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April 9, 2015



Ebola lessons

As the Ebola outbreak continues claiming victims, albeit at a reduced rate, it is time to reflect on what we have learned so far in dealing with this serious infection. Although its impact is mainly in a relatively reduced geographical area, the fact that a few cases happened in distant countries increases the potential for an expanded outbreak. So far we have learned that:
Health services in some African countries need to be significantly upgraded to manage with a large scale epidemic. In the course of travels to Africa, I saw firsthand how health services in several countries do not respond to people’s basic needs in spite of substantial funds from abroad. In many cases, significantly improved services thanks to help from foreign NGOs and governments quickly deteriorate once they leave the country. Both local governments and foreign donors bear responsibility.
Foreign aid should focus on strengthening human resources and entities should closely monitor the spending of funds they donate.
Speed of response is critical in controlling an epidemic. One of the factors involved in the initial faulty response to the Ebola epidemic was the belief that this latest outbreak would be contained as were some of previous ones. However, local and the international responses, both from the World Health Organisation and industrialised countries, were late and inefficient.
Special attention to social and cultural factors is critical to prevent the rapid spread of an epidemic. In the case of Ebola, poorer communities with the most ineffective social and health services were the most affected. Culturally, long-standing traditions that relatives should clean, dress and bury dead persons, even when they were affected by Ebola, led to the rapid spread of the infection.
Medical and paramedical personnel who could be in contact with infected persons should be provided with adequate personal protective equipment.
Lives which could have been saved with adequate

protection were lost because of the lack of it.
Ebola is an ongoing threat. So far, Ebola has affected nearly 24,000 people and killed almost 10,000, according to WHO statistics. Although the number of cases has levelled off, it is important to emphasise that Ebola is still a serious health threat.
Education is an indispensable ally in the fight against Ebola. Education starting at the community level all the way to healthcare workers is indispensable in stopping the spread of Ebola.
Local doctors and health workers should be involved from the beginning and their opinions taken into consideration. Ebola starts as a local disease, and local doctors and health workers are better prepared than foreign doctors to deal both with local customs and traditions and with the fears among the population.
Ebola survivors may also need treatment for other health conditions.
Increasing reports among Ebola survivors point to a wide array of health problems such as impaired vision, musculoskeletal problems, fatigue and chronic pain. Eye problems top the list of complaints.
Ebola is not necessarily a fatal disease. According to WHO statistics, 24,000 people in Guinea, Liberia and Sierra Leone have contracted Ebola since late December 2013, with a few isolated cases in other countries. More than 14,000 are survivors, which indicates that with appropriate care the disease isn’t necessarily fatal, a sign of hope in a dramatic scenario.
Excerpted from: ‘10 Lessons from the Ebola Outbreak’.