The Fight Against Ebola

For those of us whose understanding of the Ebola epidemic comes from what we hear on news reports and the statistics we read about the disease, Ebola can seem like a very distant problem. And especially as many are starting to contend that this current outbreak is nearly over, the havoc wrought by Ebola is turning into a fading memory.

However, many people in West Africa continue to suffer from the disease and the dislocations it continues to cause. There’s nothing like meeting those who are on the ground there, patients and health care workers, and hearing their stories to make you realize that Ebola is still very much a reality. The current Ebola epidemic is the largest in history, infecting more than 22,000 people with more than 8,800 deaths as of mid-January 2015, and we cannot rest until zero cases remain.

In late January, I traveled to Sierra Leone, Liberia and Guinea—the three countries most affected by this outbreak—to see how Ebola is being contained and how aid is laying the groundwork for stronger health care systems in these countries going forward. The Paul G. Allen Family Foundation has donated more than $61 million of its commitment to the Ebola fight thus far, and my trip provided opportunities to see the good work of the programs and projects being funded. In the midst of great ongoing suffering in these countries, it is evident that there is also great hope for their respective futures. I then traveled to Davos for the World Economic Forum annual meeting, to discuss the state of the Ebola epidemic with health and policy leaders also looking to understand the outbreak.

Here are a few stories and snapshots from my trip:

My first stop in West Africa was Freetown, Sierra Leone, and from the moment I arrived at the airport there, it was clear that Ebola remains a serious threat there. Those arriving are instructed to wash their hands take their temperature at several points—even before going through the customs checkpoint, for example.

My last visit to Freetown was 15 years ago, at the tail end of the country’s devastating civil war, as a USAID staffer evaluating the emergency response underway. Now back in the city, it saddened me that I was back in the country in support of another disaster, the Ebola epidemic

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Dealing with a vicious epidemic requires speed and accuracy, which in turn require strong logistics. The complexity of the Ebola response is truly mind-blowing. The coordination that is needed among people, supplies and vehicles demands military precision, which is why having the United Kingdom’s military help out with the response in Sierra Leone has been so valuable.

The nerve center for the response is Freetown’s 117 Call Center — the national emergency response hotline. Today, the call center employs over 225 people, and runs like a well-oiled machine. Three shifts of trained workers man the phones 24 hours a day, answering 30,000 calls a week, and processing 5,000 transactions.

Operators—mostly university students who are in need of work while classes are cancelled due to the outbreak—answer the phone and go through a questionnaire with callers, typing the responses into a record on the laptop in front of them.

Once the responses are entered in to a database, they immediately are available at the Emergency Response Centers set up in districts across Sierra Leone. Based on the information coming in from the 117 line, the Centers will send out ambulances, burial teams or health workers to follow up on the report. The eHealth team, which runs the 117 Call Center via Africom, collects the data from all the calls, looking for trends in disease reporting.

Logistics may not be a glamorous word, but it’s an extremely important component of the Ebola response. The ability to quickly collect, disseminate and analyze this data will be crucial to ending the outbreak.

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There are countless personal stories from the front lines of the epidemic—poignant, devastating, hopeful, and persistent. Some of the most compelling tales come from those who contracted Ebola and were able to recover—people like Alvin Smith, who I was able to meet in Liberia.

As a physician’s assistant in Goodwill Health Clinic, Alvin treated many patients a day. With Ebola infecting more people every day, Alvin kept going to work. One day, he got sick and became a patient himself.

Alvin had Ebola and malaria. Because of his profession, he was eligible to be treated at the Monrovia Medical Unit, a 25-bed facility run by the U.S. Public Health Service. While Alvin was recovering, his family was at home, under quarantine. They weren’t allowed to leave their house for 21 days, and had no access to food or supplies.

Fortunately, this story has a happy ending: Alvin recovered, and went back to work–this time, at the Monrovia Medical Unit, where he had received such excellent care. He is committed to giving back and to help others who are sick with Ebola.

Alvin Smith was on the brink of death from Ebola, but now he is working to ensure that those who are infected have the same opportunity at life he has.

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It was still dark when we met 26-year old nursing student Dorissa Bestman outside of a clinic in New Kru Town, a neighborhood in Monrovia, Liberia.

January 18, 2015, Monrovia, Liberia - Contact Tracer Dorissa Bestman uses a tablet provided by the CDC Foundation to follow up on her 13 daily contacts in the New Cru Town section of Monrovia. She was trained by CDCF partner agency EHealth Africa using the same Allan Foundation funds as well.

January 18, 2015, Monrovia, Liberia – Contact Tracer Dorissa Bestman uses a tablet provided by the CDC Foundation to follow up on her 13 daily contacts in the New Cru Town section of Monrovia.

Dorissa is a “contact tracer” for Ebola cases. Every day, she gets a list of people in her district who have possibly been exposed to Ebola. She visits them each morning and evening, checking their temperature, and running through a list of symptoms for Ebola, to ask if they have exhibited any signs of the disease.
During the week of my visit, Dorissa was participating in a pilot project using small tablet devices to record the answers to the contact tracing. This saved her having to fill out paperwork and deliver it to a supervisor, who would then bring it to the district headquarters, who in turn would bring it to the Incident Management Support unit, where the information would be logged in to an Excel spreadsheet and then analyzed.

New technologies like the tablets are a major time saver, and when it comes to Ebola, saving time can mean more lives saved.

Originally Posted by Gabrielle Fitzgerald on #Tackle Ebola