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He was a Liberian medical doctor, and he died from Ebola, a horrible, nightmarish illness. Info coming out of Liberia has been scarce. Since Dr Brisbane's death, we have learnt that other doctors and nurses with whom we have worked have also contracted Ebola and have died or are getting handled in the types of rudimentary services we see on the news. As we dwell in dread of each and every telephone phone, queries about how we die and what we're ready to die for have been weighing on us. The ancients had a notion of a "great death" - dying for one's nation, for example, or gloriously on the battlefield. Solon, the sage of Athens, argued that one couldn't judge a person's happiness until one knew the manner of his death. The Greeks recognised that we're all destined to die and that the greatest we can hope for is a death that positive aspects our loved ones or humanity. For emergency-medicine clinicians this kind of as us, the notion of a very good death can appear too abstract, intangible. Rarely are the deaths we see very good or useful. We see youthful folks who die in the throes of trauma grandparents who die at the end of a extended, debilitating illness people who destroy themselves people who die from their excesses, whether or not of alcohol, foods or cigarettes. Last 12 months, as component of a new disaster-medicine fellowship programme, we produced a partnership with John F Kennedy Memorial Medical Centre in Monrovia, the only academic referral hospital in Liberia. We collaborated with the hospital administration to build disaster- organizing and resilience programmes and teamed up with the emergency department (ED) workers to increase medical education and create epidemiologic studies of trauma. It was there that we met Dr Brisbane, the ED director. He instantly struck us as a genuine ED medical professional - at after caring and profane, light-hearted 1 minute, intense the next. A brief, bald man with weathered skin and thick glasses, he spoke openly and simply his laugh was best described as a giggle, and he swore frequently. When we conducted an initial vulnerability examination for the hospital, we mentioned our concerns about significant supply and personnel shortages, normal energy outages, and occasional electrical fires. Dr Brisbane replied that what scared him the most was the potential for an epidemic of some viral hemorrhagic fever. He was proper to be frightened. We encountered rationing of gloves, a restricted supply of hand soap, and an institutional hesitance to practice universal precautions, most likely simply because of the constrained resources. The hospital was not ready for the sort of epidemic it really is now dealing with - nor was the city of about one.five million people. In images: Ebola virus Throughout our time at JFK, we grew to become buddies with Dr Brisbane. We learnt that he'd skilled in Germany in the 1970s, had returned to Liberia to function, and had picked to remain through the civil war and during Charles Taylor's despotic rule, continuing to see individuals despite the bloodshed around him. He had welcomed the country's new democratic leadership and a new female administrator at the hospital - a initial. He ran a productive coffee plantation and gave us bags of coffee every time we visited him. He was the father of eight biological children and six adopted youngsters, and he had numerous grandchildren close to the globe. Within a couple of days after our return to Monrovia in June 2014, the city's very first patients with Ebola presented at Redemption, the county hospital, and we quickly received word that a medical professional and some nurses there had died. Rumours have been rampant, and workers speedily abandoned that hospital. At JFK, our colleagues grew nervous. There had been tensions in between the hospital administration and the public Overall health Ministry. There was no clear plan for what to do if a patient suspected of getting Ebola showed up at the hospital. How would personnel members protect themselves? How would they isolate the patient? How could they move the patient to 1 of the ministry's isolation centres? Dr Brisbane was a wreck. He chattered nervously, his smile disappeared when he imagined we weren't viewing, and he openly wondered how he could safeguard himself. He advised us bluntly: "Depart Monrovia." Then one morning, we arrived at the hospital at seven o'clock and ran into Dr Philip Zokonis Ireland, one particular of our young medical doctor close friends. He was agitated, his fear evident in his encounter: there was a patient in the ED with suspected Ebola. The patient had lain in a bed in one particular of the modest, crowded therapy places for six hrs, surrounded by nurses and other sufferers, right up until a person recognised his signs and symptoms. We rushed to the area and met Dr Brisbane and Dr Abraham Borbor, the head of internal medication. Other folks have been sensing that anything was incorrect. Individuals and their family members members quickly disappeared, and nurses hung far back in the hallway. An Ebola patient lies in an isolation ward in Monrovia, Liberia (Getty) The very first priority was to get the patient out of the typical room and into an isolation space, but the bed he was lying on was too broad for the doorway. So Dr Brisbane, Dr Borbor and two custodians hastily donned gowns, gloves and masks, then lifted the patient - mattress and all - and carried him into the isolation area, almost dropping him in the method. The guy had begun gasping for breath, and despite their efforts, within five minutes he was dead. Later on that day, tests confirmed that he was certainly infected with Ebola virus. His entire body stayed in the now-otherwise-empty ED right up until it was retrieved hrs later on by the Well being Ministry. We remained in Monrovia for the subsequent week and helped nonetheless we could. Dr Brisbane brought his very own thermometer and checked his temperature religiously, fearing the telltale sudden fever. He wore a fedora in the hospital as a protective talisman. And however he still joked with us, displaying a type of gallows humour. A number of days after we'd returned to the States, we got a contact from Monrovia saying that Dr Brisbane was in isolation and had examined constructive for Ebola. The next get in touch with informed us of his death and hasty burial. By late August, Dr Ireland and one particular of the nurses we knew had contracted Ebola and Dr Borbor and a healthcare assistant who'd worked in the ED had died from the virus. Read through much more: Ebola virus spread by taxi passengers, says WHO Why has 'Big Pharma' failed deadly virus' victims? Video demonstrates Ebola victim sending marketplace goers fleeing in fearDr Brisbane did not have to keep at JFK and continue to care for patients. He could simply have retired to his coffee plantation with his wife and young children and grandchildren. He was terrified of Ebola, and yet we knew that every single morning when we entered the ED, we would locate him there, seeing his patients. Physicians and nurses have a duty of care towards their individuals. We're expected, on the basis of our instruction and an unwritten social contract, to fulfil that duty even in much less-than-best conditions - in the face of depleted sources, for instance, or undesirable individuals. But we also have a duty to ourselves and our households, and when our function gets to be daily life-threatening, we have to determine what advantage we will be to our sufferers and what expense it will exact from us. In such situations, we can not be anticipated to uphold the very same duty of care. But during the world's worst Ebola outbreak to date, clinicians this kind of as Dr Brisbane are on the front lines - and are dying as a end result. They care for sufferers regardless of the dangers to themselves, in spite of the inadequate supplies and infrastructure, despite their inadequate instruction in infection management. Dr Sam Brisbane's death diminishes us as a individuals. But with apologies to his wife and loved ones, who noticed him die horribly and unjustly, and despite the deep reduction we really feel, we feel our good friend died a great death - as did all the nurses and physicians who have sacrificed themselves caring for sufferers with this awful condition. This report was initially published in 'The New England Journal of Medicine' 'This is the most terrifying epidemic I can keep in mind - and front-line health care personnel are most at risk' By Jeremy Laurance Sam Brisbane was the very first doctor to die of Ebola in West Africa. Because then, the outbreak that he strove bravely to incorporate has exploded into an epidemic. It is the most terrifying I remember in much more than thirty years as a health reporter. Healthcare staff on the front line are at highest risk. Some 152 have been contaminated in Liberia and 79 have died, according to the Globe Well being Organisation (WHO). Early signs of Ebola - fever, vomiting, diarrhoea - mimic these of other infections, so individuals might at first be handled on standard wards, exactly where they pass the virus to other people and infect medical personnel who lack protective clothes. Hospitals have become incubators of the epidemic. In Liberia's capital, Monrovia, taxis filled with households carrying suspected Ebola victims criss-cross the city searching for a bed - and uncover none. There are no totally free beds for Ebola cases anywhere in the country, says WHO. As soon as a facility opens, it is overwhelmed. A important avenue of transmission is now imagined to be the taxis and motorbike taxis that carry 1000's of individuals every day, simply because they are not disinfected amongst passengers. As sufferers are turned away from hospitals and clinics, they return residence to infect other people, spreading panic along with the virus. Sufferers with other urgent health-related demands - mothers in labour, kids with malaria - are unable to get therapy. The illness has totally overwhelmed all attempts to control it. The official toll is far more than two,000 circumstances and 1,000 deaths in Liberia, and a lot more than twice that amount across West Africa, but nearly half of these have occurred in the past three weeks. The ailment is spreading exponentially. The WHO estimates that 1,000 beds for Ebola patients are needed in Monrovia and the surrounding region alone, with at least three,000 healthcare personnel to run them, plus several other folks (pilots, cargo handlers, drivers) to get them in and out. Who will volunteer to serve in the scorching zone? The global community should now honour Dr Sam Brisbane's sacrifice and massively scale up its response.see here

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Is There a Real Roofer Around Anymore?

I remember the day when bad roofers and good roofers were a dime a dozen. Now it seems the young generation would rather play video games than work hard and most of the roofers that you see are mainly Spanish. It does not matter what race you are what matters is that you care about your work and not just about the money. Like many storm chasers across the country there are many contractors that know squat about roofing and could not even tell you how to lay the first shingle. They just want the job done as quickly as possible so that the money will fly into their bank account. In the old days there were no contracts. Roofing contractors were hard working, respected and well trusted. Many storm chasers set up shop across the country racing to start up a new LLC. During the storm season they rampage cities that have suffered great damage. These storm chasers usually know nothing about roofing and don’t even have any interest to learn. They rape insurance companies and travel with hundreds of Spanish roofers. In their business its quantity not quality that matters and the roof leaks that they leave behind is the homeowners’ problem once the LLC is gone and they travel to the next storm far away. I cannot help to wonder if this is where the old saying “Fly By Night” was created. You may be desperate for a roofer to protect your home but please don’t let emotion cloud your decision. Find a local roofer, someone that has been in the area for a longtime. You may get a roof for free, paid for by your insurance company but in the long haul you may have to pay double or even triple for damaged caused by poor workmanship. Locate a trusted roofing contractor in your area.

Roofers in Chesapeake, Virginia

Its time for you to install a new roof in your bedroom or living room but you don’t have a clue about how to get it done. Don’t even think of doing a DIY project because a roof is not something an amateur should attempt to fix.  It needs special skills, tools and experience and even those with some training will be wary about undertaking a roofing job of a major proportion.   A high roof can also be a dangerous place to be in for the uninitiated so don’t think it will be easy climbing the roof holding on to a bag of tools and other implements you will require for the job; not to mention, the sun, wind and rain that will lash you from time to time, making your work even more difficult and risky.

But why even think of doing such a big job yourself when you can find an expert roofing company in Chesapeake, Virginia to do the job for you. A little bit of research is all you need to find a very good roof repair company that will have the necessary labor and the know how to fix your roof as quickly as you want it.  A search for roof repair companies on the internet will provide you with enough and more information so that you can take your own time to go through the websites and look for a company that you feel will offer you the best deal for the job.

Don’t always go for the cheapest when looking for roofers in Chesapeake, Virginia because you don’t want a company that quotes the cheapest prices in view of employing unskilled workmen that don’t have to be paid high wages or because they use inferior material in order to keep their estimates low.  By comparing two or three roof repair companies in the area you will be able to get an idea of the average prices quoted and settle for one that is not only in keeping with your budget but also provides quality work that is affordable. 

Finding a roofing contractor in Chesapeake, Virginia that has good credentials and is known for their reliability is also important. Read reviews posted by clients to see if the company you’re interested in hiring is capable of completing a job and handing it over on time or whether they run away half way through leaving you to find another contractor and more money to finish the work.  This is why referrals are important and you should always ask for them from your potential contractor and also call the people who have provided those referrals to make sure that the company in question is what they promise to be.

If you’re in any doubt at all, it’s a wise move to get in touch with the Better Business Bureau to check if the roofing company in Chesapeake, Virginia you hope to hire is above board and has no complaints against it for any reason whatsoever. These days you have to be very careful about traders you deal with and investigating every avenue open will ensure that you hire only the best for your roof work and this will also leave you with peace of mind.

Roofing Contractor in Chesapeake, Virginia

A roofing contractor in Chesapeake, Virginia can be easily found when you wish to have your roof repaired or installed and the best way to search for one is on the internet.  Some architects and civil contractors don’t give the roof the same attention they give the rest of the house, but this can be a big mistake because the roof is a very important part of the whole structure and therefore you must find a roofing company that will build you the best roof possible thereby providing you with security and protection from external elements.

A roof is one of the most battered parts of any building because the first impact of any element such as a cyclone or even a heavy downpour is first felt on the roof of your house. Strong winds can bring down trees and cables that can also damage the roof or displace shingles and even make holes in the tiles that subsequently spring leaks. All these factors makes it necessary for any home owner to ensure that the roof of his house is always in good shape and since its not possible for an amateur to climb up to the roof from time to time to check for damages, its worthwhile to hire roofers in Chesapeake, Virginia to do the job for you.

But you must remember not to employ just any roof repair company because this is a trade that requires skills and training which can be acquired only in time and with patience. A skilled roofer is not born and it takes quite some time for him to learn all there is about roof installations, replacements, damage repairs, sliding repair, waterproofing etc. as well as how to prepare a roof estimate or arrange for roof certification among other work.  A roofing contractor in Chesapeake, Virginia with all of the above skills and experience at his finger tips is a gold mine for the residents in the area and once you discover such a contractor, you must retain his contact details to be used in future.

Most contractors these days have taken to launching their websites to take their trade out into the world and this is very useful for any home owner on the look out for a professional roofing company in Chesapeake, Virginia. Instead of simply settling for the first name you come across on the search engine, it’s better to short list a few good companies and then research them thoroughly until you find one that best suits your needs. Always look for references and testimonials given by other clients regarding a particular company because these reviews can be very useful when you have to decide between two equally good roofers in Chesapeake, Virginia.

Once you have selected the roofing contractor in Chesapeake, Virginia you wish to hire, and before drawing up a contract, set up an interview with the company in question and discuss about your project which is a useful way of gauging their attitude, support and expertise all of which will come into play once the work begins. If you feel that everything is as it should be, you can discuss methods of payment and sign the contract so that your roof work can commence without further delay.

Roofing Company in Chesapeake, Virginia

 Roofing Company in Chesapeake, Virginia

You most probably have a beautiful home that you’re proud of and you must be having your home maintained regularly by ensuring that the doors, windows, plumbing and electricity are all in order while you employ a Gardner to keep your outdoor area spick and span. While all this is necessary, its time to ask yourself whether you give the same attention to your roof because unknowingly to you there may be several things happening up there which you cannot see and therefore don’t consider important.  What you must understand is that a roof undergoes much wear and tear due to rain water, storms, snow and mould doing much damage throughout the year. Therefore in order to ensure that your roof is as well maintained as the rest of your home, it’s high time you engaged a roofing contractor in Chesdapeake, Virginia to attend to your roofing needs.

An experienced roof repair company will be able to spot problem areas at once and when hired, will be in a position to do the needful to stop minor problems from snowballing into major repairs. A slight leak that has been going on for a long time might suddenly become a waterfall creating great inconvenience to the occupants as well as damaging your valuables. An experienced roofing company in Chesapeake, Virginia will be able to take care of these problems if hired on a maintenance contract so that they will carry out regular checks and attend to the needful from time to time.

There are many roofers in Chesapeake, Virginia that will be only too pleased to attend to your roofing needs, but it’s up to the home owner to employ only the best company in the area for the job. Work carried out in a careless manner or temporary fixing of a problem area will only create greater problems later on and therefore it’s essential to find a roof repairer that can carry out expert and genuine work that will fix the problems for good. Searching for such roofing in Chesapeake, Virginia can be carried out on the internet where it’s possible to get different companies involved in the trade.

First and foremost you have to ensure that the potential roofing contractor in Chesapeake, Virginia is registered and has a license to operate in the area. He must also have the necessary skilled technicians and tools   that are generally used in the trade and also referrals to prove that they have the requisite experience to carry out the job. A roofing company that has a website will provide you with all these details and by reading the testimonials posted by previous clients; you can gauge the quality of work provided by any roofing company in Chesapeake, Virginia.

Once you have chosen a potential roofing company, you must set up an interview and discuss with him all the relevant details regarding your roofing job. You must ask your contractor various questions such as how he plans to install your roof, what new methods he hopes to use, the material. Tools and manpower that will be used for the project and how long it will take for your roofing company in Chesdapeake, Virginia to complete the work.  You must also check his credentials and if satisfied, you can go ahead and sign the contract so that work can be started immediately.