Sunday, April 06, 2014

Ebola: A Volunteer's Perspective

In the past few weeks, the entire world has heard of Guinea’s Ebola outbreak. Ebola, a deadly virus with a death rate of up to 90% (although it’s at around 60% here), is honestly a terrifying neighbor. Many Volunteers found out through friends and family, during concerned calls, texts, and facebook posts. As per usual, Volunteers were out of the loop on the international news side. While Peace Corps had its hands tied (though they did quite a bit to ensure Volunteer safety as we’ll discuss later), it was a bit troubling that PCVs heard about Ebola through their international connections before their local connections.

Volunteers have had outbreaks near or at their sites. Some Volunteers responded to this by barricading themselves at their sites, refusing to travel. Others were told to stay at the regional capitals temporarily while policies were being verified.

Perhaps scarier than the idea of Ebola by itself, is the feeling of distance between Volunteers and their medical support structures. Even with the best PCMO teams out there, the fact remains that Volunteers often live in isolated and remote places, and responses to medical problems are never as certain as calling 911 and expecting an ambulance.

Despite the panic, the reality on the ground is not nearly so precarious. The death rate is holding steady, at around 80 dead in a country of 10 million. The truth is, malaria is still far more likely to kill a Volunteer than Ebola is. The CDC, Doctors Without Borders, the Guinean Government, and other organizations are all working together to quarantine all cases, actual and suspected, of Ebola. Isolation is the best tool we have against a more widespread outbreak. While it’s true that the range of the virus has been troublingly large, much of the spread has been traced to specific families that transported their sick and dead. Those families themselves have been quarantined.

Part of the reason Ebola hasn’t spread that dramatically is due to its high mortality rate- but part of it is also due to the relative difficulty involved in catching the virus. It’s not airborne, and probably won’t be passed through casual contact during the incubation period. Only when the patient is really sick are they highly contagious. Avoiding the extremely ill and the deceased puts Volunteers at low risk of catching the deadly disease. Nonetheless, Peace Corps is closely monitoring the situation, at times instituting travel restrictions and restrictions on health center work (anything that can bring Volunteers into proximity with the sick). The main risk to Volunteers actually comes from hospitals, where proper isolation techniques can be questionable and the disease can actually spread. If a Volunteer falls ill, perhaps unconscious, and is taken to a medical center also hosting an Ebola patient, they are at risk. To ensure a rapid response, an emergency Peace Corps vehicle has been installed near the Volunteers closest to the outbreaks. Peace Corps Guinea also invited the CDC to analyze their Ebola response plan- the CDC recommended no changes. Don’t worry- we’re being taken care of!

Guinean responses to the outbreak vary. In the villages, little has changed. Ebola hasn’t taken on a menacing reality yet. The government’s texts encouraging hand washing have boosted some PCV hand washing projects- not much else has changed (except for those public health Volunteers who can’t go to work).

In Conakry though, paranoia has taken root. People are washing their hands with pure bleach. I even saw a Guinean using hand sanitizer- I had no idea it existed in Guinea (outside of Volunteer care packages). The high vigilance towards hygiene can’t be a bad thing. Hopefully it will persist after the epidemic passes away, as it will. 

1 comment:

Anonymous said...

How about an update? Seeing as how the situation has gotten a lot worse since April, with no signs of improvement