The 1995 Kikwit Ebola outbreak: lessons hospitals and physicians can apply to future viral epidemics

Abstract

General lessons from the outbreak include the importance of having simple, well-defined triage procedures; staff who are flexible and able to adapt to situations with unknowns; and the need to protect staff physically and emotionally to ensure a sustained effort to provide care.

Psychosocial effects of an Ebola outbreak at individual, community and international levels

“…Those affected are likely to experience psychological effects due to the traumatic course of the infection, fear of death and experience of witnessing others dying 3 . Survivors can also experience psychosocial consequences due to feelings of shame or guilt (e.g.…”

“…Survivors can also experience psychosocial consequences due to feelings of shame or guilt (e.g. from transmitting infection to others) and stigmatization or blame from their communities 3 – 5 . Some survivors were threatened, attacked, evicted, left behind by, or excluded from, their families and communities because they were seen as tainted and dangerous.…”

“…Contacts of those infected with Ebola also experience stigmatization and isolation 3 , 6 . Witnessing the traumatic course of the infection in others can result in fear and anxiety about falling ill or dying themselves, in addition to feelings of loss and grief from losing loved ones 5 …”

“…community or family carers, traditional healers and health workers) can also experience psychological effects. Witnessing the traumatic course of the infection and their patients’ death puts carers at risk of poor psychological outcomes, including anxiety, depression and post-traumatic stress disorder 2 , 3 , 9 . Often, those assuming carer responsibilities are family members, particularly young people, who can experience increased anxiety, frustration and grief because of their relationship with the patient.…”

“…Given the high fatality rate and lack of treatment for Ebola, carers can feel burdened by guilt for being unable to adequately look after or save the patients. Working long hours, overwhelming patient numbers, limited safety equipment and a feeling of inability to provide adequate care for, or heal, those infected can also result in frustration, anger or feelings of helplessness for health workers 2 , 3 …”