Nursing Graduate Battles Ebola

December 08, 2015

Ebola: Sheila Davis’s Toughest Battle

Sheila Davis

"Every day, there were more people showing up, and we did not know when it might end," Davis says. (Photo: Justin Knight)

By Alyssa Haywoode

The disease was ravaging West Africa. Entire families and villages were swamped by death. Local health care providers kept showing up to fight Ebola, even though they were mourning colleagues and loved ones who had been infected and died. Ebola became known as a caregiver’s disease because it killed so many physicians and nurses, the very  people who struggled to fight it.

“It was horrible, just chaos,” recalls School of Nursing graduate Sheila Davis, ’97, ’08. “The whole health system, which was terrible to begin with, just completely collapsed.”

As the newly appointed chief of Ebola response for the global nonprofit Partners In Health (PIH), the MGH Institute graduate worked to shore up health care systems in Liberia and Sierra Leone. As a nurse in a place where so much care was desperately needed, Davis also provided direct care in the “red zone,” where patients with confirmed Ebola cases stayed. She knew the protocols. She wore hazard suits. To kill germs, she walked through pans of bleach.

Unlike an earthquake or a tsunami, one-time events, the Ebola outbreak was a recurring disaster, Davis says. “Every day there were more people showing up, and we had no idea when it might end.”

Davis with helicopter

Davis approaches a UN helicopter. (Photo: Rebecca E. Rollins/Partners In Health)

It wasn’t until she was an undergraduate at Northeastern University, where she earned her BSN in 1988, that she first encountered the social justice issues that have become a staple of her career. One of her mentors was a gay man whose partner was dying of AIDS. At the time, a dense fog of stigma and discrimination shrouded the health care provided to gay men as well as to IV drug users, people of color, and sex workers, all of whom were the most susceptible to contracting the disease. Davis saw firsthand some of the abysmal care her mentor’s partner received from nurses and other caregivers. There were, of course, a number of good nurses. But she was struck by the bad ones. “If I want to continue in this profession, that can’t be how I’m a nurse,” Davis thought to herself.

Soon, she volunteered for the AIDS Action Committee. And later, because there were “no books about how to be an HIV nurse,” she and other nurses found each other. She joined the Association of Nurses in AIDS Care. After six years of caring for patients, she was considered an expert. And when funders were looking for health care providers who could implement HIV programs in Africa, Davis was among the nurses who went. HIV, she says, became “a perfect training ground for social justice in health care because we really saw the worst of the worst.”

But she needed to continue her education if she was to have a greater impact. In 1997, Davis earned a Master of Science in Nursing from the Institute to become a nurse practitioner (NP). She liked the program’s clinical focus, and she admired faculty members’ interest in HIV. Among the faculty was Inge Corless, a professor who had served as president of the Association of Nurses in AIDS Care. “I found the faculty to be extremely supportive, very interested in seeing people grow,” Davis says.

She took classes at night and worked during the day at the Community Research Initiative, a nonprofit organization that focused on HIV and AIDS research. After graduating, she became an NP at Massachusetts General Hospital, where she cared for patients with HIV and AIDS.

In 2003, she and fellow Mass General nurse Christopher Shaw co-founded a small nonprofit organization called Sibusiso, a Zulu word that means “blessings.” The organization operated in South Africa, helping local health care workers provide patients with increased services. And in Boston, Sibusiso reached out to provide
health services for immigrants from sub-Saharan Africa. After seven years, Davis felt the organization had given all it could offer, so she passed its technical assistance work on to local providers and closed its doors.

Paul Farmer

Dr. Paul Farmer (center) and Davis board a UN helicopter used to transport the team from Bong, Liberia, to Monrovia. (Photo: Rebecca E. Rollins/Partners In Health)

By 2007, Davis was back at the IHP after Corless suggested she should consider earning a Doctor of Nursing Practice degree. The new program, one of the first launched in the United States, allowed her to think more broadly about a number of issues, including population health, health financing, and patient outcomes. It also helped that she received a scholarship that covered part of her tuition. “Inge has always been my biggest advocate in life,” Davis says of Corless, who has been on the School of Nursing faculty for 17 years. “She always encouraged me to stretch and to think bigger than I probably would have.”

In 2008, Davis became one of the DNP program’s first three graduates. She also joined the faculty, teaching classes about HIV and global health in the adult nurse practitioner program. Little did she know her new education would play a key role in her future career path. “If I hadn’t done the DNP, there is no way I could have ever done the Partners In Health job.”

PIH hired Davis as its first nursing leader in 2010, and she became chief nursing officer three years later. Her first task was to develop training programs to help fill a dire nursing shortage in developing countries; she also helped open Haiti’s Hôpital Universitaire de Mirebalais. Working with the Dana-Farber Cancer Institute, she helped develop oncology programs in Haiti and Rwanda, assisting nurses in those nations to provide strong cancer care to people who otherwise would not have it.

Then Ebola hit. Dr. Jim Yong Kim, a co-founder of Partners In Health and the president of the World Bank, asked PIH for help. Davis became the chief of Ebola response and received a stark education in international crisis relief. The work was grueling and haunted by a grim fact: Ebola’s toll was so horrific because the region’s health systems were so fragile.

Writing in the Washington Post in August 2014, Kim and Dr. Paul Farmer, a PIH co-founder and Harvard Medical School professor, noted that if Ebola had struck in Washington, New York, or Boston, “there is no doubt that the health systems in place could contain and then eliminate the disease.” Farmer explains that PIH’s work is threefold: to deliver better medical care for people living in poverty, to train people to provide this care, and to generate new knowledge. “And that’s how we got Sheila, because she does all three of those activities.”

“How do you run a hospital in a place like rural Haiti or rural Rwanda without nurses?” Farmer continues. “You can’t. But also, you can’t run a hospital without nurses who are committed to those roles of training and to learning. So Sheila was a great find for us and really has shaped not only the Ebola response but our work everywhere.

“She is one of those rare people who is able to combine deep clinical knowledge, compassion, empathy, and kindness, with leadership skills that are unrivaled,” he adds. “And she’s able to do it in times of crisis. It’s a great gift to an institution or an organization like Partners In Health, but it’s a great gift, I think, to medicine broadly conceived.”

Today, Davis says Ebola has been contained. But she is on the phone daily with the PIH team in Sierra Leone, where cases are still in danger of cropping up. So for her, the work that remains is clear: the world needs better health systems and universal health care. There is no money to be saved by not investing, because that will only lead to more deadly and expensive health crises.

“I’ll never be a good Haitian nurse or Rwandan nurse. I don’t live there. I don’t know the context. I don’t know the culture,” she says. “But I can bring what I know and learn from the experts there. We try to combine it. There is synergy together and we learn from each other.”

In other words, a well-built web of globally connected nurses can help heal the world.

Partners In Health co-founder Dr. Paul Farmer talks about Sheila Davis's role.