An American aid worker with Ebola receives speedy care, while a Sierra Leonean colleague is 'left behind'

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Aaron Schachter: The Ebola crisis is still with us. Yes, the number of cases in West Africa has been declining for the past few months, but health workers are still working hard, trying to reduce the number of cases to zero. Until that happens, they remain in danger of contracting the disease themselves. The reality is that if they’re infected with Ebola, their treatment varies depending on where they’re from. That was evident recently when two clinicians working at a Partners in Health supported treatment unit in Sierra Leone both tested positive. One, an American, was quickly transferred to a special treatment unit run by the British Defense Ministry and then flown to the US. The other, from Sierra Leone, wasn’t, and those who tried to care for him felt helpless.

 

Sheri Fink: Boy, they were just trying to encourage him and make him feel better, and certainly not remind him that he was “left behind,” which is what they were talking about amongst themselves. One of the doctors said to me “We look at him and we see ourselves and it makes us all realize that we’re all vulnerable.”

 

Schachter: That’s New York Times correspondent Sheri Fink. She’s written about the two cases and that special British facility.

 

Fink: It was always thought, and it generally is the case, that Sierra Leonean healthcare workers can also gain admittance to that facility.

 

Schachter: And is that not the case?

 

Fink: Well, what happened in this case was that the American was transferred there and then pretty quickly got on a plane on thursday, two days after the diagnosis, back to the US for treatment at the NIH clinical center, the best possible supportive care, possibly experimental treatments in the US. Whereas the national health worker, when he was diagnosed on friday, the same day the American was flying home, he was not given admittance to that British facility and a doctor who works locally there, a Sierra Leonean doctor, had to go in and tell him “There’s no room for you.” At the time, there were all these Americans who didn’t have symptoms, who hadn’t contracted Ebola but were possible contacts of the American who got sick, they were at that facility preparing to go back to the US, as well as some British people who were exposed to a British healthcare worker who was diagnosed separately.

 

Schachter: Realistically, can the same level of care be provided for all healthcare workers who contract Ebola?

 

Fink: Well, can it? Why not?

 

Schachter: I assume if they’re vastly more local healthcare workers than foreign ones, the chance of them contracting Ebola is higher.

 

Fink: Oh, certainly. When you speak to any international who volunteers, they’re always, always pointing out just how impressed and how brave they are, these national workers, because they don’t have what one person I saw, Meghan Coffee, who’s a prolific tweeter, she said something on Twitter about these health workers who work “without the parachute”; they don’t have a parachute to help them if they fall. But could everyone be provided the highest possible standard of care if we’re imaginative and if the world and the people who have resources decide that that’s where we want to put them, then why not? The sky's the limit. But there are terrible inequalities in the world about who can get advanced care and who can’t based on geography, based on where you’re born, and your circumstances--and even within our own country, of course we don’t face that very often, but there are disparities all the time.

 

Schachter: One of the amazing things about recent stories that you’ve written is that about a dozen American health workers have been exposed to the virus or thought that they might have been exposed to the virus and were brought back to the United States for treatment and yet, contrary to a year ago or so, there doesn’t seem to be any notable public alarm. What’s changed?

 

Fink: One thing that’s changed is that we’ve sort of taken our eye off the ball with Ebola in West Africa. You hear now that some of the aid commitments have gone down, that the UN is seeking more funding to keep this effort going, because when you look at the numbers, things are trending in a better direction but in Sierra Leone and in Guinea, it’s just been really recalcitrant, those last cases getting to zero. Every week we’re seeing 60-80 cases, which would be a lot if you looked at previous outbreaks, it’s an improvement compared to a few months ago. But I think it’s good that we’re not alarmed in the US and it’s appropriate, because these health workers who’ve come back, it’s out of the classic quote “abundance of caution.” Now we know in the US that there are programs, we know that these people will be carefully monitored and there’s no way that you or I or anyone can catch Ebola from them unless they get sick, and hopefully they won’t.

 

Schachter: New York Times correspondent Sheri Fink, always a pleasure to speak with you. Thank you so much.

 

Fink: Thank you.