A panel of two health care professionals and a Liberian government official reflected on the successes and failures of the global response to the Ebola virus epidemic at the Rita Anne Rollins Building on Monday evening.
The panel was attended by about 100 faculty, students and visitors.
Professor in the Medicine School’s Division of Infectious Diseases Dr. Carlos del Rio began the discussion with an overview of the technical aspects of the virus before jumping into preventative measures for future outbreaks.
“The big driver of the epidemic has really been poverty,” del Rio said, who is also the Hubert Professor and Chair of the Public Health School’s Department of Global Health. “When we try to address Ebola and don’t address poverty, this thing will keep happening.”
He added that response efforts were further crippled by poor physician-to-patient ratios in the countries affected, particularly patient to doctor ratios.
In Liberia, there are 86,000 patients per doctor, and in Sierra Leone, the ratio is 45,000 per doctor.
Del Rio also reminded the audience to be aware of political and media distortion of the epidemic.
“It’s not an African problem, it’s a West African problem — just in this little area here,” he said, pointing to a map with unaffected regions labeled “NO EBOLA.”
“You saw before the November elections so many governors used the quarantine to say ‘we’re responding to Ebola,’ though it was just a political thing, not a public health thing,” del Rio said.
Other response failures, he noted, were due to funding cuts to the Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) in the past few years, even though President Barack Obama’s administration still pledged millions of dollars in September to help combat the epidemic.
The economic consequences in the affected nations, however, dwarf those of the U.S., del Rio said.
“You have children leaving school, people leaving work, people being displaced,” he said. “This is going to have tremendous long term consequences.”
Next to give a presentation, Chief Nurse Executive of Emory Healthcare Susan Grant praised Emory University Hospital’s successful treatment of four Ebola patients between August and October.
When the first two patients, aid worker Dr. Kent Brantly and nurse Nancy Writebol, arrived in August, “[Emory] very quickly realized that we did not have enough people. We needed to cast the net a little bit further,” Grant said.
Finding volunteers, she said, was not difficult.
“We had people step up and say, ‘I want to be a part of this,’” Grant said. “No one was forced to work in the [Infectious Disease] Unit, though of course, we did pay them.”
Eventually, at least 100 people would become involved in the effort, including a group of nurses Grant called “the Navy SEALs of nurses.”
“It was quite impressive, to be honest, to watch this,” Grant said, who is also a member of the Georgia State Ebola Task Force created by Governor Nathan Deal in November. “Everyone left their positions, their hierarchies at the door. It was a team effort the entire time.”
She included that the Emory University Hospital team paid close attention to the caretaking aspect of treatment as well, which was often an obstacle for nurses in so-called “space suits” recommended by the CDC.
Grant recalled several nurses telling her “the fact is you can still hold someone’s hand with Personal Protective Equipment on.”
Lastly, Chairman of the Liberian Law Reform Commission Jallah Barbu brought a new perspective to the panel, remarking on the need to educate Liberian citizens on the technicalities of the virus — transmission, sanitation needs, signs and symptoms — mentioned by del Rio at the start of the discussion.
“In Liberia, when we first heard about Ebola, it appeared to be a death sentence,” Barbu said, touching on the panic that struck Liberians at the virus’ outset.
“Ebola came at a time when people had suspicions in their government,” he added. “What people saw it as was another effort by the government to get money out of our coffers.”
Barbu continued to describe radical theories of the virus’ arrival in Liberia, as well as opposition to proper sanitary actions, such as avoiding handshakes and cremating the virus’ victims immediately after their deaths.
The virus’ decline in Liberia since November, Barbu said, was the result of not government intervention, but the spread of information.
“We begin to wash our hands, we begin to have community meetings, outreach programs,” he said. “The people have to be educated. You tell someone not to wash the dead, but it’s not about them. It’s about the person who died, the afterlife. Why can’t you wash the dead — that’s what people need to know.”
The panel then took questions from members of the audience, one of whom asked why Emory couldn’t have flown more Ebola patients to the University Hospital from the countries in crisis.
“That would be like controlling a tsunami by pulling out glasses of water,” del Rio said.
When asked about the need to invest more humanitarian aid in countries like Liberia, Guinea and Sierra Leone, the three most affected nations, Barbu instead emphasized education.
“It doesn’t matter how much you invest in Liberia,” Barbu said. “What matters is education — what are we doing for people who can’t read or write, who don’t have access to the television or the internet, to make sure they know what is going on?”
Del Rio stressed that governments and health organizations should not lose interest in the Ebola epidemic as it dies down.
He compared it to the situation in another developing country, Haiti, which, five years after a massive 7.0 magnitude earthquake killed hundreds of thousands and displaced about 1.5 million, remains in infrastructural disarray.
“If people lose interest in this, we’re going to miss a huge opportunity,” del Rio said. “We need to somehow understand that those reactive approaches are not sustainable, that there’s an opportunity to address systemic issues.”
Survivors, he said, would lead the effort to give plasma donations for treatment and, most of all, educate their communities — at least if their communities welcome them home.
“People are shunned by their families and can’t return to their villages because people think they are bringing the virus back,” del Rio said. “We need to not forget the power of public confusion, distortion and paranoia.”
Biruh Zegeye, a second-year Laney Graduate School student who attended the panel, said he learned a lot about the extensive treatment of the four Ebola patients at the Emory University Hospital.
Still, Zegeye said he had hoped the discussion touched more on future preventative actions, rather than a recap of the virus’ factual details and treatment milestones.
“I would like to see more discussion on post-Ebola measures,” he said, “like what the international community and governments should be doing in the first place.”
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