be stepping down any time soon don't forget there's lots more on our website aljazeera.com. get the latest on all the stories we're following, including that ongoing security operation in that university attack in pakistan. good evening. welcome to america tonight. i'm lisa fletcher in for joie chen. only one day after west africa was announced ebola free, the

virus returned. a student died in sierra leone. the country has quarantined more than 100 people. the case is a reminder that the world's fight against the deadly disease may not be over. that fact never far from the mind of dr ian crow who travelled to west africa to help fight the disease only to find himself in the fight of his life. >> reporter: ebola, one of the deadliest viruses known to man. this man, infectious disease specialist, knows that better than most >> reporter: had someone you your own charts with the outcome left off and you had read everything that happened to that person, would you have expected that person to have survived? >> probably not. if you had told me on one day one that a week later i would develop multi system organ failure, brain failure, respiratory failure, kidney failure, and asked me to predict

my survive, it probably would have been zero. >> reporter: he survived one of the worst ebola infections american doctors say they've ever seen. 16 months ago he was treating ebola patients as part of a world health organisation team. in the 2014 outbreak in liberia, sloan, guinea, the who counted an unprecedented 28,000 cases. some estimates go much higher sierra leone-- he says he was prepared, technically >> i've called this virus a villain of a virus. it not only kills people at very high rates, but it does so with an aggression that is really dignity-robbing for patients. no-one has ever really prepared for the devastation that you see in individual patients lives and in families and dealing with that degree of suffering on a daily, regular basis is difficult. >> reporter: he wasn't in sierra

leone long, only about a month. one day he felt fatigued. by night fall experiencing the symptoms he knew only too well. >> fever and muscle aches and at the time a severe headache and the next morning i alerted the team and took my blood and then a few hours later on that day i had a positive test. >> reporter: did you know in your gut that you probably had results? >> no. i was hoping strongly that it was because i had failed to take my malaria medications. no. i didn't think that >> reporter: two days later he arrived in the u.s. he emerged from an ambulance in full protective gear at the university hospital. one of only four bio- containment facilities in the country prepared to treaty bowl apatients

>> the-- treat ebola patient >> i don't remember much. >> reporter: he was the sickest of the four ebola patients with 100 times more virus in his blood than any of the others. he spent more than 40 days fighting for his life. his kidneys failed. he was put on dyallasis. he was given experimental drugs and given plaz ma. he was finally discharged in mid october and declared ebola free. no sign of the virus in his blood or urine. little did anyone know the virus was still hiding in his body. >> i developed severe inflammation in the left eye and we decided to sample the fluid inside the eye and that's when we found that the virus was there.

it was present at very high levels and it was active multiplying ebola virus. it was hitching a ride quietly unbeknownst no us. >> reporter: he-- to us. >> reporter: it was back attacking his left eye, robbing him of his sight >> my eye went from 2015 to virtually blind, my eye losts its pressure and became soft and began to lose its architecture. >> reporter: it changed color. >> yes. i woke up and my eye was green >> reporter: they're not sure why it changed color, but his case has given him new insight in to how insidious the virus is and tools to help other victims. >> we have learned that, indeed, the virus can hijack these immune-privileged spaces.

the eye is one of them >> reporter: spinal fluid, semen and breast milk are others. they call them sanctuary sites. areas in the body where the virus can hide. for the most part undetected. given that ebola is a disease with amortality rate of up to 90%, it's a frightening prospect. so far he says he is the only survivor with eye complications who has actually been tested and found to have the virus in his eye. is there still active ebola virus in your eye? >> it is an unned at this-- an answered at this point. despite having very high levels of virus in the eye, the outside of my eye, the surface of the eye as well as my tears, were completely negative for virus >> reporter: 30 to on 40% of survivors suffer from some type of eye problem, but it is it is

unclear how many may still still harbour the virus in their eye. that's because specialists and sophisticated procedures is needed to make the diagnosis. there's one doctor in every 45,000 people in sierra leone. making yet another turn of events for ebola survivors even more difficult to identify and treat. many are now experiencing something else. symptoms that are being called post-ebola syndrome. a host of ail meants ranging from fatigue and headaches to severe joint and muscle pain, hearing and vision loss and short-term memory loss. along with everything else, this doctor is experiencing those post-ebola symptoms too >> i have had a long list of complications. mainly this fatigue and joint

muscle pains. i've had some issues related to my brain since then. >> reporter: but none of this has stopped him from being back to the kon continent to work. he was born in zimbabwe. africa, he says, is in his heart >> i feel attached to these survivors. i'm one of them. of course, i have to hold together these odd tensions. on one hand it's fairly clear that i would have been dead in a week had i not been med-evacuated. on the other hand i'm haunted by the fact that so many of my patients and my some colleagues and a few friends of mine did not have access to the same care. >> reporter: since his eye problem, he has gone back to west africa several times. in august of 2015 he returned with a team of eye specialists from emory to help educate doctors on this latest discovery about ebola's aggressive

persistence and donate much needed diagnostic equipment. he is also using his personal experience to teach medical approaches here in the u.s. about the ongoing effects of ebola. last month he returned to his university school of medicine where researchers are walking on annie bowl avaccine. he-- an ebola vaccine. he talked to crowds where he was treated like a returning hero. >> he halls a talent for brother-in-lawing the-- bridging the gap in being a patient and being a doctor. >> reporter: his mentor was in the audience >> he can bring those two worlds together and make the illness itself vivid to the doctors who are listening to him. that, of course, will make all of us better doctors should we be in the position of having to

care for annie bowl apatient future. >> i have an opportunity, as i speak these days, to unpack a very compelling scientific and medical story and to call attention to the emerging need to take care of these 15 or 16,000 survivors. he knows his journey is far from over, given the uncertainty of ebola. he considers himself lucky and fortunate that both doctors and experience. >> i've always loved that sacred space, that is the bedside. i've loved that part of practising medicine and practising infectious diseases, but i haven't known it to the degree that i do now. i think i probably have a new, just a small new appreciation for what it means to be helpless

and vulnerable in that space, and that can only make you a better caregiver. probably ultimately will change how i practice medicine for the rest of my days next on america tonight the future of ebola. i sit down with one of the world's leading infection shows disease experts to discuss the battle against ebola and talk about the strides that the scientific community have made to prevent another outbreak. then later, a gims at the special of europe's ongoing refugee crisis and the migrants in limb go-- glimpse-- migrants in limbo. >> water is a human right! >> flint in a state of emergency. >> this can cause death... all kinds of health effects. >> we're already having trouble, but now what little i have has to completely go towards water.

>> only on al jazeera america.

the director of the of medical, his research to prevent and diagnose from hiv to agents of the bio- terrorism is known across the globe. i sat down with this doctor for a fascinating conversation about ebola. the latest research, innovations and where we are globally with not only this deadly disease but other viral villains.

>> we're doing a series of stories on ebola and one of these phrases that keeps popping up is post ebola syndrome. can you explain so the average person can understand what post ebola syndrome is and how it is different from ebola? >> first of all, post ebola, it means people have cleared the virus and they are no longer ill with ebola virus, but some of the manifestations that people are left with and quite frankly we don't know how long they will be left with that because some of them have been having these symptoms for months to even as long as a year and they include a wide variety of things related to vision, the eyes, to joint aches, to neurological issues, issues of restlessness, sleeplessness, weakness. some of the really quite severe

to the point of being relatively incapacitated. >> reporter: in addition to his concerns about post ebola syndrome, his team is working to understand something even more dangerous. whether the ebola virus is live on in the bodies of survivors. there's probably no team of researchers better equipped and more sophisticated and more capable than yours here. how much do you all know about the ebola that's getting into these sanctuary sites, eyeball, spinal fluid and elsewhere in the body? >> that is a big mystery. that's the reason why we're doing a very large survivor study. to follow people, a large number of people, for a considerable period of time, measured over years, to determine the extent of their symptoms and, importantly, are any of these symptoms associated with a hiding of the virus in a very secluded place like the eye or

the semen or even in the central nervous system and whether or not that ultimately clears >> i guess questions like if you have the post ebola syndrome, what is the likelihood that you're going to have it in your body is a question mark? >> it is a question mark that is becoming clear that it is extraordinarily unusual if someone is going to relapse; namely, get ebola, get completely better, have symptoms but not be exposed to ee goal aagain and then-- bee bowl aagain and then throughed get a relapse of ebola >> reporter: so far he hasn't found the virus in any of the survivors. nonetheless, they hope to study 1500 survivors and six thousand of their contacts. so far 1100 survivors and almost a thousand contacts have signed on. those who sign up will be followed for two years.

it will be the largest survivor study ever done >> reporter: are you optimistic? >> i'm optimistic that we're going to learn a lot. we certainly, when you study such a large number of individuals, learn a lot about a disease that has been around and recognised since 1976. >> reporter: are we globally prepared for the next magnitude of order if the history repeats itself? >> things are better now and our preparedness to be able to respond in remote areas such as in the west african countries of liberia, sierra leone and guinea. one of the things that is an under lying lesion in all of this is the relatively inadequate health care infrastructure in certain countries. there would not have been an outbreak of the magnitude that we saw in west africa if the

countries involved had even minimum health care infrastructure >> reporter: do you and your team have an idea of what the next ebola could be? are there certain viruses that you look at that could emerge in a dangerous way? >> sure. i could give you a list of viruses that might be outbreak viruses >> reporter: is it long? >> you can make it as long as you want >> reporter: i wanted you to say it is really short. >> i will tell you an important thing is that you can make all the lists you want, but the one that gets you is usually the one that you don't expect. if you had asked me in the beginning of 1981 what do you think the next big global threat would be, i wouldn't have been able to say hiv aids, which we recognised in the summer of 1981 because no-one had ever heard of aids or hiv. it was a brand new disease.

so when you say make a list, you've got to realise there's a list of known viruses, known bacteria, known microbes, and then there's a list of things that we don't know about. so you're dealing with two buckets of things that you have to be prepared for. >> reporter: let's talk about vaccines because here at m i.h.a.t. you an your team developed the ebola vaccine. what goes into creating a vaccine? >> it is a spectrum. it goes from a fundamental concept all the way up to the actual product. so from the year 2000/2001 until around 2013, the investigators in my institute, several of them, were working on this concept development, pre-conditional studies, into an annual mall, perfect it, perfect it, perfect it, and just coincidentally about the time

the outbreak was recognised, we were getting ready to go into a phase one trial in humans to determine if it was safe and effective. >> reporter: you got lucky >> yeah. we got lucky, and then as soon as it was clear that we were dealing with an outbreak, we had to go into out break mode. so we worked with the fda and we expedited the process that would usually take many, many months. we did it in a couple of months >> reporter: what are you thinking about now? >> a lot of threats. things that are affecting the u.s., dengue fever in south america and the carribean. we developed a disease, chicken gunya which is a serious disease causing joint problems. now we're dealing with a new

virus called zika virus which is causing a serious problem in brazil and other south american countries >> reporter: you've been a key voice and key source of information to the white house for three decades >> >> right. >> reporter: what was it like when you brought the news of ebola to the administration? >> well, the president is a very smart guy. he got it right away. he was very much involved in our effort to do something about ebola, both in west africa and then we got a wake-up call when there was the threat of there being more cases in the uas there was a lot of panic in the u.s. in that the people heard that the two nurses got infected by taking care of the patient in texas. they equated that we were going to get an outbreak of ebola in the u.s. they could see the gruesome

pictures of people dying and they make the connection of that happening here. you don't want to be overly confident, but that was never going to happen here. the reason for that is that we have the infrastructure of being able to identify and isolate cases. when you're dealing with anyone from the general public or the president of the united states, you advise them to act according to the scientific evidence. that is the reason why i think we had a very successful response in the united states. >> reporter: soon he will travel to west africa, to check on the survivor trials and visit a number of clinics in liberia that his team helped renovate in the event of another outbreak. the national institutes will even help staff them. >> reporter: given the new infrastructure and the new doctors and nurses that are being trained up, do you think we're fairly safe in saying there's probably not going to be

another ebola outbreak to the level that we saw last year? >> there may be an outbreak of ebola, but i feel pretty confident with the experience that we've had in west africa now that you would almost certainly not see an outbreak of the magnitude that we just saw because people are prepared, they know what to do, they're well trained, they have experience. the ebola outbreak was an acutely dramatic representation and example of the phenomenon of emerging infectious diseases. new infections have been emerging since the beginning of mankind. to think that it's going to stop is extremely naive because the history of civilization has told us that this just happens in a continuum. what can we do about it? we can try and prepare ourselves

as best as we can, and each time you get challenged by something like ebola, you get a little bit better and a little bit better at being able to respond to these challengess next on america tonight the most vulnerable among us, refugees prayed on for profit and abused supposed to protect them.

now a glimpse at tomorrow's special coverage of the european refugee crisis. for profit companies accused of providing inhuman conditions and security guards with chequered pasts. >> reporter: all along europe's

refugee trail there are helping hands. but where many see humans struggle, others see profit. that is sometimes down right criminal and beyond cruel. home care is the largest provider of refugee services in germany making millions in profits, but it has been accused of having a grim record, including as this photo shows, abusing the care. >> we have a problem that the security is the right wing connection, have right wing connections. >> reporter: a newspaper uncovered abuse by a resident-based security company after this video of guards threatening a lebanese asylum seeker surfaced. the guards were linked to a far right anti immigrant, anti

refugee group that demonstrates every week across germany. the european commission now estimates that three million asylum seekers could arrive in europe by the end of 2016. if the commission is right, then the wars driving the refugee crisis do not end, that can only mean more misery and more profiprofit that's america tonight. tell us what you think at aljazeera.com/america tonight and talk to us on twitter and facebook and come back, we're tonight, tomorrow.> written everyday. it's not always pretty, but it's real... and we show you like no-one else can. this is our american story. this is america tonight.

begun battle underway in a university in pakistan after gunmen kill several students. you're watching al jazeera live from doha. also on the program, iraq's prime minister vows to crackdown on sectarianism. china detains a swedeish active visit. worried over falling birth rates, thailand offers a financial incentive to