Many heroic local doctors, nurses stay at work despite lack of gloves, equipment, experience
LONDON (Thomson Reuters Foundation) – Hospitals battling the Ebola outbreak in West Africa desperately need more staff, as local doctors leave their posts and foreign doctors are reluctant to come forward, medical experts said during an online debate on the disease.
Medical staff are among the most vulnerable to infection, and several have already died of the virus. Locals have no previous experience of Ebola, how to protect themselves or contain the disease.
“The fear factor is high, but people need to understand that Ebola can be controlled, be it within a clinic or within a country,” said Francis Kasolo, coordinator of the World Health Organization’s Sub-regional Ebola Outbreak Coordination Centre in Conakry, Guinea. He was one of five panellists at the debate organised by Thomson Reuters Foundation.
The crisis is symptomatic of the state of local health systems, the panellists said. The three most seriously affected countries – Sierra Leone, Guinea and Liberia – have very few local doctors and nurses. Sierra Leone, for example, has only a few hundred local medical staff to serve a population of nearly 6 million, according to WHO figures.
Ambulances are also in short supply. Just four serve a population of about 470,000 in Kailahun district in eastern Sierra Leone, according to Anja Wolz, emergency coordinator for medical charity Medecins Sans Frontieres (MSF), who was recently in Sierra Leone.
There are not enough protective suits made to the right specification, and hospitals even lack gloves, the experts said.
Aid agencies and local authorities do not have enough resources to collect dead bodies safely. The panellists said they had heard reports of people in Liberia waiting 30 hours or more for someone to collect their dead.
Although some medical staff are fleeing their posts, many are staying despite the dangers.
“The heroic local doctors and nurses must be acknowledged and we need to find ways to remunerate them for their dangerous work,” said Johan Von Schreeb, professor of international disaster medicine at the Karolinska Institut in Sweden.
QUARANTINE
In an attempt to contain the virus, Liberia imposed a quarantine in West Point, a large slum in the capital Monrovia, on August 19. Security forces have been deployed to stop people from entering or leaving the area.
Although quarantines are an effective way of stopping transmission in principle, in practice they are very difficult to maintain and have a major impact on those forced into isolation, said Korto Williams, country director for ActionAid Liberia.
“To do this and not have an effective plan for contact tracing, will not help to end the crisis,” Williams said, referring to the need to trace all the people that Ebola patients have come into contact with.
“Quarantine should not mean the creation of plague villages,” he added. “Ebola affected communities must not be abandoned. There should be no ‘no go’ areas for health workers.”
He added that trade and communications should be allowed to continue in areas under quarantine, to avoid further impoverishing those whose communities and livelihoods are already at risk.
CAN ANY GOOD COME OF THE OUTBREAK?
The outbreak will take many months to stabilise, Kasolo said.
In the meantime, local medical staff are gaining experience in how to treat and contain the epidemic, which will hopefully stand them in good stead in the future, some of the panellists said.
But more money and resources are desperately needed to improve local health systems.
Kasolo said that several donors are interested in building the health systems in West Africa.
“This is the marathon that will follow this run,” he added.
(Editing by Tim Pearce; timothy.pearce@thomsonreuters.com)
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