Ebola: "Patient Zero" and beyond

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A 2-year-old child who died in Guinea in West Africa in December of 2013 is believed to be “Patient Zero”, the first Ebola case of the current outbreak.

Health workers responded to this potentially lethal situation, but seemingly not quick enough. Ten months later, an outbreak has resulted in some 8,000 Ebola cases in West Africa alone, and more than 4,000 deaths. The cases spread quickly because there was a lag in the time spent initially reporting and diagnosing the disease and understanding what was happening. And now there are many reasons why the disease continues to spread and people continue to die.

During my trips to Africa I learned that there are cultural practices there that hinder infection containment, practices that don’t exist in the United States.

For example, some African countries have unique burial practices. Loved ones feeling strong emotions are not discouraged from hugging the deceased person’s body or touching it in various other ways. This practice is of concern because the Ebola virus can be carried within the still-live tissue of a person who is deceased, and transferred to the grieving loved ones.

Another concern is the general fears that people have. Fear breeds fear of everything, not just a disease. There’s fear of the government not telling them the truth; fear of whether medical personnel are actually spreading the disease, instead of helping them. Indeed, on Sept. 19 eight people traveling in southeastern Guinea to raise awareness about the spread of Ebola were killed by residents who misunderstood their motives.

Many also fear seeing health workers in hazardous material suits, the special personal protective equipment that looks like spacesuits. Some are suspicious of what is happening in hospitals. They refuse to take their sick loved ones there because they are afraid that person will die and they will never see them alive again.

In addition to the cultural differences, some African countries have highly pressured medical systems.

There’s very little medicine, very few hospitals and very few medical personnel. Those who are there are underpaid. In some countries, there may be only one doctor – if you are lucky – to take care of a city of more than 100,000 people.

At times you may not even have a physician. You might have only a clinical officer, which is the equivalent of a physician’s assistant in the United States. He or she has been training for two years to take care of a whole town.

Now, with the Ebola crisis, the patient-to-health-worker ratio has become even more unsustainable. Hundreds of new patients are brought into hospitals every day. Who is going to take care of them? That is why we are seeing a tremendous push to bring in medical personnel from the United States and other developed countries, who know how to control this disease. They don’t have the means to be able to do it on their own.

Another factor is that many of the existing hospitals and pharmacies were built by missionaries or governmental agencies in the early or mid-1900s. Much of the equipment in those hospitals is still from that era, such as lab and orthopedic equipment and hospital beds.

Additionally, many of these hospitals have small capacities. In one room, there may be 30 beds. Many hospitals don’t have sufficient bed linen. Linen actually carries the Ebola virus. If a person infected with Ebola is lying in linen, the linen becomes infected. In a hospital where one room has 20 or 30 beds, but not enough linen, family members usually supply it. They might not have the ability to clean or dispose of it, once infected. Also, health workers could be laying infected people on top of mattresses without linen, infecting the mattresses with Ebola.

Complicating matters is high populations in places like Liberia and Guinea. Porous borders between African countries also contribute to the spread of infection. There is very little capacity to contain sick people within the country where they caught the virus.

Finally, people in the West may suggest that we should not send our medical personnel to Africa, fearing that they will bring Ebola back to our shores. But if we do not send them on that vital mission, we won’t be able to contain this disease. That could result in a spread of Ebola to hundreds of thousands of more people. You are talking about infecting other areas of Africa and, possibly, the world, even developed nations. That’s why we must be quick to address the very serious problems in West Africa.

About Dr. Vilma Vega

Dr. Vilma Vega, MD is an Internist and Infectious Disease/HIV Specialist in Sarasota, Florida. She is co-founder of Hearts Afire, a non-profit mission organization, organizing professionals-- physicians, nurses, pharmacists, business people, ministers and others to respond to special needs and provide relief to a variety of hurting locations worldwide. Dr. Vega is in the process of developing programs for healthcare professionals through her new company Transition MD as well as teaching and inspiring others to live out their divine blueprint through the development of her own program, BLUEPRINT TO A BALANCED LIFE based on biblical principles.