Les Roberts – Freetown, Sierra Leone – October 7th, 2014
I had a great lunch yesterday with Laura Miller (PFMH ’11) and Susan Purdin (former Program on Forced Migration and Health faculty who taught the Reproductive Health course for years).
What was so bizarre is that I could not hug them or shake their hand….no one does! No one! Last night I saw the British special Ebola Representative leave a meeting with the CDC lead here in country…. and they did not shake hands! Everyone is washing their hands 20 or 30 times a day. There are hand washing stations as you enter every hotel and government building and restaurant. I have had my temperature taken 5 times today and 8 times yesterday. Every hotel and office and controlled public facility has infra-red thermometers to scan your forehead before you enter. Everyone…. poor and rich alike are hyper aware of this disease risk.
In order to control this outbreak there needs to be:
- cases suspected….calling in….self-diagnosing
- transport to a facility
- triage or holding of suspected febrile cases (w/ testing, diagnosing, treatment)
- contact tracing (which can lead back to step one)
- and safe burials
CDC is convinced safe burials are the highest priority. WHO thinks treatment capacity is the greatest bottleneck / priority (because identification, triage, contact tracing all don’t work if you can’t refer cases and if the health system is not trusted).
I do not know who is right but I am sure both are needed…it is all freakin’ needed. I have been made WHO’s Foreign Medical Team Coordinator which really means getting hospital beds up and running…with all the training and management and supply chains that goes with it. Not what I expected to do…..but maybe the most important thing I can do. Today we likely do not have ½ the beds in country that we need for the existing cases. I expect that we can triple the treatment beds in the next two months while I am here….and all modeling, even best case scenarios suggest, we will be even further behind the patient bed demand than we are now.
Man, this is one heavy gig!