Via Ebola Deeply: Ebola Kills, but Now Routine Health Problems Do, Too. Excerpt:
The healthcare systems of Liberia, Sierra Leone and Guinea were already fragile before Ebola took hold. This outbreak has crippled them, as they struggle to function with understaffed clinics, limited resources and low numbers of healthcare workers.
In Monrovia, several hospitals remain closed to patients without Ebola, and others – such as the Ministry of Health’s flagship hospital, JFK – have limited beds and are staffed by healthcare workers desperate to avoid catching the virus. Other centers require written proof that patients are free of Ebola; a time-consuming task that are not possible with medical emergencies.
According to a September 2014 needs assessment by the United Nations Office for the Coordination of Humanitarian Affairs (OCHA), “The collapse of healthcare systems [in Sierra Leone and Liberia] is challenging the provision of basic care, maternal and newborn care. The disruption of health services means that many children are not receiving life-saving vaccinations, and may be left untreated for preventable but potentially fatal common childhood illnesses, such as malaria, pneumonia and diarrhea.”
The report says that a total of $97.1 million is needed to ensure access to basic health services in Liberia, Sierra Leone and Guinea, which would include HIV prevention and treatment services, as well as protective gear for midwives and access to safe birthing centers.
Before Ebola hit Liberia, the population of 4 million relied on about 50 trained doctors, boosted by a steady trickle of foreign locum teams. Until a few years ago, Liberia’s Minister of Health, Dr Walter T. Gwenigale, also worked weekend shifts as a surgeon in order to make up the shortfall. The biggest threats to health were communicable diseases such as malaria and typhoid, while the under-five mortality rate hovered at about 235 deaths per 100,000 live births (below the average for sub-Saharan Africa) in 2012.
Sierra Leone has one of the highest maternal mortality rates in the world, ranked fifth from bottom in a study of 181 countries by the WHO. According to UNICEF, 890 of every 100,000 pregnant women died during pregnancy or childbirth in 2010. Still, there had been dramatic improvements to the healthcare system since the end of the civil war in 2002; 10 years later, 63 percent of births were overseen by a midwife, doctor or doula.
Now fewer women are giving birth in hospitals or clinics. Many don’t want to risk simply being in the same building as Ebola patients. Others prefer to give birth with the help of family members instead of healthcare workers who might have been exposed to the virus. Some can’t get a hospital bed. The same problems extend to asthma attacks, anaphylactic shock, infected wounds, snakebites and road accidents.