Ebola is creating a new epidemic of untreated illness and injury

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Carol Hills:  The worst may be over, but the fight against Ebola in West Africa is not over. There are still new infections and deaths being registered and health officials warn it's too early to let anyone's guard down against the disease. Over the last few months we've been checking in with Sharon McDonnell. She an epidemiologist from Maine who volunteered to lend her skills to the fight against Ebola. McDonnell's currently based at a hospital in a poor neighborhood of Liberia's capital Monrovia and she says that, despite improvements, it's still a crisis there.

 

Sharon McDonnell: We still have over four hundred cases in the last twenty-one days, which gives you a sense of how desperate that would be in any other setting.

 

Hills:  What's your average workday like?

 

McDonnell: Well, I get up. It's about forty-five minutes in traffic down to the hospital. We have to go through a screening process with the patients and it's quite... You stand in line and you wait and you get your temperature taken. You wash your hands, you get your feet sprayed. At this point, we've only been open maybe since the twelfth of January, so this reestablishing services... It's everything from "Let's find an extension cord for the oxygen tank for the child in respiratory distress" to "Can we get any sort of link for our media, our internet?" Just everything is sort of out there.

 

Hills:  So, this hospital is just trying to come back to speed after really being forced to shut down because of Ebola. You've described what it's like for you as a healthcare worker. What about the patients?

 

McDonnell: For every Ebola case that's in the outbreak, there is a ten times greater outbreak of non-Ebola disease that was completely unable to be seen because the health facilities in the entire city were closed.

 

Hills:  What do you mean by non-Ebola healthcare?

 

McDonnell: It's everything else. It's women delivering babies; it's malaria; it's hypertension; it's heart attacks; it's typhoid. It's everything else that wasn't Ebola.

 

Hills:  So, you're saying the hospital, which is just getting back on its feet, is also trying to just deal with Ebola but then it's dealing with all these other things.

 

McDonnell: Well, the big trick here is trying to discriminate between an Ebola case -- which you want to really isolate from everybody else -- and all the other people who have fever and runny noses and nausea and vomiting. Almost every child that comes to a health center in Africa has symptoms that sound exactly like Ebola, and trying to distinguish those and still give care to people who need it and separate those who have Ebola from non-Ebola is a huge undertaking.

 

Hills:  Have you had any instances where you really didn't know what was going on and your sort of risked infecting people?

 

McDonnell: Well, we've had a few incidents. One of them was a young child that, as it turned out, had had symptoms like nausea and vomiting. No history of contact as near as we could ascertain. Came in at night and then began to get sicker. The staff is trying to keep asking questions once someone comes in to sort of keep probing and gently asking questions. Sometimes more history will come out and, in this case, the fact that a family member had died and another family member was sick put everyone on alert. So, then you have to make the ward a contained area. It's not ideal.

 

Hills:  So, the girl that you mentioned came in. It turned out she had had contact with people with Ebola. Did healthcare workers then have to go into quarantine because of that? Because you didn't know when you admitted her?

 

McDonnell: At that point, we contained the child and then everybody that had contact with her had to be put under quarantine, so we lost seven of our staff for twenty-one days. So, we can't take many more of those without decimating our staff.

 

Hills:  So, at the start of the Ebola crisis there was a lot of distress between healthcare workers and the public, a lot of members of the public fearing that they would actually die if they went to a hospital instead of being treated and... you know this whole thing. What's the level of that distress now? Is there a better relationship with the community and more trust established?

 

McDonnell: Well, it varies around Monrovia. In our community, there has been a longstanding history of mistrust of government services, certainly. Health workers are viewed as being harsh and perhaps not very kindly -- like they were not treated in a respectful way -- and the staff felt like these people are coming in and they're giving us Ebola, and they felt quite at risk about this. It becomes very important for us that that screening is as civilized, as kind, and as controlled as it can be so we're signalling to everybody that we're really trying to be careful.

 

Hills:  Sharon McDonnell is an epidemiologist from Maine. She's in Monrovia, Liberia helping to fight the Ebola epidemic. Thanks so much, Sharon.

 

McDonnell: Thank you.

 

Hills:  You can ask Sharon what it's like to work at a hospital where every patient has to be treated as a potential Ebola risk. She's joining us right now on our Facebook page to discuss her experiences in Liberia. Ask Sharon your questions at facebook.com/pritheworld.