About Ebola and its effect on medical practice in west Africa.

For all sad words of tongue or pen, the saddest are these- it might have been ...john whittler.

Ebola is a dangerous, cataclysmic, deadly viral disease that has affected west african countries of Guinea, Sierra Leone, Liberia, Senegal and Nigeria causing so much pain, death and misery.

It is unfortunate that presently there is a lot of outburst and concern with this present outbreak despite the fact that Ebola has been around for close to 38 years and is a sad testimony to the apathy of the world to a disease that has the capacity to destroy and devastate whole families and communities with death to the health workers and psychological trauma to those fortunate to survive it.

The present out break defies the normal pattern.

1. it is not localized to rural villages and communities.

2. it affected major cities and towns.

3. the strain of this present outbreak which is different from the usual one.

4. the potential it has  shown to spread globally thus putting the whole world at risk of its spread.

5. its devastating ability to be contacted and to kill its victim.
6. the prominence of vomiting and diarrhea more than the usual bleeding from orifice thus causing the name to be changed to ebola virus disease(EVD)

The effect of this on the response of the international community and the practice of medicine in the affected countries has been massive and interesting.

I will focus today on the effect it has had on practice of medicine. It is no gainsaying the fact that those who are affected mostly by the Ebola virus disease are the health workers who are usually those that will usually have first contact with the patient apart from their family members or those who brought them to the hospital. This is worsened by

1. their not applying any protective measures when initially attending to these patients since the presentation are usually like any other common illness like malaria, diarrhea, upper respiratory tract infection.

2. most clinics and hospitals do not practice or adhere to safe medical practice like a regular routine of disinfecting and cleaning the work environment viz a viz reducing the possibility of giving or receiving infection to or from the patient.

3. unavailability of funding to be able to ensure the continuity of applying safe and simple practice such as regular and consistent disinfecting of the clinic and in their handling of patients.

4. unavailability of personal protective equipment(PPE) which can be worn in handling suspected cases.

5. not quickly putting in place a system of surveillance and having a high suspicion index of viral disease with possible hemorrhagic symptoms like ebola, lassa fever that are highly infectious.

6. poor understanding of the need to spend money on the basic things that help to prevent hospital acquired infection by the government or even those managing the health centres even when they  happen to receive some funding which unfortunately comes irregularly.

7. poor sensitization and awareness of the public with regards to this terrible disease.

All this are the poor working conditions and human neglect that have also contributed to the widespread of this present outbreak.

It is however interesting to see the changes these has brought both on government, health workers and even on the part of the general public with regards to awareness about the importance of personal hygiene both at individual and hospital level.

It is good how the health personnel have seen how important it is to protect themselves and not to take many things for granted. The government carefree attitude toward the health sectors and its staff well being is now being awakened may be because it affected the rich and everybody is now talking about the need to fund the sector more and take care of its health workers well being.

Across these countries, the need for ensuring and practicing personal cleanliness and cultivating more healthy living practices. Even though it is sad that many lives had been lost which truly is a sad testimony to the health system in west africa but maybe in the long run it might be to the benefit of the future of their health system as everybody becomes proactive with regards to their health practices and the health system to mange the health challenges that they faced and will continue to face.

What do you think about the ebola situation in west africa? Do you think more could be done? Do you think that maybe in the long run it can lead to better health system being put in place. Your opinions will be highly appreciated. Next time we will discuss about the international response to this outbreak.