The view from the Ebola Treatment Centre, Makeni, central Sierra Leone

Barnes, Solomon; Hussain, Nageena; Hogan, Julia; Logan, Victoria; Wardrope, J

doi:10.1136/emermed-2015-205002

Cited by 5 publications

(4 citation statements)

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“…Healthcare workers face a particularly high risk of infection and death, as they are in direct contact with symptomatic patients [58–60]. This also creates an indirect impact on other health staff, who are afraid and anxious to face rejection from their families and communities [16, 55, 61, 62].…”

Section: Discussionmentioning

confidence: 99%

The link between the West African Ebola outbreak and health systems in Guinea, Liberia and Sierra Leone: a systematic review

2017

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BackgroundAn Ebola outbreak started in December 2013 in Guinea and spread to Liberia and Sierra Leone in 2014. The health systems in place in the three countries lacked the infrastructure and the preparation to respond to the outbreak quickly and the World Health Organisation (WHO) declared a public health emergency of international concern on August 8 2014.ObjectiveThe aim of this study was to determine the effects of health systems’ organisation and performance on the West African Ebola outbreak in Guinea, Liberia and Sierra Leone and lessons learned. The WHO health system building blocks were used to evaluate the performance of the health systems in these countries.MethodsA systematic review of articles published from inception until July 2015 was conducted following the PRISMA guidelines. Electronic databases including Medline, Embase, Global Health, and the Cochrane library were searched for relevant literature. Grey literature was also searched through Google Scholar and Scopus. Articles were exported and selected based on a set of inclusion and exclusion criteria. Data was then extracted into a spreadsheet and a descriptive analysis was performed. Each study was critically appraised using the Crowe Critical Appraisal Tool. The review was supplemented with expert interviews where participants were identified from reference lists and using the snowball method.FindingsThirteen articles were included in the study and six experts from different organisations were interviewed. Findings were analysed based on the WHO health system building blocks. Shortage of health workforce had an important effect on the control of Ebola but also suffered the most from the outbreak. This was followed by information and research, medical products and technologies, health financing and leadership and governance. Poor surveillance and lack of proper communication also contributed to the outbreak. Lack of available funds jeopardised payments and purchase of essential resources and medicines. Leadership and governance had least findings but an overarching consensus that they would have helped prompt response, adequate coordination and management of resources.ConclusionEnsuring an adequate and efficient health workforce is of the utmost importance to ensure a strong health system and a quick response to new outbreaks. Adequate service delivery results from a collective success of the other blocks. Health financing and its management is crucial to ensure availability of medical products, fund payments to staff and purchase necessary equipment. However, leadership and governance needs to be rigorously explored on their main defects to control the outbreak.

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Section: Discussionmentioning

confidence: 99%

The link between the West African Ebola outbreak and health systems in Guinea, Liberia and Sierra Leone: a systematic review

2017

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“…ETUs were restricted to Ebola patients, and had therefore higher levels of expertise and preparation to take care of Ebola patients. 26 27 …”

Section: Discussionmentioning

confidence: 99%

‘Once there is life, there is hope’ Ebola survivors' experiences, behaviours and attitudes in Sierra Leone, 2015

et al. 2016

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BackgroundIn Sierra Leone, over 4000 individuals survived Ebola since the outbreak began in 2014. Because Ebola survivorship was largely unprecedented prior to this outbreak, little is known about survivor experiences during and post illness.MethodsTo assess survivors' experiences and attitudes related to Ebola, 28 in-depth interviews and short quantitative surveys with survivors from all four geographic regions of Sierra Leone were conducted in May 2015.ResultsSurvivor experiences, emotions and attitudes changed over time as they moved from disease onset to treatment, discharge and life post-discharge. Survivors mentioned experiencing acute fear and depression when they fell ill. Only half reported positive experiences in holding centres but nearly all were positive about their treatment centre experiences. Survivor euphoria on discharge was followed by concerns about their financial situation and future. While all reported supportive attitudes from family members, about a third described discrimination and stigma from their communities. Over a third became unemployed, especially those previously engaged in petty trade. Survivor knowledge about sexual transmission risk reflected counselling messages. Many expressed altruistic motivations for abstinence or condom use. In addition, survivors were strongly motivated to help end Ebola and to improve the healthcare system. Key recommendations from survivors included improved counselling in holding centres and long-term government support for survivors, including opportunities for participation in Ebola response efforts.ConclusionsSurvivors face myriad economic, social and health challenges. Addressing survivor concerns, including the discrimination they face, could facilitate their reintegration into communities and their contributions to future Ebola responses.

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“…Surveillance, diagnostic facilities and investigation of cases are important to control an outbreak, but these would be useless without trained health workforce and relevant technologies [ 41 ]. Healthcare workers face a particularly high risk of infection and death, as they are in direct contact with symptomatic patients [ 42 , 43 ]. This also creates an indirect impact on other healthcare workers who are often afraid and anxious to face rejection from their families and communities [ 44 ].…”

Section: Introductionmentioning

confidence: 99%

Zero tolerance for complacency by government of West African countries in the face of COVID-19

Erhabor

Adias

et al. 2021

HAB

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A novel Coronavirus (SARS-CoV-2) causing a cluster of respiratory infections (Coronavirus Disease 2019, COVID-19) first discovered in Wuhan, China, is responsible for a new illness that has been found to affect the lungs and airways of patients with associated symptoms of fever, cough and shortness of breath. In the light of few cases recorded so far in West Africa there is tendency for complacency. The region needs to make strategic plans based on available evidence to enable them effectively deal with this rapidly evolving pandemic. At this very moment countries like China, Italy, France, Spain, Iran, UK and many others are witnessing sustained and intensive community transmission of this virus and increasing numbers of severe disease and death particularly among elderly patients with other comorbidities. The reality of the seriousness of this pandemic is alarming. Government of member states of ECOWAS need to prepare themselves by building capacity as well as implement evidenced-based steps to mitigate this rapidly evolving pandemic by testing persons presenting with symptoms (fever, cough and shortness of breath), isolating and treating those found positive, tracing and quarantining contacts, implementing social distancing as well as optimizing human and material endowment to allow healthcare workers offer safe quality clinical care for affected patients to prevent secondary infection among healthcare workers.

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The view from the Ebola Treatment Centre, Makeni, central Sierra Leone

Cited by 5 publications

References 0 publications

The link between the West African Ebola outbreak and health systems in Guinea, Liberia and Sierra Leone: a systematic review

The link between the West African Ebola outbreak and health systems in Guinea, Liberia and Sierra Leone: a systematic review

‘Once there is life, there is hope’ Ebola survivors' experiences, behaviours and attitudes in Sierra Leone, 2015

Zero tolerance for complacency by government of West African countries in the face of COVID-19

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