l. NY Times reports that Ban Ki-moon will visit Liberia, Sierra Leone, and Guinea soon with Dr. Chan of WHO and Dr. Nabarrro of UN to access what more can be done to stop the continuing EBOV epidemic. Ban Ki-moon’s request to UN members for money to combat EBOV remains underfunded.
2. NEJM 17 December on-line only has a Perspective by Dr. Lisa Rosenbaum, a Journal Correspondent, presenting the case for and against trainees at academic medical centers (AMC) being ‘released’ to deliver care to EBOV patients in West Africa. The Perspective is fair to both sides of the question. See the Perspective at: http://www.nejm.org/doi/full/10.1056/NEJMp1415192?query=TOC
3. PLoS ‘Speaking of Medicine’ has a very similar editorial on ‘serving’ in West Africa by Mello, et. al. from Stanford Law School posted today. See the PLoS editorial at: http://blogs.plos.org/speakingofmedicine/2014/12/17/supporting-go-fight-ebola/?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+plos%2FMedicineBlog+%28Blogs+-+Speaking+of+Medicine%29. In my opinion, trainees should be ‘transferred’ to the CDC for training, deployment, and post-deployment isolation. With the ‘transfer’ would come health care insurance, stipend, malpractice insurance, etc. Certainly there is federal money available for this project; HHS will receive > $2.0 Billion for EBOV prevention and treatment in the U.S. in the omnibus spending act just passed by Congress.
4. Fogerty International Center at the NIH reports today on NIH efforts in sub-Saharan Africa to train junior faculty. This program has been successful according to this report. This program needs to be expanded along with increased efforts to train medical students and nurses in West Africa. See the Fogarty report at: http://www.fic.nih.gov/news/pages/2014-mepi-progress-african-medical-education.aspx?utm_campaign=news&utm_medium=email&utm_source=top2014
5. ACAPS issued today a Country Profile on Sierra Leone. The profile is 12 pages; nothing is left out. Sierra Leone’s economy is supported by other countries’ donations or in-kind ‘gifts’, particularly by China. Family size averages 6 people; most toilets are shared between families. Water is a precious commodity and not guaranteed all hours of the day or night. Large percentage of women have been raped in the civil war which was ended by UN action. Medical services outside of the urban areas are not supported by the government. Seventy percent of the population lives in poverty; 40% of young people have no jobs. Girls are usually married between 15-19 y.o. and often pregnant. Female genital mutilation occurs in nearly 90% of girls and women. The government is run by a tribe accounting for only 2% of the population. The situation is much worse than we have been led to believe. Read this report at: http://www.acaps.org/img/documents/c-acaps-country-profile-sierra-leone.pdf
6. NIH reports today that the nurse at the Clinical Center is still being observed. No information on her EBOV status.