It doesn’t matter how you define the Ebola outbreak
I agree that the end result of the Ebola epidemic must be a health system that can effectively and efficiently manage its health surveillance program and deliver quality healthcare according to well-known standards. An effective health surveillance program will detect not only Ebola, but other diseases that kill more people annually in West Africa, such as Malaria, Measles, TB, and HIV/AIDS. More women die in childbirth and other pregnancy-related conditions. More children die for not being immunized every year than the total number killed by the Ebola epidemic.
After reading this Scientific American article on why scientists continue to be perplexed by how to define the ebola outbreak, I thought that we as health professionals must inform reporters and journalists so they learn to use public health thinking, science, and epidemiological information to understand and educate the people about the what the real problems and the solutions are. The problem is a weak health system. The solution is that all donor response, either in the form of emergency or development assistance, must be designed to improve the health system so it can not only address Ebola, but all the other prevalent diseases and conditions that kill people in West Africa (and other parts of the world).
The problem is not the Ebola epidemic becoming endemic. The Ebola epidemic is a symptom of a weak health system, the same way, that high child and maternal mortality are also symptoms of a weak health system that cannot meet the health needs of the population it is supposed to serve. Whatever Dr Dye, Dr Bausch, Dr. Kobinger and other doctors do must improve how well the West African countries meet the health needs of their people, be it Ebola, HIV/AIDS or antenatal care.
It is not enough to go to Liberia and train healthcare providers on how to effectively isolate suspected patients, do effective lab testing, manage confirmed Ebola cases and prevent transmission. They must also involve the country’s nursing and medical schools to ensure they continue the teaching and future generations of health professionals have the same knowledge as Dr Dye and Dr Bausch. They must also work with Ministries of Health of these countries to revise the job descriptions and work routines and supervision procedures of health staff in government run facilities to ensure that they all continue working according to standards after the donors leave.
They must also help Ministries of Health to set standards for private health providers so they also can report suspected cases. They must help the Ministries of Health to plan for next year’s budget to ensure that all facilities have enough gloves for their health providers, as well as medicines and supplies. Otherwise, when the emergency response and the international attention end, the gloves, the medicines and all the protective equipment will end with it. Aid effectiveness and sustainability must be the standards to which assistance to West Africa is measured.
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