Oct. 8, 2014

British, Cuban, Chinese Teams Fight Ebola in Sierra Leone

As international medical teams have come into Sierra Leone in recent weeks Ebola treatment in Sierra Leone gradually is being taken out of the hands of the Government of Sierra Leone.

A 165-man medical team from Cuba arrived in Freetown on October 3 to join the Ebola  fight. The team comprises 63 doctors and 102 other specialists including nurses.

A contingent of British army engineers and medics arrived in Sierra Leone at the end of September to participate in the British plan to create 700 new beds for Ebola treatment in Sierra Leone. The British army medics are apparently intended for an Ebola treatment unit that will be reserved for medical personnel who come down with the disease. Separately, as many as 160 volunteers from the British National Health Service are said to have volunteered to come to Freetown to staff the new Ebola Treatment Center being constructed in the suburb of Kerry Town.

Earlier in September a 59-member Chinese medical team arrived in Sierra Leone to help in the Ebola battel. They will all be based at the new Chinese Friendship Hospital at Jui, in the eastern outskirts of Freetown, which has been converrted by the Chinese from a general hospital to an Ebola treatment facility.

In Kenema a new Ebola treatment facility has started operations, run by the Red Cross, with international staffing. In Kailahun MSF continues operations at its Ebola treatment center, again headed by international staff.

The number of doctors in these different facilities rivals Sierra Leone's  total complement of indigenous doctors, and the international personnel will all be working on the Ebola outbreak. By contrast, the only full-fledged, government-run Ebola treatment center (as opposed to 'holding' center or 'isolation' center) in the country appears to be the newly established facility at the Hastings Police Training School. The Kenema Ebola center, previously government run and colocated with the government hospital has been relocated and taken over by the Red Cross.

The picture with the crucial laboratory facilities, without which a confirmed diagnosis of Ebola can not be made, is similar. Of the four or five Ebola testing labs in the country, all are run by foreign organisations. The Chinese have brought in two, at least one of which is being used at their hospital in Jui. The South Africans are operating one at Lakka, outside Freetown.  The US CDC was last reported to be operating the Kenema  Ebola lab, and the Canadian public health agency continues to operate the lab in Kailahun.

All of this foreign support is most welcome. It will allow the government to concentrate on resuscistating health care for non-Ebola patients, which had virtually collapsed. Non-Ebola patients had been reluctant to visit health centers, for fear of inadvertently contracting Ebola, and many health centers had themselves elected to suspend operations, rather than run the risk of inadvertently starting treatment on a patient later discovered to be infected with Ebola. In some cases health care workers had abandoned facilities.

However, all the foreign support for Ebola treatment, welcome as it is, will not by itself end the outbreak. The epidemic is being fuelled by new infections arising within the communities, under circumstances that have been well elaborated:
relatives harboring/treating Ebola patients at home, and burial rituals involving close contact with highly infectious Ebola corpses. Unless these sources of new infections can be brought under control, the treatment centers will merely be responding to an ever-widening epidemic.