Last night I posted my reservations about transporting Dr. Brantly and Ms. Writepol home to the US. This morning I received an eloquent and effective response from a member of an NGO who prefers to remain anonymous:
Both these people were part of a very overworked and under-resourced team (by US standards) caring for dozens of Ebola patients. The facilities in Liberia are over flowing, they don’t have enough trained people to look after the ones who have beds, let alone the ones who are brought for treatment but can’t be accommodated.
With these 2 staff going down, there are even fewer to look after them. They were running the unit at ELWA, having taken over from MSF. When they went down, the unit had to be handed over to the Ministry of Health as Samaritan’s Purse couldn’t cope.
Not exactly sure about ELWA but there has certainly been shortage of PPE in many places – and I would not be surprised that items we would use once and discard are being washed, disinfected and re-used – which reduces their protectiveness (is that a word?). For example – the strict practice is to double glove when dealing with Ebola fluids – however if you are running short of gloves – what do you do?
Ebola centers have dozens of patients for every one nurse / doctor. There is no airconditioning – it’s hard to work for hours in all the PPE. So even though the technical treatment is the same in USA – the level of care is different. I’m sure there will be one doctor / nurse per patient per shift.
If you are the ‘essential staff’ caring for Ebola patients and you go down – who is going to look after you? Not only are there fewer left standing, it’s hard to be objective when caring for friends and family – bad medicine for surgeons to operate on family members – so their colleagues might unintentionally take more risk (for example there are ‘rules’ about shift hours because you get tired and make mistakes).
Why bother flying them home? Basic treatment is the same, level of care is different. AND because it’s been a huge relief to the other medical staff who are still there / had pulled out / weren’t going to go back in to hear that there is hope.
I cannot tell of the despair we all felt last week when no one was able to help Dr Sheik Umar Khan any further. If Dr Brantly had also not been able to be moved, it would have destroyed morale even further.
Finally with the international support that has materialised we have heard that the aid organisations such as MSF are going to scale back up. We are all hopeful that we can now move in the right direction and stop this outbreak.