LONDON, Aug 21 (Thomson Reuters Foundation) - Hospitals
battling the Ebola outbreak in West Africa desperately need more
staff, as local doctors leave their posts and foreign doctors
are reluctant to come forward, medical experts said during an
online debate on the disease.
Medical staff are among the most vulnerable to infection,
and several have already died of the virus. Locals have no
previous experience of Ebola, how to protect themselves or
contain the disease.
"The fear factor is high, but people need to understand that
Ebola can be controlled, be it within a clinic or within a
country," said Francis Kasolo, coordinator of the World Health
Organization's Sub-regional Ebola Outbreak Coordination Centre
in Conakry, Guinea. He was one of five panellists at the debate
organised by Thomson Reuters Foundation.
The crisis is symptomatic of the state of local health
systems, the panellists said. The three most seriously affected
countries - Sierra Leone, Guinea and Liberia - have very few
local doctors and nurses. Sierra Leone, for example, has only a
few hundred local medical staff to serve a population of nearly
6 million, according to WHO figures.
Ambulances are also in short supply. Just four serve a
population of about 470,000 in Kailahun district in eastern
Sierra Leone, according to Anja Wolz, emergency coordinator for
medical charity Medecins Sans Frontieres (MSF), who was recently
in Sierra Leone.
There are not enough protective suits made to the right
specification, and hospitals even lack gloves, the experts said.
Aid agencies and local authorities do not have enough
resources to collect dead bodies safely. The panellists said
they had heard reports of people in Liberia waiting 30 hours or
more for someone to collect their dead.
Although some medical staff are fleeing their posts, many
are staying despite the dangers.
"The heroic local doctors and nurses must be acknowledged
and we need to find ways to remunerate them for their dangerous
work," said Johan Von Schreeb, professor of international
disaster medicine at the Karolinska Institut in Sweden.
In an attempt to contain the virus, Liberia imposed a
quarantine in West Point, a large slum in the capital Monrovia,
on August 19. Security forces have been deployed to stop people
from entering or leaving the area.
Although quarantines are an effective way of stopping
transmission in principle, in practice they are very difficult
to maintain and have a major impact on those forced into
isolation, said Korto Williams, country director for ActionAid
"To do this and not have an effective plan for contact
tracing, will not help to end the crisis," Williams said,
referring to the need to trace all the people that Ebola
patients have come into contact with.
"Quarantine should not mean the creation of plague
villages," he added. "Ebola affected communities must not be
abandoned. There should be no 'no go' areas for health workers."
He added that trade and communications should be allowed to
continue in areas under quarantine, to avoid further
impoverishing those whose communities and livelihoods are
already at risk.
CAN ANY GOOD COME OF THE OUTBREAK?
The outbreak will take many months to stabilise, Kasolo
In the meantime, local medical staff are gaining experience
in how to treat and contain the epidemic, which will hopefully
stand them in good stead in the future, some panellists said.
But more money and resources are desperately needed to
improve local health systems.
Kasolo said that several donors are interested in building
the health systems in West Africa.
"This is the marathon that will follow this run," he added.
(Editing by Tim Pearce)