EBOLA Outbreak: Why Ghana can’t take any chances

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EBOLA! I don’t know how you feel, but a lot more shivers go down my spine anytime I come across it, regardless of me being a healthcare practitioner.

West Africa is presently battling with an Ebola Virus disease outbreak (EVD), but for us in Ghana, we have been spared, of course with some suspected cases, all turning out to be negative.

But should we be celebrating yet?

Recent Outbreak; History and characteristics

On March 13th, 2014, the Ministry of health, Guinea, notified the WHO of a rapidly evolving outbreak of Ebola virus Disease. Six out of the seven blood samples collected, tested positive, thus confirming the first EVD outbreak in Guinea.

Retrospective epidemiological investigation indicated that, the first cases of EVD occurred as early as December 2013. The spread of the outbreak later continued to neighboring countries of Liberia and Sierra Leone in March and May 2014 respectively.

As of June 29th, the cumulative number of EVD cases in the three countries stood at 763 including 468 deaths, according to the WHO.

Major Challenges contributing to the ongoing outbreak include;

Lack of understanding and experience in the communities and among Healthcare workers coupled with limited capacities for rapid response.
Close community ties including social and commercial activities leading to highly mobile communities.
High exposure to Ebola Virus in the community through household care and customary burial procedures.
Indeed, the scientist who discovered the Ebola virus, Dr. Peter Piot, is quoted to have said that, the current outbreak of the deadly virus in West Africa is “unprecedented.”

It is on record that, this is the first time that three countries are involved, the first time the outbreak is happening in capital cities.

Response so far

There have been quite a number of interventions in response to containing the outbreak, by the WHO in partnerships with MSF, Red Cross and the Ministry Of Health in the countries affected.

MSF, who have been on the ground in almost all the hot spots have revealed of the inability to manage the situation if help does not come soon.

The situation looks threatening to the Africa region and global public health, thus informing the WHO (Africa region office) to convene a two-day emergency meeting of Ministers of Health and Partners in Accra.

WHO ministerial emergency Ebola meeting in Accra,Ghana

WHO ministerial emergency Ebola meeting in Accra,Ghana

The main goal of the meeting was to bring countries and key stakeholders to a consensus on the optimal way to interrupting the outbreak.

The meeting recognized a number of challenges in the area of:

Coordination of the outbreak
Communication within various response structures
Cross border collaboration
Logistics
Case Management
Infection control as well as surveillance specifically relating to the issue of contact tracing

Ministers of Health at the end of the 2-day emergency meeting agreed that the current situation is urgent and a serious threat to Africa and global health thus adopting a common inter-country strategy for accelerated response to Ebola outbreak in West Africa that stresses the need for coordinated action by all; Health Partners, national leadership and Government in all countries.

Highlights in Ghana

Whilst Ghana received all applause and appreciation from the WHO for making it possible to host the event, it also has no recorded case yet.

There is ongoing surveillance for EVD as part of surveillance for viral hemorrhagic fevers (VHF). Twelve samples of suspected VHF from Brong Ahafo Region, Ashanti Region, Eastern Region, Greater Accra Region and Upper East Region sent to the Noguchi Memorial Institute for Medical Research (NMIMR) for testing, have been declared negative for Ebola and other VHF.

Other Surveillance and Laboratory activities ongoing include;

Sixty regional surveillance and disease control officers and 90 port health staff trained on Ebola surveillance with training being cascaded to lower level.
Orientation on EVD held for all Regional Health Administrations
GhC15,000 released to NMIMR by GHS to support laboratory activities
Thirty PPE (Personal Protective Equipment) presented to NMIMR by WHO

With Planning and Coordination, an Initial GhC 800,000 has been approved by government to support the immediate needs of the Ebola Preparedness and Response Plan with GhC 50,000 released to the Ghana Health Service (GHS) so far.

Other evidenced based measures are ongoing regarding Case Management and Social Mobilization such as PPE kits including cadaver bags presented to MOH by WHO and media engagement with information on EVD, mode of spread, signs and symptoms and prevention.

Regardless, Ghana’s Health service is still confronted with Challenges, such as;

No isolation unit designated yet to manage cases
Inadequate information campaign to the community level
Limited training of health workers on infection prevention and control measures

At a time when health facilities are running out of detergents and disposable hand gloves, none should say ‘we are ready’.

Agreeably, this is “an epidemic of dysfunctional health systems”, and we must fix the lapses, especially that regarding Public Health, epidemic preparedness and case management know-how for healthcare professionals.

Yes, No Need to panic but we all need to activate our Alert modes.

We can’t afford to play on political and cultural lines. It does not matter which facility or family a case is reported, what matters is preventing the spread. Indeed, it is every individual’s responsibility too, in safeguarding the situation.

You need really close contact to become infected. So just being on the bus with someone with Ebola, that’s not a problem, the least we can all do is to ensure proper hand hygiene always. It’s also advisable that we hold on with bat eating especially for now.

Of our public hospitals, the Korle Bu Teaching and the 37 Military hospitals should be commended for their efforts towards client education. We must insist on other health facilities to follow suit by displaying literatures around its premises, and engaging patients and staff routinely to what the Ebola Virus disease is about.

WHO, presently does not recommend any travel or trade restrictions be applied to all the countries affected by the outbreak based on the current information available, but then again our borders cant be left ajar on any day.

At a fatality rate of 90%, we can’t take any chances. There is hope; unfortunately we may be running out of time.

Let’s do this together….

(Author of article is the leading online voice for healthcare in Ghana)

Follow @kobbyblay

References:

Strategy for Accelerated response ot Ebola outbreak- Dr Keiji Fukuda, WHO

Scientist who discovered Ebola, Dr. Peter Piot with Amanpour on CNN

WHO Ebola Emergency meeting communiqué

WHO Ghana Ebola Viral Disease (EVD) Preparedness and Response Activities-WHO Africa

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