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When Mambu Momoh first started volunteering as a Laboratory Technician at Kenema Government Hospital (KGH) in Sierra Leone, he never imagined he would one day become a published researcher who would receive global recognition for his tenacity and dedication to science in the face of unimaginable odds. As Momoh recounts, his lab diagnosed the first case of Ebola in Sierra Leone in May of 2014. At the time, Momoh did not think he would survive after becoming a patient in the Ebola ward where he worked. Read more about his incredible story as a first-line responder surviving Ebola, his unique path to studying Biomedical Sciences at Tulane, and his perspective that training and retaining local expert scientists should be at the forefront of outbreak preparedness, especially in low-resource countries: 

Can you tell me a little bit about your academic and research background?*

I’m from Kenema District, in the eastern part of Sierra Leone. Kenema is also where I started my education. Because my family did not have the means to send me to a university, I worked to put myself into one of the polytechnic schools the country created after the 11 years of civil war, Eastern Polytechnic College. At that time, I became one of the most successful students in my program. I was called upon by the ministry of health to start volunteering at Kenema Government Hospital, apparently a prerequisite to eventually taking on a formal role in the government-run institution, which is not readily available after college. So in my case, I had to volunteer for almost three years as a Laboratory Technician, where it was my responsibility to collect diagnostic clinical samples while also helping patients with clinical lab testing. The ministry finally enrolled me into the system after this period of volunteering, which was also when I began teaching at the same polytechnic I attended a few years prior. This was around 2007 to 2009, so a long time ago. (laughs) At that time, I was far from being established as an academic, but due to my dedication, as well as my love for the work and collaboration, I was able to carve my unique path to research. 

I joined the Viral Hemorrhagic Fever (VHF) Laboratory at KGH, where one of our main focuses is diagnosing viral hemorrhagic diseases, namely Lassa Fever and Ebola. While testing clinical samples, I challenged myself to ask scientific questions that went beyond diagnosis. Our site has been at the center of every outbreak in Sierra Leone. My lab diagnosed the first case of Ebola in the country. From these experiences, we acutely feel the urgency of why we must understand the viral immunology of Ebola and other emerging pathogens, and how this knowledge informs the development of therapeutics and prevents future outbreaks.  

While working at VHF, I had the opportunity to interact with many visiting experts. Through this, I began to learn many new skills and techniques which applied to my work. I also had the opportunity to learn highly critical skills in genomics and viral immunology through visits to the United States, skills which I have brought back to Sierra Leone. For example, I was able to apply what I learned in the development and validation of the first rapid diagnostic tests for Ebola and Lassa when they were later deployed. Rapid diagnostic tests helped with the Ebola outbreak in Sierra Leone, and are still being used across West Africa for Lassa Fever diagnosis. 

Over the years that I’ve been leading the VHF Lab team at KGH under the Sierra Leone Ministry of Health, I’ve been key in providing partnerships with many collaborators on different projects, including working with scientists at the Scripps Research Institute, Tulane University, the Harvard/ Broad Institute, and UTMB in the USA, as well as Redeemer’s University in Nigeria to study the transmission dynamics of Lassa Fever, Ebola and other emerging infectious diseases with the goal of providing useful information for their accurate, reliable diagnosis and other therapeutic information. I played a critical role with our partners here at Tulane, and at Zalgen, to build and validate the two rapid diagnostic tests I mentioned earlier.

Through my work as a member of the Viral Hemorrhagic Fever Consortium (VHFC), I’ve expanded my knowledge in the field of biomedical sciences and learned how to work as an independent researcher. This led me directly on the path to graduate studies. 

What are some of your career goals? How has this led you to the program you’re completing currently at Tulane? 

I first came to Tulane to pursue my interests in Microbiology and Immunology. After completing my Master of Science and returning back home, I decided I wanted to continue my education at Tulane through enrolling in the PhD program in Biomedical Sciences. I aim to advance infectious disease research in Sierra Leone and champion the capacity-building of the next generation of scientists in my country.

My first time in the U.S. was to attend a genomic training at Harvard with Pardis Sabeti, and I was incredibly inspired by the work everyone was doing and what science at that level looked like. My next thought was how I could bring that to Sierra Leone. Many people who are given these opportunities think about how they can stay in the U.S., but that was not my aim. I returned home to help establish a viral genomic sequencing unit in our lab under high containment conditions after the end of the Ebola scourge in my country. My long-term goal is to obtain a PhD in the U.S. to expand my knowledge and expertise in biomedical sciences and bring that knowledge back to Sierra Leone to create the workforce that will fight infectious diseases. It’s such a big opportunity to have a cohort of scientific experts at the VHFC with a wide array of academic backgrounds to learn from, and who are also invested in learning from us. It’s such a great thing for the whole world to learn from.

My specific interests are in viral immunology, particularly trying to understand the immunological dynamics of Ebola and Lassa fever, and other emerging infectious diseases in order to support the development of novel vaccines and other countermeasures. I’m also highly interested in the development of rapid diagnostics capabilities. Early diagnosis is key to stopping the spread of infectious diseases. Having a rapid diagnostic platform that is capable of conducting surveillance in hard to reach, low-resource areas is a great thing— with a huge impact in preventing regional disease spread.

You recently worked on a study investigating cellular immunity in Lassa fever survivors. Why is it important to understand the immune response to Lassa and other similar viruses? 

That is a great question, and it is actually a big part of my PhD project. My current research objective is to gain an understanding of humoral and cellular immunity in Ebola and Lassa survivors, and how this will inform vaccine strategies and development. Vaccinating Ebola survivors is important because studies have shown that the virus is likely sequestered somewhere in people who survive the disease, and may still pose a threat. Because survivors may be one of the sources of Ebola re-emergence, this brings up many questions related to studying immunity in both Ebola and Lassa Fever survivors. Pursuing these questions can inform us how to develop vaccination and other therapeutic strategies to protect both survivors and their communities. 

From your experience as an epidemic responder and researcher, what have you observed to be some of the most important factors that hospitals, communities, or governments must consider for outbreak preparedness?

When I give talks to members of the scientific community about being a first responder to outbreaks in my country, I try to express what it means to be both in the community that is being impacted and a scientist. During the Ebola outbreak, this is exemplified by how I found myself as a patient in the ward at the hospital where I worked. At KGH, our greatest challenges were limited expertise and infection control. We had previously utilized a system-based capacity for admitting Lassa patients, and then Ebola struck. Because we were the only setting at that time which had a level of preparedness for Lassa viral hemorrhagic fever, this system-based capacity was forced to hold more than 100 Ebola patients. Compared to the system-based capacity, our actual capacity was only for 16 patients. When dealing with a highly infectious disease of this nature, under those circumstances, infection control became nearly impossible. 

There was a horrible moment when we almost lost all of our colleagues in the hospital to the Ebola disease. When there were very few of us left working, our families nearly gave up on us, because they thought there was no way we could survive. When I was admitted as a patient, I was the first person to come out of the Ebola ward alive at that particular point in time from a room that was designated for admitting infected health workers. When I share my experience with those in the scientific community, I highlight what we were able to achieve with very very little resources. And how we believed in ourselves, even before the international community stepped in. My knowledge of highly contagious viruses, and the skills I gained through working as a laboratory scientist, directly allowed me to survive Ebola.

My personal experience has led me to conclude that human capacity building is paramount to effective outbreak preparedness and should be the key focus. I can attest that it was expertise, the human capacity, that helped me survive Ebola. It is how we diagnosed the first case of Ebola, and it is how we helped patients throughout the outbreak. So building human capacity is one key thing that hospitals should embark on, in addition to the investment in material resources. When you have the expertise, you can be more flexible with utilizing the limited available resources. This is why expanding this cohort of the workforceresearchers, scientists, and first responders, is critical for developing countries’ outbreak preparedness. Additionally, with this expanded workforce, surveillance capacities are increased. Which means you don’t have to wait until the outbreak has already started, and can instead stem outbreaks before they have the chance to spread. 

In Sierra Leone, infectious disease surveillance is a challenge because rapid diagnostic technologies need to be functional in areas without substantial infrastructure. For example, lack of electricity is one of the biggest obstacles we face. If I’m advising scientists, I will always advise them to consider how their technology can be developed to fit the infrastructure where it will be deployed. So in the case of diagnostics, the platform needs to be robust, but not too highly sophisticated. 

So ultimately, I think the two most important factors are building surveillance through accessible diagnostic platforms and building human capacity by investing in the people who will have the ability to respond to future outbreaks. 

What advice would you give to an aspiring scientist interested in a career similar to yours?

It doesn’t have to start and end with us. There are a lot of diseases that the global community are interested in, but there are also lots of diseases that circulate in our communities which are neglected. To aspiring scientists, I would emphasize the importance of taking risks and challenging themselves— taking inspiration from examples like my own; the risks I took, and the challenges I overcame, which have brought me this far. To apply the love of your community, your workplace and the knowledge and skills you gain towards developing your own techniques and technology that will be most applicable to your communities, as well as the wider global community. 

When you think, for example, of Malaria—  around 1 out of every 8-10 children who come to our community hospitals in Sierra Leone die of Malaria, as reported by our health ministry in 2015-2016. Similar numbers would exist for other neglected tropical diseases. This is not Ebola, this is not Lassa Fever, this is not Covid. So what do we do? There are a lot of these diseases being a leading cause of death in our localities, so, the knowledge gained must be taken down to the community level to bring about better countermeasures and prevention strategies. I am very interested in focusing on countermeasures research for these neglected infectious diseases, which serve as one of the major health burdens, in addition to epidemic-prone diseases. 

My personal advice that I give, since I began teaching at the polytechnic I attended, is to take necessary risks in the pursuit of your goal, have patience and determination in everything you do, and to take advantage of where you are and build connections with the people around you. 

I never dreamt of where I’d be today, and I hope to serve as a living example of what’s possible. When I abruptly found myself as an Ebola patient in the same hospital where I was fighting to save my people, I knew it was a death sentence because only the corpses of health workers left the room I was about to enter. I felt like I was at the gallows, waiting to die. To come from that, to become a scientist with demonstrated contributions to science, with more than 30 peer-reviewed publications in highly rated journals, all before completing an advanced degree, is unbelievable. I already feel fulfilled, and I am so proud of the recognition I received from my community and the globe, and from Time Magazine in particular, where I was recognized as one of the Ebola heroes of 2014 who were at the forefront of the Ebola outbreak response.  

In the VHFC, I have known and worked alongside scientists like Robert Garry, Kristian Anderson, Luis Branco, Matt Bioson, Pardis Sabeti, Robert Cross, John Schieffelin, and others who have always instilled in me the confidence that I could do more. You always have to take advantage of these kinds of great resources, and whatever the job is that you find yourself working in, to learn more. Do that, and connect with people, and you will find that whatever your aspirations are, you can do it. 

*Interview conducted by Kyra Benowitz on February 23rd, 2023