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‘Critical threshold’: The failed race to save the life of Ebola-stricken doctor Martin Salia

By the time he arrived in the United States, Martin Salia, a surgeon who contracted the deadly Ebola virus in Sierra Leone, had “no kidney function and was unresponsive.” That sent doctors scrambling — ultimately unsuccessfully — to save his life at a Nebraska isolation facility equipped for treating Ebola patients.

The doctor with Maryland ties had been flown from Freetown in a specially equipped air ambulance for treatment at the Nebraska Medical Center. But within the first 12 hours, he was in complete respiratory failure and had critically low blood pressure, doctors said at a news conference Monday.

Salia was rushed onto emergency kidney dialysis and a ventilator and was given several medications to support his organs. Doctors administered the experimental drug ZMapp on Saturday, and Salia also received a plasma transfusion from an Ebola survivor. That treatment is thought to offer antibodies to fight the virus, doctors said.

“We used every possible treatment available to give Dr. Salia every possible opportunity for survival,” said Phil Smith, the medical director of the biocontainment unit. “As we have learned, early treatment with these patients is essential. In Dr. Salia’s case, his disease was already extremely advanced by the time he came here for treatment.”

Salia died at about 3 a.m. local time on Monday.

Hours later, Jeffrey P. Gold, chancellor of the University of Nebraska Medical Center, said it was harrowing, sorrow-filled day for the hospital and its staff. He called the doctors and nurses who worked with Salia “heroic.”

“We are reminded today that even though this was the best possible place for a patient with this virus to be, that in the very advanced stages, even the most modern techniques that we have at our disposal are not enough to help these patients once they reach the critical threshold,” Gold said.

Salia, a native of Sierra Leone whose wife and two children live in New Carrollton, Md., initially tested negative for the virus but a subsequent test came back positive on Nov. 10.

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Reached on her cellphone Monday afternoon in Omaha, Salia’s wife, Isatu, said through tears: “We are in so much pain and grieving. He was a wonderful father and husband. We are a family in a lot of pain.”

In an earlier statement released through the Nebraska Medical Center, Salia thanked the hospital’s staff for trying to save her husband’s life.

“We’re very grateful for the efforts of the team led by Dr. Smith,” she said. “In the short time we spent here, it was apparent how caring and compassionate everyone was. We are so appreciative of the opportunity for my husband to be treated here and believe he was in the best place possible.”

Isatu Salia traveled to Nebraska over the weekend but was able to see her husband only through a video connection set up by the hospital, a Nebraska Medical Center spokesman said. On Sunday, officials had described Salia’s condition as “an hour-by-hour situation.”

Martin Salia contracted the virus in Sierra Leone, where he was the chief medical officer and surgeon at the Kissy United Methodist Hospital in the capital of Freetown. He also worked at several other hospitals in Sierra Leone.

After Salia initially tested negative, his colleagues embraced him, celebrating the good news. The hospital has since been shuttered and three of his colleagues are being isolated over Ebola fears.

It is still unclear how Salia contracted Ebola, which had killed nearly 5,200 people worldwide as of Nov. 11, according to the World Health Organization.

Salia is the second person to die of Ebola in the United States. The first, Thomas Eric Duncan, died at a Dallas hospital after contracting the virus in Liberia and then flying to the United States. Five other patients who contracted the virus in West Africa but were treated in U.S. hospitals have survived, as did two nurses who were stricken with Ebola while treating Duncan in Dallas.

Most recently, an American doctor, Craig Spencer, was discharged from New York’s Bellevue Hospital Center, where he’d been treated for Ebola. Spencer’s positive diagnosis came after he’d returned to the United States from Guinea.

Salia’s body will be cremated, according to Nebraska Medical Center officials, who said they were talking to family members about the process. An autopsy is considered too dangerous to perform, given that the bodies of Ebola victims are even more contagious than living Ebola patients.

But samples from Salia’s body will be analyzed by the Centers for Disease Control and Prevention, hospital officials said.

According to the United Methodist News Service, Isatu Salia paid for the $200,000 ticket to fly her husband from Sierra Leone to the United States for treatment, though the United Methodist Great Plains Conference is reportedly raising money to help cover the cost of travel and medical expenses.

And Bishop Mark Matthews of the United Methodist Baltimore-Washington Conference has issued a statement asking all United Methodist Churches in the region to contribute to a fund for Salia’s wife Isatu and their two sons.

United Methodist Church officials described Salia as a doctor who was committed to helping the poorest and sickest inhabitants of his native country, long before the deadliest Ebola outbreak in history erupted.

“Through the years, he chose to work with people who were marginalized and no place else to go” for medical treatment, said Rev. Maidstone Malenga, assistant to Bishop Matthews. Malenga said Kissy Hospital, where Salia was working when he fell ill, was in an extremely poor area of the capital.

Gary Henderson, executive director of the global health initiative for the United Methodist Church, said he met Salia in Freetown last spring, during a visit to Kissy Hospital.

“He kept saying it was such a privilege to be there, and that God wanted him to be doing it,” Henderson said. At the time, Henderson said, malaria was considered the gravest health problem in Sierra Leone. But by the time he’d returned home, Henderson said, “Ebola was all over the news.”

In a statement, President Obama issued “heartfelt condolences” to Salia’s family.

“Dr. Salia dedicated his life to saving others,” Obama said. “He viewed this vocation as his calling.”

Pamela Constable contributed to this report.

[This post has been updated multiple times.]

A doctor’s mistaken Ebola test proves tragic

FREETOWN, SIERRA LEONE – NOVEMBER 16: Friends and colleagues of Dr. Martin Salia, a doctor who contracted Ebola while working in Sierra Leone talk about his illness at Kissy Hospital in Freetown, Sierra Leone, on November 16, 2014. Salia, who worked at Kissy Hospital, contracted Ebola while working as a surgeon in Sierra Leone. He is critically ill and receiving treatment at the Nebraska Medical Center in the United States. (Nikki Kahn/The Washington Post)

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