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Editorial

Stemming Ebola calls for education and collaboration

 Contradicting those who call the Ebola outbreak in West Africa a “natural disaster,” Harvard Medical School professor Paul Farmer has said, “This is the terrorism of poverty....The idea that some lives matter less is the root of what’s wrong with the world.” 

He is co-founder of Partners in Health, which provides medical services in disaster areas and organizes basic health care systems in impoverished areas.  He has written on health, human rights and the role of social inequality in infectious diseases.

Joanne Liu, international president of Doctors without Borders, calls the outbreak “an emergency within an emergency.”

Both organizations establish clinics and hospitals in impoverished areas, creating the framework for routine care and routinely dealing with outbreaks of typhoid, malaria and cholera.

Now those clinics and hospitals in Sierra Leone, Guinea and Liberia are overwhelmed with Ebola patients.  Others who need the usual services are afraid to go or are turned away because of overcrowding.

Doctors without Borders has been warning the World Health Organization (WHO) that this outbreak was more serious than previous ones. Like the Centers for Disease Control (CDC), WHO has suffered severe budget cuts.  Its epidemic response unit was severely cut.  Its work in Africa is complicated because its Africa director does not report directly to the director-general and executives in the three countries are political appointees.  Sierra Leone, Guinea and Liberia are among the world’s poorest countries, with civil unrest, corruption, poor infrastructure and few social services.

Globally, response was slow.  Time was lost looking for someone to blame.  Seeing screaming headlines and lacking real information, people began worrying and believing we were all in danger.

Ebola is nasty and difficult to treat, but is not highly contagious.  It is spread only by people who are symptomatic. People who are exposed but have not become sick are not communicable.  It is not spread through the air, but by close contact through body fluids. Those most likely to develop it live or have travelled in West African countries or have cared for Ebola patients.

Ways to minimize risks of catching it are what we because flu season is approaching: cover coughs and sneezes, wash hands frequently, don’t shake hands much, don’t hug when sniffly and stay home when sick.

Our response to Ebola might have been faster if we had a Surgeon General.  A few in the U.S. Senate have been holding up a vote on the nominee for years.

“Stopping Ebola at its source is the single most effective way to protect Americans,” said Tom Frieden, head of the CDC.

Senegal and Nigeria also have had cases.  Both have been declared Ebola free by WHO.  Their actions are instructive.

Senegal had one case: a student from Guinea exposed before flying to Senegal.  He was treated and recovered. 

As soon as the case was discovered, Senegal closed its 200 mile border with Guinea, and suspended air and sea contact with West Africa.  It later allowed air transport of medical supplies and personnel. 

Experts were consulted.  The patient was isolated and treated. His contacts were traced.  They were monitored for the 21-day incubation period. They were given money, food and counseling. Confidentiality kept them from being social outcasts.   Extensive public education was done.

Nigeria, Africa’s most populous country, did not close its borders. It carefully screens travelers.  Authorities mobilized within days of the arrival of the first case, a Liberian official who collapsed at Lagos’ airport.

Experts from WHO and CDC were brought in. Partisan politics was set aside. The government and opposition worked together. Managers were put in charge. Patients were isolated and treated. Contacts were traced and monitored.  Those who developed symptoms were isolated.  More than 900 contacts of 20 Ebola patients were traced and monitored twice a day. There were 18,500 face-to-face interviews.

An extensive, multi-language, multi-media public awareness program educated the public, encouraged the sick to seek treatment and dispelled rumors.  Teams went to 26,000 households near those exposed.

The U.S. educational response depends on the CDC and state, regional and local health departments.  The Spokane Regional Health District has an Ebola webpage at www.srhd.org with links to the CDC and Department of Health resources.  The CDC Ebola webpage is cdc.gov/vhf/ebola.

Faiths can best help by educating people.

Nancy Minard - Contributing Editor






Copyright © November 2014 - The Fig Tree