Saturday, July 05, 2014

Reflection: Obstacles to stopping the Ebola epidemic

In the last four months or so, a major epidemic of the Ebola virus has spread through the three nations of Guinea, Sierra Leone and Liberia.  Over 600 have been infected and over 400 people have died.  The epidemic started out from an animal source—either bats or monkeys. It continues to spread when someone has close contact with a sick individual (touch or contact with infected bodily fluids—blood, vomit, diarrhea). It is felt that between 60 and 90% of confirmed cases will die. ELWA Hospital set up an isolation unit in April and had to start using it in June to treat patients infected with Ebola.  Here are some links with more information on the epidemic and the response from ELWA Hospital and Samaritan’s Purse.

We in the medical field often feel that the solution to a health problem is getting the right diagnosis, or the right medication, or the right knowledge.  Once the right info is in the hands of the doctors and the patients, everything will be OK.

But the current Ebola epidemic in Liberia points out another major issue that we sometimes overlook:  Fear and lack of trust, and how it becomes an obstacle to tackling a major health issue.

The fear which the Ebola epidemic has created leads to conflict between those who desire to make a difference and those they are trying to reach.  This quote is from a CNN article posted online in the last 24 hours:  “There is also a real sense of mistrust toward health workers from communities. In Sierra Leone and Guinea, WHO has said that community members have thrown stones at health care workers trying to investigate the outbreak.”  In Liberia as well, there are teams investigating the epidemic or doing contact tracing (trying to keep track of and monitor those who have been in close contact with someone who came down with Ebola). These teams have run into resistance from communities, sometimes not even being allowed to talk with people who may have come in contact with the virus.  In several cases government officials have had to intervene.  And finally from a recent SIM update:  “Still unreported are the sick in hiding, too afraid to confirm their fears that they have contracted the virus. Just last week, three possible Ebola patients came to ELWA Hospital seeking medical help, only to leave before doctors could put on the protection suits required to treat them safely.”   I’ve talked with ELWA staff about this on the phone. Fear grips family members and they run.  When you put yourself in the shoes of a family member of someone who is sick, it is easy to understand the storm of emotions they are facing.

I am not in Liberia right now—I’m currently in Massachusetts.  But I’ll be returning to ELWA Hospital again at the end of August for three and a half weeks to help the team there. As I think about the situation my teammates are facing in Liberia, and the challenge confronting the entire healthcare community, I find myself wondering how the Ebola epidemic will be stopped.  An effective treatment would be nice, but that is years and millions of dollars away.  The above events move a different set of priorities to the top of my list. How do we respond to the kind of fear that grips communities in the shadow of this kind of threat?  How do we foster trust; how do we build the kind of relationships that will make the difference?   How do we give people the courage to face all the facts about this disease and take the steps to allow the health authorities to contain the epidemic? The best chance of survival right now lies in receiving supportive care like what is being offered at ELWA—how do we give people the confidence to come early on for testing and treatment?
I don’t have answers for this… but I know that when the answers come, they will be based on love, trust, courage, and faith.  Lord, please pour out your Spirit of wisdom and love on all of us who are involved in caring for those infected and those at risk. 

1 comment:

Unknown said...

Thanks Sacra's for your commitment to Liberians, will pray fear will be subdued and help and hope will prevail! Kris Gorham Tunnicliff