Nurse Mark Simmerman has worked hard to help fight SARS. “This has been the most demanding job of my career in terms of responsibility and work hours, but it has been a privilege to live in Thailand and work with the people here,” he said.

On April 24, 2003, Mark Simmerman, RN, MS, FNP, was deployed by the. Centers for Disease Control and Prevention’s International Emerging Infections Program in Bangkok, Thailand, to help fight an outbreak of severe acute respiratory syndrome in a hospital in Taipei, Taiwan.

“The hospital had been quarantined with 1,000 patients, staff and visitors contained to the facility by a police cordon,” Simmerman said. Afraid of spreading the virus, the hospital’s air-conditioning system had been turned off and the staff was working in personal protective equipment gear in temperatures higher than 90 degrees.

“The nursing staff was significantly impacted and the most at risk,” Simmerman said. “They were fearful, overworked and extremely tired.”

Of the 117 SARS cases at the hospital, 39 were nurses and several died.

Concerned about being infected and angered at the handling of the situation, they also were responsible for very sick patients suffering from isolation, depression and anxiety. Because of his research of infectious diseases and the nature of his job, Simmerman was part of the team sent to advise and improve Taipei’s response to the deadly virus.

“The nurses assumed I was a doctor, but I told them I was a nurse,” Simmerman said. “I understood their challenges and could help. As soon as I said that, the environment changed.”

Today, the Taipei Department of Health, working closely with the CDC, has reorganized its outbreak response structure with a SARS task force commander and emergency center. It has established dedicated SARS hospitals, better screening methods and developed an infection-control curriculum to train workers.

Simmerman and two Taiwanese doctors have published the implications of unrecognized SARS and the proposed preventive actions in The Nurse Practitioner (Vol. 28, No. 11). Their article acknowledges the hospital nurses who showed remarkable dedication and courage under difficult circumstances. “Nurses can do all sorts of amazing things,” Simmerman said. “They learn core competencies and skills and can transfer them to a wide variety of opportunities.”

Simmerman first saw nurses in action when he was a 17-year-old volunteer in Eritrean refugee camps in the Sudan. “Coming from a middle-class neighborhood, I saw things I never expected to see happen to people, and I met two nurse practitioners — Terry Shields and Laura Sarconen — who were doing things I never thought nurses could do. They had a profound impact on the rest of my life,” Simmerman said.

He entered nursing school that fall and was a registered nurse by the time he was 20.

After accepting a U.S. Public Health Service commission, working as a public health nurse with the Indian Health Service in Montana and earning his family nurse practitioner degree, Simmerman took an assignment in Alaska. With another nurse practitioner, he cared for patients in several villages, traveling by snowmobile, boat and propeller airplane. The nearest doctor was 300 miles away.

“We [cared for] everything — pregnancy, injuries, suicide, diseases, dog bites . . . it was a trial by fire in a stressful, challenging environment,” Simmerman said. “I kept a 25-dog team during the long, dark winters to keep my mind engaged.”

Wanting to earn his doctorate degree at Tulane University and increase his epidemiology skills, Simmerman went to work for the CDC as a public health adviser with the National Immunization Program in New Orleans.

That led to a dream opportunity to become operations director of the CDC’s first International Emerging Infection Program in Thailand.

“It was a new concept for NCID (National Center for Infectious Diseases) to establish an international surveillance and research program by working collaboratively with a host country,” he said. “We had to establish an office, lab, vehicles and hire staff. I appreciated the chance to do something where I wasn’t following in anyone’s footsteps. We were inventing the wheel.”

Simmerman got a close-up, hands-on view of SARS in Taiwan and avian flu in Vietnam. He is writing his thesis on the burden of influenza in Thailand.

Based on the success of the Bangkok model, the CDC is starting similar collaborative programs in Kenya and Cairo.

“This has been the most demanding job of my career in terms of responsibility and work hours, but it has been a privilege to live in Thailand and work with the people here,” Simmerman said.