At a time of the year when people typically give thanks, and at a time in history when Ebola virus has made an appearance in the U.S., the healthcare system and infrastructure has been in the limelight.
The U.S. has the most advanced healthcare system and infrastructure in the world resulting in an unmatched ability to maintain strict infection control and quarantine protocols as well as aggressive tracking and surveillance of those who may have come in contact with an infected person.
Historically, Ebola has been a disease threat in countries also stricken with poverty and a host of other infrastructure and healthcare limitations. Sadly, the result of these infections coupled with lack of medical care and resources meant severe disease resulting in multi-system organ failure, subsequent complications and, all too often, death. But medical care in an industrialized country with a modern healthcare system can treat some of these problems before they escalate thanks to trained healthcare professionals, readily available diagnostic tools and medications, such as hyperimmune antisera.
A recent Centers for Disease Control and Prevention (CDC) Morbidity and Mortality Weekly Report (MMWR), detailed the healthcare infrastructure and preparedness of a four-county region of Southeastern Liberia — one of the countries where the Ebola outbreak began — as determined by an assessment completed during August 2014.
Liberia is merely 10 years removed from a violent civil war that affected every part of the country’s infrastructure. As a result of the conflict, and prior to the Ebola outbreak, each of the four counties assessed for the CDC report had one hospital with 100-150 beds and six doctors who traveled between the four hospitals. By the time of the August visit, only three of six doctors remained. In addition, many nurses had stopped working, while those who remained had not been paid in almost three months. Increasingly, nursing students and volunteers were performing direct patient care with little or no access to essential infection control and clinical items, such as clean gloves, running water, hand washing stations, soap, bleach, alcohol-based hand gel, medications, diagnostic tools, isolation areas or personal protective equipment. Although patients could arrive with any medical need, the lack of these types of equipment and protective protocols were particularly devastating for halting the spread of Ebola.
Imagine a woman entering a hospital or clinic to deliver a baby. She would likely be cared for by students and community volunteers while the available doctors were tasked with treating Ebola patients. And, because of the lack of caregivers, that woman would likely be receiving care from some of the same staff treating Ebola patients without isolation areas, personal protective equipment or maybe even water or alcohol-based hand gel to use between patients. For many with Ebola, knowing the lack of supplies and staff available, medical care in a hospital or clinic is not even considered. Instead, infected patients stay in their homes, being cared for and living among family members, increasing the likelihood of spread in homes and local communities.
So as Thanksgiving approaches and feelings turn to what we are thankful for, recognize the fortune of living in a developed, modernized country with an advanced healthcare system and the resources to fight Ebola — and perhaps give a kind thought to those less fortunate. Finally, we should also be thankful for all of those men and women who have sacrificed their time to be with those who are suffering from Ebola in West Africa.
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