Beyond the Ominous Ebola Prognosis

An Analysis

By Sherman C. Seequeh

Monrovia, Liberia

The Perspective
Atlanta, Georgia
September 25, 2014

                  


Health workers remove the body of a young man suspected to have died of Ebola.
Courtesy of (Reuters/James Giahyue)

The rate of infection. The Prognosis. The Diagnosis. The big news now in the worst case scenario is that West Africa will hit 1.4m infection before January. But I have a question. Yes, please, I have a question. During the last so-called normal days—postwar days before Ebola—I observed that hospitals, health centers and clinics were jostling every day. I had a time to visit and/or attend referral hospitals such as JFK, Redemption, Catholic and a couple of community clinics. And my experience was that every time I visited any of these, there were crowds of people needing or seeking medical care; I mean people attending OPDs; those admitted not included in this. I can’t say what the numbers were.

But the conditions were that if you didn’t book a ticket or a seat before 5am, particularly for Catholic Hospital and JFK, you would decide to return home that day without treatment just by looking at the hugeness of people clamoring for medical attention or simply you must get ready to leave the hospital or clinic up to 6pm. In other smaller health facilities, a near-similar condition existed - a kind of dress-I-dress movement on long wooden benches. That created the temptation for bribery. I mean, our hospitals were jam-packed with sick people; and don’t ask me what kinds of sicknesses they were. All I can remember is that from Mondays to Fridays, some of them running on Saturdays, health facilities jostled to the brim throughout the country.

Please let me ask: With the Ebola outbreak and the resultant total breakdown of normal healthcare services, where are these hundreds of thousands of Liberians who had sought medical treatment on the daily basis as far as all the diagnosis and prognosis of Ebola infection and fatalities is concerned? Are these citizens, perhaps fifty thousand on the daily basis, who had sought medical treatment from Monday to Sunday in our hospitals and clinics, factored in all the frightening predictions? Do these pre-Ebola illnesses count in the national medical crusade and response taking place in this country now? And to what equally serious level and attention? Or, putting it in other words, have all other ailments suffered before the current emergency, ceased to exist? And since Ebola takes on the symptoms of most ailments, if not all, traditionally known in Liberia, is every sickness now diagnosed as being Ebola, treated as Ebola infection and therefore placed in the gloomy predictions we are getting?

I agree that utmost precaution must be taken in so far as the exceptional transmission of Ebola is concerned, coupled with the risk particularly for health workers. But—and I stand corrected—if we don’t take it easy in the way we obscure the line between Ebola and other curable ailments, we will definitely settle down on a long nightmare. This is so primarily because, every sick person in the country—and from what we all had seen in our hospitals and clinics, the multitudes of people seeking treatment before the current health crisis—the Ebola response tactics would thread on false prognosis and many will suffer and die for nothing.

The evidence of this is that every time an Ebola Treatment Unit (ETU) is set up, it becomes quickly overwhelmed. I bet—and I stand corrected—this situation is not necessarily because of the high numbers or statistics of Ebola people paraded around here, but mainly because people who live in war-torn, poverty-fraught Liberia do get sick, and they get sick in the thousands every God-given day. No doubt, the pre-Ebola situation has got worse where our major health facilities have fallen into debris. So, as long as all roads lead—and must lead—to ETU as far as the awareness campaign is telling, every other sick person is brought into the treatment centers. How many ETUs do we need to accommodate those kinds of influxes of sick people that would naturally be produced hourly and daily across the country anyway? I don’t know the number of clinics and hospitals and health posts that were in action before Ebola. But my question is, would we need more or the same number of health facilities in ETUs to stop the influxes, the long waits and premature deaths of people?

I think health sector stakeholders need to pause and consider this: while tracing, tracking, containing and treating Ebola patients, there rings the dire urgency to improve and accelerate testing exercises and procedures so that those diagnosed and treated as Ebola and thousands of other known ailments are separated and given their own kinds of attentions. The number of people wailing for alleged misdiagnosis of relatives is growing; the number of those dying behind ETU fences or those waiting in the rain and scourging sun for entry is also growing; and certainly those who are losing dear life for being mixed with deadly Ebola sufferers is also growing. It’s time ingenious thinking prevailed!



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