“Why don’t they just put a photo on those?” was the first question artist Mary Beth Heffernan asked last summer, when the Ebola epidemic took hold in West Africa and she started seeing news images of health workers in alien-like Personal Protective Equipment. The PPE suits, meant to keep any part of a workers' body from coming in contact with a patient, often left nurses and doctors’ eyes just barely visible through goggles.
Wouldn’t putting a photo of the person inside the suit on the outside make the whole dynamic less intimidating? Heffernan, who teaches at Occidental College, has done work about bodies before — in 2007, she photographed the tattoos of soldiers close-up, so you only saw ink against skin. She had also thought quite a bit about headshots or mug shots, and how family photos were the happy flip side to such clinical portraits. She imagined photos on PPE suits being a “hybrid” of the serious I.D. card image and the family portrait.
“That was such a passive question, ‘Why don’t they just use photos?''” says Heffernan. But in late February, she went to Monrovia to actually do it.
The problem was figuring out how to get invited to an Ebola Treatment Unit in Guinea, Liberia or Sierra Leone. She wrote a proposal, leaving out her more abstract interest in how mug shots, headshots or family portraits alter relationships. She focused instead on medical research about the psychosocial effects of PPE and “source isolation,” when a patient is kept away from other humans because of his or her illness.
Unsurprisingly, patients' anxieties have been found to increase exponentially when patients are isolated. Not only are they ill and alone, but their illness puts anyone who cares for them at risk. This would be nerve-wracking enough even if healthcare workers weren't wearing intimidating, clinical suits that obscured all of their features.
In January, when Heffernan had been sending her proposal out for over a month, she visited her brother, Dr. Phil Bolduc, in Massachusetts. He told her that Rick Sacra, the missionary doctor who had contracted Ebola while working in Liberia in August, worked at his clinic. Bolduc introduced Heffernan to Sacra, who emailed Jerry Brown, the Liberian doctor who had been on the cover of Time magazine’s “Person of the Year” issue. Sacra also connected the artist with the doctor who ran the biggest ETU in Monrovia, Soka Moses, who wrote Heffernan a letter about how crucial the psychosocial dynamic has been in treating Ebola, “given that we have almost nothing else to offer.”
Soon, she had an official invitation to Liberia, signed by Moses Massaquoi, Liberia Chair of Ebola Case Management. She rushed a grant application to the Arnold P. Gold Foundation, which supports humanistic projects in the medical field, asked Occidental if she could redirect a faculty enrichment grant she had received for a different project toward this one and, by late February, was headed to Monrovia with Marc Campos, Occidental College's photographer, whose travel the college funded. The two of them had cameras, six printers, extra ink, sticky labels to print photos on and a suitcase of PPE suits, just in case.
They stayed at the Royal Grand Hotel in Monrovia and hired cars to take them to the ETU where they would be working most days, ELWA2 (an abbreviation for Eternal Love Winning Africa, a missionary-founded hospital, although this particular ETU was actually run by the Liberian Government's Ministry of Health). Later, they would also travel out to the more rural Tubmanburg ETU and set up a printer and portrait station there.
Right away there were hurdles: Because electricity is not on a grid in Liberia and the travel adapters Heffernan brought were too weak, power surges ruined two printers within the first few days of her trip. Ink went twice as quickly as expected.
Then there were more nuanced problems. When photographing the healthcare workers, Heffernan would coax: “Look into the lens so it’s like you’re looking at the patients.” Certain workers found this uncomfortable at first — one man at ELWA2 looked at the camera quizzically when first photographed. Then, a few days later, after he had a better idea of how the image resonated with patients, asked to be photographed again, with a warmer expression on his face.
Initial patient reactions were, it seemed, positive. One patient visibly gasped when she saw her healthcare worker’s face for the first time. And the workers liked the photos, too. At ELWA2, portrait labels began disappearing, ending up on steering wheels or the backs of iPads.
“It served as some token of their time there,” says Heffernan of the overworked, underpaid healthcare workers who had almost eradicated the disease from their country by the time she arrived. “They just went through this unbelievable national horror and then they’re going to be cut loose." Still, she didn't have the budget to keep printing as many as they'd like.
Other nuances affected the project, as well. The members of an ambulance crew based in the impoverished West Point neighborhood that the Liberian government forcefully quarantined in August seemed reticent to participate. Eventually, she realized that the stigma associated with the disease was so great in West Point that crew members preferred their anonymity. But another ambulance crew, a self-organized group of first responders who served rural areas as well as parts of Monrovia, posed proudly for photos, intentionally muting their smiles because grins seemed inappropriate for a crew that occasionally had to transport bodies.
By the time Heffernan and Campos left Liberia on March 14, they had set up still-functioning photo-printing stations at two physical sites and left a third with the Liberian Ministry of Health's Case Management team to be deployed where needed. They imagined most sites would be closing down soon, as no new cases had been reported in weeks, but by March 20, a new case had been reported.
“This is an obvious humanistic project,” Heffernan says, acknowledging that humanism is often suspect in the world of contemporary art — many artists who work with photography, including herself, have a resistance to using the notoriously manipulatable medium to convey or document truths about human nature. "But I wanted to act."
Two weeks after her return, she received a note from Joy Hardt, the chief nursing officer at the Tubmanburg ETU, the site Heffernan had visited for the first time just two days before leaving. All the nurses, doctors, psychosocial staff and laboratory technicians had started wearing photos of grinning versions of themselves outside their suits, Hardt reported, and patients had voiced appreciation. So had the staff. "It makes it feel more like I am working with people, with my team," one doctor said, "instead of inanimate objects.”
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