By Dr. Peter A. Dumbuya, Columbus, Georgia, USA.
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News on the Ebola virus disease (EVD) from the home front is not comforting, despite the best efforts of governments, inter-governmental organizations, non-governmental organizations, and ordinary citizens and friends of the affected countries: Sierra Leone, Liberia, and Guinea. The Atlanta-based Centers for Disease Control and Prevention (CDC) has warned that “Without additional interventions or changes in community behavior, CDC estimates that by January 20, 2015, there will be a total of approximately 550,000 Ebola cases in Liberia and Sierra Leone or 1.4 million if corrections for under-reporting are made.” These are mind-numbing numbers that call for a redoubling of efforts to contain and defeat this deadly disease.
In the meantime, the number of Ebola cases and deaths continue to rise. As of October 8, the CDC reported 8,399 cases of Ebola of which 4,655 have been confirmed by laboratory tests. The total number of people who have died from the disease stood at 4,033. Liberia tops the chart with 2,316 deaths followed by Sierra Leone with 930, and Guinea with 778. We are now in the tenth month since the Ebola outbreak and the disease shows no signs of slowing down in the affected countries.
SLLG Education and Fundraising Event
With the gruesome reality of EVD in mind, I headed to the Carter Center in Atlanta, Georgia, where the Honorary Consuls of Sierra Leone (Mrs. Cynthia O. Jarrett-Thorpe), Liberia, and Guinea (SLLG) held an Ebola education and fundraising event on Thursday evening October 9. After a brief introduction by Dr. John Stremlau, the Center’s head of peace programs, Ms. Isha Sesay of CNN took the podium as the event’s coordinator of ceremony. Ms. Vanessa Manley put on a special solo-performance on the essence of our connected humanity in the face of adversity such as that posed by the EVD.
First to present a first-hand experience of what it was like to combat Ebola in Liberia and Sierra Leone was Dr. Leisha Nolen of the CDC, and she pulled no punches. In common parlance, Dr. Nolen is a disease detective, and in the CDC community she is an Epidemic Intelligence Service Officer. She’ll be back in Sierra Leone in November to continue the fight against Ebola. She began her presentation by informing her listeners that Ebola is transmitted from person to person through contact with the body fluids of an infected person.
A person is infectious only when she/he starts to show signs and symptoms of the EVD, usually between four to ten days with a maximum of twenty-one days for symptoms to manifest themselves. Ebola signs and symptoms include, but are not limited to, high fever, vomiting, diarrhea, bleeding, and severe headache. In helping to stop the spread of Ebola, the CDC, Dr. Nolen told the audience, works with health ministries and Doctors without Borders, among others, to identify and quarantine sick people in isolation wards. The challenge of identifying Ebola patients in poor and densely populated communities hampers contact tracing and quarantine efforts, Dr. Nolen said.
Among the challenges to containing Ebola, Dr. Nolen identified conflicting beliefs about the existence of the disease with some people viewing it as a hoax by governments to solicit funds from western donor governments. Risky burial practices (including the handling/washing of corpses by bereaved relatives) and the limited number of burial teams also hamper containment efforts. The limited number of doctors, nurses, and other health care workers is being depleted further by Ebola-related deaths in the affected countries.
According to the Liberian Ambassador, Mr. Jeremiah C. Sulunteh, there are currently 710,000 Liberians to one medical doctor; there are four (4) ambulances when the country needs eighty-eight (88) to combat the deadly disease. Other problem areas include: a dearth of vehicles and ambulances to transport the sick to isolation wards; few beds in isolation wards; limited personal protective equipment (PPE); and generally poor infection control protocols and information about the disease’s chain of transmission.
Dr. G. Marshall Lyon, an Associate Professor of medicine in the Division of Infectious Diseases at Emory University in Atlanta, is one of the doctors who treated the Americans (Dr. Kent Brantly and Nancy Writebol) who contracted Ebola in Liberia. He also spoke of a lack of PPEs, medical supplies, and health care facilities in the affected countries. Dr. Lyon told the audience that the needs are many and varied and include trained staff to care for the sick, stuff such as intravenous fluids and PPEs, and systems to include health care and public health facilities, mechanisms for contact tracing, and laboratory capacity to conduct tests for infectious diseases like Ebola.
On Saturday October 11, the U.S. began a screening program in five airports for travelers from the Ebola-affected countries. Some pundits and politicians are calling for a total ban on all flights originating in these countries. The new screening programs went into effect just as the second Ebola case is being reported from Dallas, Texas, where Thomas E. Duncan from Liberia died of Ebola on October 8.
So, what is the takeaway from Thursday’s education and fundraising event? The participating medical professionals had clearly identified the various ways of preventing and containing the Ebola virus disease. It is now up to the countries affected to learn the lessons of this outbreak which is the worst of its kind since the first Ebola outbreak in Central Africa in 1976. Dr. Nolen spoke of Ebola containment challenges posed by densely populated cities with homes that lack running water and indoor plumbing, electricity, and good roads, and where chronic poverty runs rampant among communities.
I left the event thinking of ways governments, civil societies, and individuals can help improve infection control protocols and communication.
Ambassador Bockarie Stevens of Sierra Leone called for diaspora Sierra Leoneans to use their cell phones to call relatives and friends back home to stress safe hygiene practices as prudent ways to control infection from Ebola. In the longer term, rebuilding broken health care systems, training our citizens in infectious disease control practices, and deploying our Medical Colleges in the study, prevention, and treatment of tropical diseases is the best investment we can make in our countries’ future health, welfare, and stability.
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