It is clear that Ebola is the most dangerous emerging infectious disease since the HIV/AIDS crisis began in the 1980s.
Health care workers must identify those with the virus, isolate them and monitor everybody who was exposed. This is the only way to break the chain of infection. But, with the exception of Nigeria, the overwhelming number of cases of Ebola in West Africa have made it impossible for health care workers to follow up with all those exposed to the virus.
The heritage of colonialism and the slave trade has left West Africa with too few hospitals and not enough trained health care workers. Since the outbreak, over 200 healthcare workers have died there, and many others are fearful of coming to work, especially when they do not have the necessary protective gear.
The Kenema Government Hospital in Sierra Leone used to be full of patients and families with ordinary problems, but now Ebola is the main illness being treated. The hospital is located close to where Sierra Leone, Guinea and Liberia converge — the center of the Ebola outbreak.
The hospital chief of staff was Dr. Sheik Humarr Khan, a highly trained and experienced African who ran the Lassa Fever Program. An internationally known specialist in hemorrhagic viral diseases, Khan worked there for 10 years. His predecessor died of Lassa Fever from a needle prick.
In May 2014, Dr. Khan saw Sierra Leone’s first Ebola patient, a woman who had been exposed in Guinea. She was placed in the Lassa isolation ward, which soon became an Ebola ward.
Most of Dr. Khan’s patients were poor and couldn’t afford food or medicine so he often bought it for them. In a short time the ward was filled with Ebola patients. Kahn always used a type of biohazard outfit that included breathing mask and goggles, a plastic face shield, three pairs of gloves, rubber boots and a plastic apron.
As the number of Ebola patients increased, it was necessary to set up a large plastic tent in addition to the isolation ward. Khan kept in touch with the World Health Organization and the Sierra Leone Ministry of Health, pleading for more help and resources.
Despite the precautions he had taken, in July Khan suspected he had acquired the virus. He isolated himself at home and called for a lab technician to take a blood test. It was positive. An ambulance took him to the Kailahun Ebola center because he didn’t want his fellow health care workers to see him dying.
The government of Sierra Leone regarded his infection as a national crisis. Emails were sent to individuals, the U.S. Centers for Disease Control and Prevention, the Public Health Agency of Canada, the U.S. Army and Doctors Without Borders. The international groups consulted by phone for three days. Their final decision was to not give Dr. Khan the ZMapp drug, which was stored in the very next room at the health center. The reason given was that it had been tested only on monkeys. Khan died a few hours later. The drug was then given to a U.S. doctor and an aid worker who had Ebola and were soon transferred to the U.S. These two white health care workers survived.
Role of racism, capitalism
How much has racism been a factor in the treatment of this terrible disease?
Was racism the reason that Thomas Eric Duncan was refused admission on his first visit to the Dallas hospital? He had a temperature of 103 degrees and said he was from West Africa, but he was sent home.
When finally admitted, was racism the reason the medical staff didn’t request one of the new drugs for him? His family made phone calls and rounded up people on a radio show to press the hospital to get the medicine, but by that time it was too late.
Was racism the reason Dr. Khan wasn’t offered a transfusion with plasma from a patient who had recovered from Ebola? It was used for other patients. As a highly skilled, experienced doctor, was he asked his opinion or were his wishes ignored?
The medical-industrial complex didn’t send the disposable hazmat suits that have been stockpiled because the countries involved didn’t have the money to pay for them. This is racism.
Several small companies have worked for years on Ebola vaccines with potential, but the big drug companies have refused to consider putting money into human trials. Now that Ebola has come to the U.S., the medical-industrial complex, a huge, powerful capitalist industry, is reconsidering whether it can make a profit off this disease.
By contrast, when West Africa called for help, socialist Cuba answered. Fidel Castro wrote that “the time of duty had come,” and 15,000 doctors and nurses volunteered. Cuban doctors set up a hazmat training hospital in Havana. The first 256 Cuban health care volunteers had two weeks’ training, and are now in West Africa. Hundreds more are undergoing special training in Cuba.
The many courageous health workers who are fighting this epidemic, like the Cubans and Dr. Khan, are today’s heroes.
Eolis is a retired Emergency Department nurse and family nurse practitioner. The information on Dr. Khan came mostly from the article “The Ebola Wars” by Robert Preston, New Yorker magazine, Oct. 27.