Evening Ebola Update, Fri, 12/12: Survivors suffer in villages/Dr. Jim tells how to zero out EBOV/Will 120,000 women die from childbirth complications?   1 comment

12/12/14

Dear Colleagues:

l.  Dr. Jim, President of the World Bank, has an Op/Ed in the NY Times today telling all how to reduce the number of EBOV cases to zero.  The following actions need to happen: massive amounts of money (Dr. Jim notes that when one EBOV patient in Nigeria infected 19 other patients, the result was 19,000 contacts who had to be traced which required 800 HCW costing $13 Million); more HCW; bringing prevention, contact tracing, and treatment to the district level; becoming ‘nimble’ when an outbreak begins; getting cooperation from all African countries when an African country has an EBOV outbreak.  See Dr. Jim’s Op/Ed at:  http://www.nytimes.com/2014/12/12/opinion/jim-yong-kim-world-bank-the-path-to-zero-ebola-cases.html?_r=1

2.  The Lancet 13 December has a Comment from Eba at UNAIDS re: human rights vs. coercion in stopping the EBOV epidemic in West Africa.  Eba states that coercion, such as the forced quarantines in Liberia, and large forces of military troops do not produce adherence to WHO or UN precautions.  Only by engaging the affected community is adherence to precautions obtained.  (Note that Sierra Leone has ‘banned’ Christmas this year and begun ‘lockdown’ in its most EBOV-affected district (Kono); just what Eba has warned against).  See his article at:  http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)61412-4/fulltext

3.  The Lancet 13 December has another Comment by Delamou, et. al. from research institutes in Guinea and Belgium discussing the effect of the EBOV epidemic on maternal health in Liberia, Sierra Leone, and Guinea.  Maternal care and hospitals have ended in these countries because: non-EBOV hospitals have been closed; no EBOV tests are available to test pregnant women who present for care; HCW are fearful of working around pregnant women.  The authors believe that the UN Population Fund is correct: 15% of 800,000 pregnant women in these 3 countries over the next 12 months will die as a result of childbirth complications (120,000 pregnant women).  This is an unbelievable number of deaths.  See the Delamou article (especially reference #4 in the bibliography) at: http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)62364-3/fulltext

4.  CDC MMWR 12 December has two articles on the fate of EBOV survivors who return to their villages.  The first article by Lee-Kwan, et. al. says that Sierra Leone survivors face many challenges: their belongings have been burned; no one wants to hire them to work; they are stigmatized by villagers who believe they may still be infectious; they have no place to live.  The CDC has established a consortium of counselors to help these survivors by: providing necessities; telling tribal leaders what the facts are re: survivors; hiring survivors to do burials, be HCW, contact tracers because they have immunity against EBOV; providing counseling to survivors.  See the article about Sierra Leone survivors at: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm63e1212a1.htm?s_cid=mm63e1212a1_e

5.  The second CDC MMWR article by Arwady, et. al. deals with EBOV survivors in Liberia.  The authors found these survivors had the same challenges that the Sierra Leone survivors experienced.  Psychologists did all that the Sierra Leone psychologists did and added a welcoming ceremony in the survivor’s village and a Certificate of Medical Clearance for each survivor.  See the article about Liberian survivors at:  http://www.cdc.gov/mmwr/preview/mmwrhtml/mm63e1212a2.htm?s_cid=mm63e1212a2_e

RGL, MD

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Posted December 13, 2014 by levittrg in Ebola

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One response to “Evening Ebola Update, Fri, 12/12: Survivors suffer in villages/Dr. Jim tells how to zero out EBOV/Will 120,000 women die from childbirth complications?

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  1. Robert/Nick: Very goodcomments. I would have an interest to hear of any benefits for your SEARCH ENGINE OPTIMISATION campaigns as soon as this is integrated.

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