Ebola: Still outpaced, nurses strike, and why West Africa?

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Ebola crisis: ‘We are still being outpaced by epidemic,’ MSF head tells MPs

Via The GuardianEbola crisis: ‘We are still being outpaced by epidemic,’ MSF head tells MPs. Excerpt:

The Ebola epidemic is still outstripping efforts to contain it, according to doctors from Médecins Sans Frontières who have mounted most of the early response in west Africa. Speaking to MPs from the House of Commons international development committee, MSF’s head of UK programmes said the apparent decline in numbers in Liberia did not signal the end of the epidemic. “We are still being outpaced,” said André Heller-Perrache . ”There are far more actors on the ground but we are still being outpaced by it, with Sierra Leone being the most concerning case we have.” Dr Javid Abdelmoneim, a UK-based doctor in emergency medicine who has recently returned from Sierra Leone where he was a volunteer with MSF, said there was “too little of everything being done in terms of intervention”. He described how doctors in MSF’s treatment centre in Kailahun would don protective suits to meet an ambulance that could have been travelling across the country for 10 hours expecting dead bodies, which are highly infectious. “Usually there is a patient who is dead,” he said. “There was [in one ambulance] one dead woman and two who were alive but terrified. They have watched this poor woman die a wretched death and they are thinking, ‘I’m now going to die as well.’” Prof John Edmunds, from the London School of Hygiene and Tropical Medicine, who in September called the outbreak a potential doomsday scenario, said he would not say that the nightmare had been averted. “Things have improved dramatically in Liberia now – cases were doubling every two weeks. Now there is a turnaround and they are declining. “The number of cases in Liberia has flattened out. The increase has stopped and come down, but we haven’t got rid of Ebola. In Guinea and Sierra Leone the rate of increase hasn’t really changed much at all.”

Ebola in Sierra Leone: Health workers go on strike

Via BBC News: Ebola crisis: Sierra Leone health workers go on strike. Excerpt:

More than 400 health workers involved in treating Ebola patients have gone on strike at a clinic in Sierra Leone.

The staff, who include nurses, porters and cleaners, are protesting about the government’s failure to pay an agreed weekly $100 (£63) “hazard payment”.

The clinic, in Bandajuma near Bo, is the only Ebola treatment centre in southern Sierra Leone.

In Mali, a nurse and the patient he was treating earlier became the second and third people to die from Ebola there.

Nearly 5,000 people have been killed in the outbreak of Ebola in West Africa, mostly in Guinea, Liberia and Sierra Leone.

The World Health Organization (WHO) has declared the outbreak a global health emergency.

The Bandajuma clinic is run by medical charity MSF, which said it would be forced to close the facility if the strike continued.

MSF’s emergency co-ordinator in Sierra Leone, Ewald Stars, told the BBC that about 60 patients had been left unattended because of the strike at the clinic in Bandajuma.

Meanwhile, Reuters reports that in the US, National Nurses United are organizing strikes and rallies over inadequate protection for healthcare workers.

Ebola: Why West Africa?

Thanks to Greg Folkers for sending the link to this conditionally accepted paper in PLOS Neglected Tropical DiseasesWhat factors might have led to the emergence of Ebola in West Africa? The abstract:

An Ebola outbreak of unprecedented scope emerged in West Africa in December 2013 and presently continues unabated in the countries of Guinea, Sierra Leone, and Liberia. Ebola is not new to Africa and outbreaks have been confirmed as far back as 1976. The current West African Ebola outbreak is the largest ever recorded and differs dramatically from prior outbreaks in its duration, number of people affected, and geographic extent.

The emergence of this deadly disease in West Africa invites many questions, foremost among these: Why now and why in West Africa?

Here, we review the sociological, ecological, and environmental drivers that might have influenced the emergence of Ebola in this region of Africa and its spread throughout the region. Containment of the West African Ebola outbreak is the most pressing, immediate need.

A comprehensive assessment of the drivers of Ebola emergence and sustained human-to-human transmission is also needed in order to prepare other countries for importation or emergence of this disease.

Such assessment includes identification of country-level protocols and interagency policies for outbreak detection and rapid response, increased understanding of cultural and traditional risk factors within and between nations, delivery of culturally embedded public health education, and regional coordination and collaboration, particularly with governments and health ministries throughout Africa.

Public health education is also urgently needed in countries outside of Africa in order to ensure that risk is properly understood and public concerns do not escalate unnecessarily.

To prevent future outbreaks, coordinated, multiscale, early warning systems should be developed that make full use of these integrated assessments, partner with local communities in high-risk areas, and provide clearly defined response recommendations specific to the needs of each community.

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