 51%; that is, half of the key capabilities for preparedness were in place. Conclusion: Results indicate that the US mass fatality infrastructure is sub-optimally prepared for MFI that exceeds 25 or fewer additional deaths in a 48-hr period. National leadership is needed to ensure sector-specific and infrastructure-wide preparedness, with a special focus on training, drills, and planning activities for large-scale or complex MFI.
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