Nation & World

UN: Doctors, nurses play role in both treating, spreading Ebola

The World Health Organization is sounding the alarm that it has too few doctors and nurses willing to work in Africa to respond effectively to the continent’s outbreak of Ebola.

Margaret Chan, director-general of the World Health Organization, told reporters Friday at the agency’s headquarters in Geneva that “the number of new patients is moving faster than the capacity to manage them.” She said the world health community needs three to four times as many resources at it has committed “to catch up with the outbreaks.”

As of Friday, 4,784 people have fallen ill with Ebola, of whom more than 2,400 have died, she said. The most affected countries are Sierra Leone, Guinea and Liberia, where, Chan said, “there is not a single bed available for an Ebola patient in the entire country.”

Sarah Crowe, an official of the U.N. Children’s Fund, better known as UNICEF, said there were 370 beds occupied by Ebola victims in Liberia. “There’s a real sense this virus is taking over the whole country,” she said via a teleconference hookup from Monrovia, the Liberian capital.

Chan said the WHO still is seeking 500 to 600 doctors from abroad and at least 1,000 more nurses to dispatch to Africa to counter the epidemic. But with 301 health workers known to be infected with the virus _ almost half of whom have died _ finding volunteers has been difficult.

“The thing we need most is people,” she said. “The right people, the right specialists who are appropriately trained and know how to keep themselves safe.”

Cuba on Friday became the largest donor of medical personnel to the Ebola crisis with a pledge to send 62 doctors and 103 nurses to infected areas. Cuba’s minister of public health, Roberto Morales Ojeda, announced that his country would dispatch the workers in Geneva. Chan and U.N. Secretary-General Ban Ki-moon had appealed personally to Cuban President Raul Castro for the contribution, Chan said.

The Cuban team will be based in Sierra Leone.

More health care workers are needed. “We need to bring in more human resources if we want this to be effective,” Sylvie Briand, the WHO’s director of pandemic and epidemic diseases, told McClatchy.

Any people with experience can probably help, Briand said, but she said the effort especially needs people who have worked in physically demanding conditions.

The infection rates for health care workers have been particularly high in Liberia, where 171 have fallen ill, of whom 84 have died, according to a situation update Tuesday from Liberia’s Ministry of Health and Social Welfare.

​​Moreover, nine health care workers have been diagnosed with Ebola, including seven deaths, in the Democratic Republic of the Congo, where the disease’s outbreak is unrelated to the outbreak in West Africa, the WHO said.

The infection rate in the three most infected countries is substantially higher for women health care-givers, U.N. officials said.

Infected doctors and nurses also become a means for spreading the disease, David Heymann, a professor of infectious disease epidemiology at the London School of Hygiene and Tropical Medicine, told McClatchy. “Once health workers get infected, they risk infecting other patients and family members,” he said. “They’re the entry point into the community.”

Avoiding infection is a major challenge for workers. Ebola is deadly to as many as 90 percent of the people who contract it, usually through contact with bodily fluids, either directly or when they’ve been left on other surfaces.

Briand said that the high infection rates among health workers probably reflect a lack of needed safety measures in the early days of the epidemic. “People were not protected enough,” she said.

Heymann, a former epidemiologist for the U.S. Centers for Disease Control and Prevention, said the quick spread of the virus probably took place because hospital workers didn’t realize they were dealing with Ebola in the early days of the outbreak.

“Ebola resembles malaria, it resembles influenza,” he said. “They see a patient with a fever who might look like he’s having malaria, or something else,” and don’t take proper precautions. Then the hospital becomes contaminated and other patients are infected.

The fact that many health care workers in Africa also have jobs outside large public hospitals also may be a factor in spreading the disease.

“Maybe they don’t pay as much attention to IPC (infection prevention control) practices when they are operating elsewhere,” Briand said. “I know in some circumstances some midwives were helping friends to deliver and this is where they got contaminated.”

“It was not within the Ebola world. It was outside the Ebola world,” she added.

Still, the WHO says it’s likely that the agency is going to have to come up with incentives, including bonus pay, to persuade​ enough health workers to take on an Ebola assignment, and it has scheduled trips to key cities around the world in an effort to secure more funds and recruits.