* Any views expressed in this opinion piece are those of the author and not of Thomson Reuters Foundation.
Health charities on the frontline of the Ebola crisis are demanding more action from states to combat the disease from a clinical treatment side – providing more staff and treatment centres – with some stating this is the most effective way to halt this latest outbreak.
This is of course necessary – the treatment response is woefully underfunded and underserved. The health systems in West Africa have, at the time of writing, lost almost 150 staff to the disease, and many more are too scared to go to work as a result. This is an urgent problem not least because many other diseases and conditions will also be going untreated due to the weakened health system.
But is focussing on treatment the most effective way to curb this latest Ebola surge? It could indeed save some lives – although once you’ve contracted Ebola, treatment is no certainty of survival. Previous outbreaks could be stopped with treatment centres due to their remote and localised nature. Yet experiences from past dealings with Ebola may not be applicable this time due the sheer scale of the outbreak which is ten times the size of the previous largest and growing.
Ultimately, without some huge-scale community outreach there’s no amount of treatment that will stop this outbreak. Public trust in health services, already fragile, is quickly eroded by Ebola due to high fatality rates. People see family members going into a treatment centre with a 50 per cent chance (at best) of coming out again and so naturally enough they are sceptical.
As faith in the health system dissipates, people turn to traditional remedies and continue with risky practices such as burial ceremonies that expose others to the virus, or those infected remaining at home while relatives pray. And people can migrate, carrying the virus with them and spreading it into new, ill-prepared communities.
So there needs to be a focus on prevention rather than just treatment including extensive programmes that teach communities what to do when someone falls ill. We need to remove a rapidly developing stigma that comes with the onset of symptoms which can lead to people hiding the disease or moving away. And we need to strengthen health systems so they can provide efficient case follow up and tracing, along with providing a sympathetic isolation and treatment network.
With this in mind, Doctors of the World has a project in northern Sierra Leone that’s helping to construct isolation units as well as training local health staff on prevention protocols with plans for much wider community outreach in the pipeline.
To do this there needs to be extensive (social) media campaigning, engagement of community institutions, particularly religious ones, along with expert support and capacity building of the health system. Never forget that there are two partners in the health system – users and providers. To address this problem we need to engage both.
