Category Archives: ETU

Life, Death and Grim Routine Fill the Day at a Liberian Ebola Clinic: “I think the world needs to come.”

Experience what it is like to be at an Ebola Treatment Unit in Bong County, Liberia, by reading this article written by Sheri Fink of the New York Times and view all 12 of its excellent slideshow photos:  Life, Death and Grim Routine Fill the Day at a Liberian Ebola Clinic

The article also has one of the most touching quotes published:

One night, he said, someone died under the same roof. “It’s too pathetic,” Mr. Davies said through tears. “I think the world needs to come.”

-Kolast Davies, ArcelorMittal employee, Yekepa, Liberia

Health workers prayed before the start of their shift at the Bong County Ebola Treatment Unit in Suakoko, Liberia. Ebola is under assault here in a cluster of cobalt-blue buildings operated by an American charity,  International Medical Corps. Daniel Berehulak for The New York Times

One night, he said, someone died under the same roof. “It’s too pathetic,” Mr. Davies said through tears. “I think the world needs to come.”

-Kolast Davies

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MSF Ebola Treatment Unit

How is Ebola being treated on the ground?

As the death toll from the Ebola outbreak spirals and cases recorded outside its West African epicentre increase, concern is growing over the measures in place to contain the deadly virus.

But with the battle to tackle Ebola taking a heavy toll on the struggling health systems in affected countries, what is being done on the ground to treat those infected and stop the disease from spreading?

In this fascinating article, BBC World News shows how an Ebola treatment facility run by medical charity Medecins Sans Frontieres (MSF) operates:  How is Ebola being treated on the ground?

Selected Field Notes from Liberia Situation Report 118 Sept. 10, 2014

A new ETU will soon be accepting patients in Bong County.  Save the Children found 40 vulnerable children living in a school in Margibi County whose parents had died and who were rejected by their community.  More ambulances are needed in Nimba County.

Here are selected excerpts from highlights of Liberia Ebola SitRep 118 Sept 10 2014

Bong County
• The new ETU has been officially turned over to the County Authority and County Health
Team. It is awaiting admission of patients
Lofa County
• Total number of patients in Foya Case management center (FCMC)- 32
Montserrado  County (including Monrovia)
• 1828 (98%) of the 1859 contacts under follow up were seen by 4 contact tracing teams.
• Of the 1859 contacts being followed, 2 became symptomatic today.
• Of the 1859 contacts being followed, 87 completed 21 days today.
• Of the 22 deaths reported 9 were from ETUs and 13 from the communities.
• Total admission at Redemption Holding Unit – 28.
• Red Cross made available 12 contact tracers to be used in our current tracing structure. They will be assigned in New Kru Town, where there are more than 300 contacts as of today.
• Health promotion section completed verification of gCHVs to be trained by UNICEF on Friday of this week
• 30 volunteers from SEARCH, a local NGO, were trained in contact tracing
Margibi County
• 147 contacts completed 21 days of follow-up
Save the Children discovered (15) families in the Mamba-Kaba and Kakata Districts with a total of 40 vulnerable children whose parents have died from Ebola.
• Affected children, rejected by the Community in Dolo Town, are living in a school building
Nimba County
• Africare donated $100. USD worth of scratch cards to CHT to strength communication and 20 gallons of gas as monthly support to each of the District Health Teams for Surveillance/Case tracing and specimen collection
• The Surveillance/case tracing and psychosocial teams reunited one Ebola survivor with her family and community people in Cooper Village
Issues & Constraints
• PPEs nearing stock-out in the County
The one ambulance for the transport of confirmed cases to the ETUs in Monrovia is inadequate
CAN ANYBODY DONATE 3 AMBULANCES FOR NIMBA COUNTY?

Appeal to Newspaper Reporters and Investigative Journalists

Dear Newspaper Reporters and Investigative Journalists:

Please read the Liberian MOHSW Situation Reports and report the news.  In the Liberia Ebola SitRep No. 115, there were 2073 cases as of Sept. 7, 2014.  In the same report, the number of patients treated at Ebola Treatment Units (ETUs) in isolation was 51 in Lofa County and 162 in Montserrado County.  Only 213 were isolated at ETUs.  How many were being treated at hospitals in Ganta, Sanniquellie, Kakata, the Firestone Rubber Plantation, etc?  We are not being told in the MOHSW Situation Reports if there are any beds in those locations. 

Please report the shortage of beds– how many cases compared to how many are in treatment, so the world can see that the health cares of so many are not being met. 

Get tougher on your reporting of the needs in West Africa.  Carefully read the MOHSW SitReps.  Publish the gap between medical supplies in MOHSW warehouses and what is projected to be needed in the next 3 months.  Talk about 5 Ebola patients housed in Monrovia’s Central Prison that a SitRep from a few days ago commented on. 

Also, does anyone have a better guess as to how many are infected in Liberia with Ebola, since the “reported numbers” are only 25%-75% of the real numbers?

Please praise MSF, Samaritan’s Purse, and SIM for all they have been doing in the field and for being advocates for West Africa.

Finally, please criticize the World– that means me, you, our governments for not helping soon enough and strongly enough.    Please tell the world that everyone needs to EXPONENTIALLY increase their aid for Ebola-hit West Africa to meet the expected “EXPONENTIAL” increase in cases and deaths during September and beyond.  The 600 million budget proposed by the WHO is not enough, never mind the amounts donated by world governments so far.

Do your investigative journalism so real story of Ebola in Liberia is told.   

 

More Ebola patients than room at Ebola Clinics in Liberia

Here is a Wall Street Journal article:

Deadly Disappointment Awaits at Ebola Clinics Due to Lack of Space

Sick Patients Are Turned Away; At Least 1,515 Hospital Beds Needed in Liberia, Sierra Leone and Guinea

By Drew Hinshaw in Monrovia, Liberia, and Betsy McKay in Atlanta

Sept. 7, 2014 8:55 p.m. ET

Workers wearing protective gear stand inside the contaminated area at a hospital run by Doctors Without Borders in Monrovia, Liberia, on Sunday. Agence France-Presse/Getty Images

Milton Mulbon arrived in a taxi at the gates of an Ebola clinic in Liberia’s capital, Monrovia, with his 24-year-old daughter, Patience, bleeding in the back seat. Guards turned them away.

“They’re telling me no space?” he protested, the taxi parked nearby. “She’s lying down in there almost at the point of death!”

Taxis, ambulances, and even men pushing their sick in wheelbarrows are crisscrossing Monrovia, looking for an open bed in West Africa’s overbooked Ebola clinics, health-care workers say. Sometimes they get in, through persistence and good timing. Mostly they don’t.

Liberia, Sierra Leone, and Guinea—the three nations bearing the brunt of the outbreak—need at least 1,515 hospital beds for the more than 20,000 people who could be infected before the outbreak can be curtailed, according to World Health Organization estimates. At present, there are only a few hundred beds. International support has been slow to come and is just beginning to address this specific problem, with the U.S. promising 1,000 additional beds in a new aid package.

The shortage is so dire that ambulances have picked up people raging with the symptoms of Ebola, driven them around for hours, then dropped them back at home, medical workers say.

The odds of surviving Ebola at home, without intravenous hydration, are slim. Along the way, the sick often infect their families. That is creating ever more Ebola patients arriving at the gates of overcrowded clinics.

Some, like Mr. Mulbon, collect a bag of sanitary products and painkillers. His daughter, the mother of two boys, died within hours of receiving it. “She was helpless,” Mr. Mulbon said.

Health workers complain they can’t throw down mattresses fast enough. Some organizations, including Doctors Without Borders, are asking Europe and the U.S. to send disaster relief—even military personnel—to help West Africa get ahead of an Ebola epidemic that has been under way since December.

“Many months into an Ebola outbreak, we’re in the position of turning away patients who look like they have Ebola,” said Henry Grey, a Doctors Without Borders emergency coordinator. “That’s an indication of the direct failure of the international community.”

Ebola patients at the hospital. Agence France-Presse/Getty Images

A few foreign governments are beginning to respond. On Friday, the European Union said it would pledge €140 million ($181.3 million) to the three hardest-hit countries, €97.5 million of it going directly to their national budgets.

“The situation is going from bad to worse,” said Kristalina Georgieva, the EU commissioner for international cooperation, humanitarian aid and crisis response.

On Thursday, the U.S. Agency for International Development said it would build 10 Ebola treatment centers with 100 beds each, part of a nearly $100 million aid package to the three nations. USAID Administrator Raj Shah said the agency is moving to fund and deliver beds and several hundred critical-care personnel “as quickly as possible.”

The challenge isn’t just delivering beds. It is training staff, said Jeremy Konyndyk, director of USAID’s Office of U.S. Foreign Disaster Assistance, which is coordinating the U.S. government’s response.

“We could get a bunch of tents and beds in here in no time,” said Mr. Konyndyk. “The hard part is who staffs those beds.”

It takes between 200 and 250 health workers to treat 80 Ebola patients, according to the World Health Organization. USAID and the U.S. Centers for Disease Control and Prevention are both looking to recruit and train health workers to take care of Ebola patients. The CDC program will begin in late September.

The trouble is finding doctors and nurses willing to treat a deadly disease—with no vaccine or formally approved treatment. In addition, the training is challenging, because they have to learn to care for patients while wearing cumbersome protective gear and meticulously guarding their safety.

Meanwhile, USAID is giving sick people who can’t find a free bed a home treatment kit. It includes bleach and disposable gloves, Mr. Konyndyk said.

An estimated 3,685 people have been sickened by the latest outbreak, WHO says. About half have died.

But those numbers represent a small portion of the true toll, the organization says. Because most Ebola victims are suffering at home, their deaths or recoveries aren’t noted in any official tally. Now, as clinics open, some of those who have been fighting the virus at home are beginning to show up.

A WHO clinic opened late last month in what had previously been a dental office. It was meant for 30 patients. But on a recent Tuesday, it was overbooked, with several patients sprawled out on the concrete floor, including children. The hospital’s director was reviewing a list of patients in the car on her way to brief Liberia’s Health Ministry.

Dr. Anne Deborah Omoruto Atai counted 44 patients. It was an improvement from a week prior when they had more than 70 people in the clinic with patients dying on the ground, she said.

“It’s difficult to give them adequate care when they’re lying on the floor,” she added. “We just leave it to natural selection.”

Across town, workers at the Doctors Without Borders clinic were assembling a 400-bed tent hospital in the mud and rain. The field clinic they already have, with 125 beds, uses 350 head-to-toe body suits, 25,000 liters of water and 2,500 gallons of bleach—every day.

Taxis pull up here so frequently that both Doctors Without Borders and the CDC worry the taxis themselves have become conveyors of the virus. The disease spreads through bodily fluids and if a healthy person were to put his hands into the sweat left by previous passenger, it could spread—and in a way that would be impossible to trace.

“We’re hearing stories of people taking four taxis across town,” said Caitlin Ryan, communications officer for Doctors Without Borders.

Outside the clinic, two taxis pulled up at the same time. Once again, there wasn’t any room for the sick. So a shouting match ensued.

“We are all Liberians,” screamed a man who had brought a sick girl in his cab.

“They think we don’t want to help,” said Randy Tomanne, one of the guards. “Their child is ill. There’s no other way you’d feel.”

Later, a third taxi arrived. The driver said he had been paid $10 to take a family with a 6-year-old girl lying across their laps to a clinic. He had no idea it was an Ebola clinic.

“He just said the hospital,” said the driver, Ibrahim Somir, while a man in a head-to-toe plastic suit sprayed down his taxi in bleach.

Before leaving to try his luck elsewhere, the girl’s uncle shrugged off the risk he’d put the taxi driver in: “What else should we do?”

Ganta Ebola Treatment Unit (ETU) opening delayed

Ebola in Liberia: Ganta holding site remains uncompleted

Via the Daily ObserverAs Ganta Remains Ebola Hotspot in Nimba... Excerpt:

Despite the raging of the deadly Ebola Virus which has claimed more than 70 lives in Nimba with over 300 contacts, the status of the holding site situated at the Ganta Hospital Compound remains in limbo. 

The site, which was expected to be officially turned over to the Administration of Nimba County on 4th September 2014, is yet to be completed with several other facilities still untouched. 

“We do not have water in the entire building as of present, and this place cannot be opened in the absence of water,” Supt. Fong Zuagele told the Daily Observer in frustration. 

When this reporter visited the project site, there was still work ongoing in bathrooms and other places in the building. 

Clean up was still ongoing as well, and there was no sign of its being ready to hold patients as there are yet no beds or other necessary supplies. 

Even though those recruited to work in the facility are still undergoing training in Monrovia, the continual delay in the completion of the holding site is causing dismay among residents in Ganta. 

Over 70 persons — suspected, probable and confirmed deaths — have occurred in Nimba since the Ebola outbreak intensified in July. With Ganta carrying the highest death rate, the holding site issue remains the stickiest part in the fight against Ebola, causing frustration among the citizens. 

Since the outbreak, people continue to die at home in Ganta daily, to which many have attributed the death rate, due to neglect or no care. 

Among the latest dead is a six-year-old girl who died on the 2nd of September 2014 at home in the Small Ganta Community, the hot spot in Ganta at present. 

According to reports, this little girl was the last remaining relative of the Roseline Tokpah family, whose death spread the virus in the Small Ganta Community. 

Roseline Tokpah, an employee of Ecobank – Ganta, and her entire family, including her husband, died of Ebola after Roseline’s sickness was believed to be the result of food poisoning — until she died. 

Nearly all of those who came in contact with Roseline are said to have died, and the little girl was believed to be last of her family. 

“If there was a holding site, at least this little girl was going to be cared for and survived,” said one of the residents.