Thursday, September 8, 2016

Should You Still Care about Ebola Now that the Outbreak is over?

I volunteered twice as a doctor during the Ebola outbreak of West Africa; once at the peak of the outbreak in Bong Ebola treatment Unit (ETU) in Liberia and the second time in Sierra Leone when the outbreak there continued, refusing to die down.  I was very moved by what I saw and the people whom I came to know, both the Ebola patients and the people who went there to help.  They inspired me to write a book on Ebola: Lest We Forget: A Doctor's Experience with Life and Death During the Ebola Crisis.

In today’s era of global travel, infectious disease epidemics pose a constant and ongoing threat well beyond their countries of origin. No recent outbreak has exemplified this more than the Ebola contagion of 2014–15. Devastating as it was to the three African nations it swept across—Liberia, Guinea, and Sierra Leone—its further spread was effectively cut off by an initially chaotic but ultimately successful international intervention by the World Health Organization, the US and other Western governments, many NGOs—and the selfless efforts of both African healthcare workers and hundreds of volunteers from around the world.

As an infectious disease specialist with experience gained from disaster relief efforts in more than a dozen countries, yet even I soon realized that my two six-week assignments to Ebola-stricken West Africa this was a different sort of volunteer mission. The Ebola contagion in West Africa, like the leprosy of an earlier era, subjected its victims to isolation and stigma. The patients who were in most need of close human contact had to deal with it virtually alone. Their sole relationship other than with fellow patients was with health personnel communicating through a barrier of protective coverings. Most terminal patients died a lonely and scary death, unattended, struggling with their last breath. Children separated from their parents almost certainly could not comprehend why they had been abandoned.

Healthcare workers were also affected in ways that once seemed unthinkable. The epidemic devastated the fragile and inadequate healthcare infrastructures of the countries where it originated, literally killing off up to one half of all doctors and nurses and transforming hospitals from places of healing and refuge into incubators of the deadly pandemic.

This was one of the greatest and deadliest Ebola outbreaks since 1976 and it was the first ever in West Africa.  WHO designated it as a Public Health Emergency of International Concern (PHEIC) in August 2014 as it posed a public health risk and had the potential to spread widely to the rest of the world because of its high mortality, its intensive transmission pattern in the communities and healthcare facilities and the weak health systems of the countries affected. Thankfully it was stopped from becoming a pandemic by the coordinated international response although that took some time to happen.

It is true that Ebola has receded from the front pages to be replaced by the Zika virus which has become the latest global threat.  Zika is not a deadly virus like Ebola but has serious consequences on some fetuses causing microcephaly.  However scientists and public health personnel have warned about walking away from the Ebola outbreak once it is over and no longer grabs the attention of the public and politicians, that the healthcare infrastructure of the  three countries affected greatly by it ; Liberia, Sierra Leone and Guinea needs to be built up to ward off yet another outbreak of diseases.  Despite the warning the US government has moved funds spearheaded for Ebola till 2019 for surveillance and training purposes to Zika when requested funding for Zika is not forth-coming.  Our memory for the raging Ebola outbreak is short-lived and fades as soon as it stops to present a real threat to us.  Such a book on Ebola will be extremely helpful to continue to raise awareness for the general public and politicians.  But do they care and would they read it?

Last but not least, the Ebola outbreak is a tragic human story which has to be told and remembered even after it is over.  The memory of those who died and the frontline Ebola fighters who bravely confronted the deadly virus without regards to their own safety and life had to be honored.  Currently there are no books on the detailed narration of what the patients went through in the Ebola Treatment Unit.  The reporter from the New York Times embedded with us in the Bong Ebola Treatment Unit (ETU) pleaded with the medical director for admittance into the ward so she could have first-hand knowledge of the unit for her reporting but permission was not granted.  

There continues to be books written about the holocaust reminding us that we are not to repeat history.  Although Ebola cannot be compared to the holocaust, books on Ebola should be published and read so we learn from this devastating outbreak to prevent it from happening again.  No one lives in isolation in this highly mobile world.  There are no walls or barriers to prevent Ebola or other deadly diseases to spread internationally. Lest we forget!

Should you still care about Ebola now that the outbreak is over?