Making Unique Observations in a Very Cluttered World

Thursday, 7 August 2014

Ebola Cases Mix With Malaria Amid ‘Slow-Motion Disaster’ -

Ebola Cases Mix With Malaria Amid ‘Slow-Motion Disaster’ - 

As the death toll rises in West Africa amid the worst Ebola outbreak on record, a separate threat is compounding the problem: the rainy season and the malaria that comes with it.

In Sierra Leone, with the most Ebola cases in the epidemic, a fearful population is failing to seek medical attention for any diseases, health officials say. If they have malaria, the feeling is they don’t want to go near a hospital with Ebola cases. If it’s Ebola, they don’t believe the hospitals can help them anyway, instead turning to traditional healers.

It’s a widening challenge complicated by the fact that Ebola, malaria and cholera share common symptoms early on, including fever and vomiting, which can cause confusion among patients, said Cyprien Fabre, head of the West Africa office of the European Commission’s humanitarian aid department.

“We now have increased mortality for these other diseases” as well, Fabre said by telephone from Freetown, the country’s capital, after visiting Ebola treatment centers in Kenema and Kailahun near the eastern border. “This is a slow-motion disaster.”

The issue threatens to further undermine health and welfare in Sierra Leone, which has the world’s highest rate of child and maternal mortality, Fabre said.

The outbreak has killed 932 people in Guinea, Liberia and Sierra Leone since it was first reported in March, according to the World Health Organization. That includes 45 deaths from Aug. 2 to Aug. 4, the health group said.

Broken Heart

“I’m afraid of going to the hospital because if they don’t tell you about having Ebola, it will be something else that will break your heart,” said Ibrahim Kalokoh, a 34-year-old disc jockey, in an interview in Freetown. “If I am experiencing malaria symptoms, I would rather rush to a pharmacy and buy drugs than go to the hospital.”

The Deadliest Disease on Earth

“Right now,” he added, “going to the hospital is the worst you can suggest to me, with all the Ebola noise around.”

Beyond the fear are other issues contributing to the problem, according to Fabre. Health workers afraid of getting infected are becoming increasingly reluctant to help out, and one treatment center has exceeded its capacity of 88 beds.

Mushroom Hospitals

“Health-care practitioners are afraid to accept new patients, especially in community clinics all across the country,” Liberian President Ellen Johnson-Sirleaf said. “Consequently, many common diseases which are especially prevalent during the rainy season, such as malaria, typhoid and common cold, are going untreated and may lead to unnecessary and preventable deaths.”

As traditional healers pick up the slack, Sierra Leone President Ernest Bai Koroma today ordered the closing of so-called “mushroom hospitals” run by untrained doctors and nurses in impoverished areas.

A Spanish priest, Miguel Pajares, is the first Ebola-infected European citizen to be returned home, according to newspaper El Pais. Pajares arrived in Spain this morning and is being cared for at a hospital in Madrid, the newspaper said. Two Americans who were infected with the disease were brought back to the U.S. in the last week.

The Ebola virus is spread through direct contact with bodily fluids from an infected person. There is no approved cure. Standard treatment is to keep patients hydrated, replace lost blood and use antibiotics to fight off opportunistic infections. The hope is that the body’s immune system will eventually beat the disease.

Death Rate

In the past, the death rate for the disease was about 90 percent. The rate in the recent outbreak has been about 60 percent, probably because of earlier treatment, health officials have said.

A number of aid organizations are contributing in West Africa. In July, the Bill & Melinda Gates Foundation gave a $1 million grant to the U.S. Fund for UNICEF, which is providing medical and hygiene supplies to the region, according to a statement. In Sierra Leone, help is on the way from the International Red Cross, which is building a new treatment center near Kenema, the health ministry said this week.

Unlike the facility in Kailahun, a typical tent-like structure built by Doctors Without Borders, the existing clinic in Kenema is inside the local hospital, where isolation units and separate wards have been carved out, Fabre said. Patients afraid of coming in contact with Ebola are avoiding such hospitals and aren’t getting treated for other ailments, he said.

Shaking Hands

In the capital of Freetown, chlorine has taken over the city. At the entrance of supermarkets, sidewalks, offices, religious houses, and even some private homes in the capital, there are plastic buckets filled with water and chlorine for the washing of hands. Religious leaders are also advising people to limit touching and clustering.

“We have asked our congregants to lay the right hand on the chest, and lower the head a little as a sign of greeting instead of shaking hands until we have no new cases of Ebola,” said Sheik Alie Yunus Kallay, a member of the Interreligious Council Taskforce on Ebola.

In neighboring Liberia, protective equipment for health workers is an urgent need, said Ernest Gaie, country director in Liberia for the Washington, D.C.-based charity Africare. And as in Sierra Leone, medical staff’s fear of infection has left some hospitals understaffed, according to Gaie.

Stretched Resources

Protective gear “would help these lives and help regain the confidence that the health workers have lost,” Gaie said in a telephone interview from Monrovia, the country’s capital. “Unless the health workers are in those facilities, I’m sorry, the families are not going to take people who are showing symptoms there.”

Resources are stretched across West Africa as the humanitarian community is also facing crises in other parts of the world, such as Gaza and Syria. That’s contributing to a “pessimistic” mood among aid groups, Fabre said.

“It’s far from being over,” he said. “We are still behind the epidemic spreading.”

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