The PJ Tatler

Authorities in Sierra Leone Tell Families to Care For Ebola Patients at Home

They’re out of Ebola beds in Sierra Leone and it appears that the outbreak is about to get a lot worse.

Authorities are advising families to keep their loved ones who have contracted Ebola at home. About all they can do is give out painkillers, re-hydrating solution, and gloves.

No masks. No gowns. No faceguards. No isolation. The chances that thousands of family members will contract the disease are very high. But there’s nothing the government can do about it until more help arrives.

New York Times:

“It’s basically admitting defeat,” said Dr. Peter H. Kilmarx, the leader of the federal Centers for Disease Control and Prevention’s team in Sierra Leone, adding that it was “now national policy that we should take care of these people at home.”

“For the clinicians it’s admitting failure, but we are responding to the need,” Dr. Kilmarx said. “There are hundreds of people with Ebola that we are not able to bring into a facility.”

The effort to prop up a family’s attempts to care for ailing relatives at home does not mean that officials have abandoned plans to increase the number of beds in hospitals and clinics. But before the beds can be added and doctors can be trained, experts warn, the epidemic will continue to grow.

C.D.C. officials acknowledged that the risks of dying from the disease and passing it to loved ones at home were serious under the new policy — “You push some Tylenol to them, and back away,” Dr. Kilmarx said, describing its obvious limits.

But many patients with Ebola are already dying slowly at home, untreated and with no place to go. There are 304 beds for Ebola patients in Sierra Leone now, but 1,148 are needed, the World Health Organization reported this week. So officials here said there was little choice but to try the new approach as well.

“For the first time, the nation is accepting the possibility of home care, out of necessity,” said Jonathan Mermin, another C.D.C. official and physician here. “It is a policy out of necessity.”

Faced with similar circumstances in neighboring Liberia, where even more people are dying from the disease, the American government said last month that it would ship 400,000 kits with gloves and disinfectant.

“The home kits are no substitute for getting people” to a treatment facility, said Sheldon Yett, the Unicef director for Liberia. “But the idea is to ensure that if somebody has to take care of somebody at home, they’re able to do so.”

The international response to this crisis has been pathetic. The US has stepped up and we will almost certainly continue to increase our efforts.

But other industrialized nations have failed in their responsibility. US Secretary General Ban Ki Moon has called for an astonishing 20-fold increase in assistance. Where is the rest of the world?

Africa’s biggest trading partner, China, has said it would provide $1 million in cash, $2 million in food and specialists each to Liberia, Sierra Leone and Guinea. The Asian giant is also sending 170 medical workers to Liberia, state-run Xinhua News Agency reported. Currently, 58 Chinese are staffing an Ebola-treatment ward and blood-testing lab off the side of a Chinese-built clinic. Of these, 35 are drivers, handymen and chefs, said Guo Tongshing, the clinic’s chief doctor.

India, with deep trade links and air connections to West Africa, recently pledged to contribute $12.5 million, but no medical personnel. Brazil, which has spent a decade wooing African nations across the Atlantic, has contributed about $413,000.

Russia, which has also sought to rekindle Cold War allies here, sent a team of eight virologists to Guinea, once a Soviet outpost, and protective clothing.

South Africa—a country eager to cement its leadership role on the continent—has sent a mobile lab to Sierra Leone. There is no record of any monetary contribution from the country.

African health workers are part of the crisis response, though. The African Union has sent about 75 medical workers, and Uganda, which has extensive experience with Ebola, has sent 15.

Meanwhile, Japan, the world’s third-richest economy after the U.S. and China, is sending $40 million to the cause, but no personnel. Toyota Motor Corp. plans to donate cars to help transport patients.

Even France, the European country with the most military bases in Africa, has been slow to send in army medics. The former colonial power will construct and operate a 50-bed clinic in Guinea, staffed with 15 French medics at a given time, in addition to Red Cross volunteers, the state agency managing medical reservists said.

In another three months, there may be more than a million cases of Ebola in West Africa. By that time, no amount of aid will make a difference. The disease will run its course and probably spill over borders to western Europe and the US.

Now is the time when a maximum effort might save thousands of lives — including citizens in the west. For surely, it is far better to fight it over there, than have to fight it over here.