Liberia and ebola

doi:10.15406/ogij.2015.02.00049

eISSN: 2377-4304

Obstetrics & Gynecology International Journal

Editorial Volume 2 Issue 4

Liberia and ebola

Mary Zozulin

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Department of Electrodiagnostic, Frank Pais Hospital, Cuba

Correspondence: Mary Zozulin, St Marys Hospital, USA, Tel 2035731425

Received: June 21, 2015 | Published: July 16, 2015

Citation: Zozulin M. Liberia and ebola. Obstet Gynecol Int J. 2015;2(4):145. DOI: 10.15406/ogij.2015.02.00049

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Editorial

Much has been said and blamed for the terrible scourge called Ebola that swept through Liberia this past year. I have my own observations. Liberians have asked: Why did only Africans get sick then die? Why did only Kissi tribe get sick? Why did ebola spread so fast? Why did ebola stop so fast?

The story started in Dec 2013 when a fever in the forest between Guinea, Sierra Leone and Liberia was killing people. Cases were increasing and deaths were adding up. The fever was accompanied with stomach illness and bleeding. French Doctors without Borders came and were investigating. This was the condition when I came to Foya Borma Hospital in Liberia the last few weeks of Feb 2014. My daughter was there for a year with the Peace Corps. I was asked to help at the hospital. Before I had a tour of the facility, a nurse was yelling for me to go the OR to do a cesarean. I came in a dank, humid, hot OR room that was not as clean or equipped as the tent hospitals I had seen in the Air Force. An OR table was there from WW2 I believe with no monitors, no anesthesia machine, no oxygen, no electricity, and no running water. "The baby is dead" I was told.

There was no way to know anyway and the woman had walked miles in the bush after laboring for days at home then waited at the steps of the hospital until morning light to see us. The old surgeon spoke with such accent I thought he was speaking a different language so I went into emergency mode and did a stat C/S as soon as the nurse who did anesthesia got the spinal in. Baby was indeed alive, but no one cuddled or fed him for a day to make sure he was REALLY alive. That same day a lady who came in sick with the fever and bleeding died. I saw her in her room that day but could do nothing. A boy came in with an infected leg and bone after months with a fracture that the Bush Doctor treated by placing skin and muscle cuts and pressing dirt and herbs into the leg. We sent him to Monrovia. I am sure he lost the leg if he survived. I did more cases, then my daughter and I visited and made our way back to Monrovia where I caught a flight to JFK without a plane change (8hr flight).

After being home a few weeks my daughter called me and exclaimed "We got Ebola!" I knew what Ebola was and the small but deadly outbreaks in The Congo. Also I knew it was a military biological weapon. My first response was "You have to come home NOW!" She was not evacuated until August. It was a rough few months for a mother.

The story continued and indeed Ebola was in Foya and half the nurses and the nurse who did anesthesia died. The hospital administrator was trying every plea to government and NGOs to get help and supplies. The people asked why they were cursed. The CDC and WHO said it will be self limiting. Doctors without Borders quickly became over run. Then it happened.

A sick woman left her home quarantine in Foya and took a motor bike (hanging onto a driver on a dirt bike) then a taxi (a small vehicle with 10 people a few goats maybe a chicken and all supplies) to reach Firestone. She was violently ill and died the day after reaching Firestone hospital. She spread Ebola from the northern border, along the eastern border to the coast all the way to the western border of Liberia. Then the numbers blew up and Liberia was out of control. Then a man took a flight from Monrovia to Nigeria and got people sick. Another few doctors and volunteers spread to Spain and in the US. Then it came to Dallas unintentionally and spread to nurses. Then the help came to build roads and get supplies and educate and remove bodies in Liberia and now Liberia has no more cases as of this month.

Ebola is not over though. It is still in the bush, in the bat, in the hunter, in our psyche. It is still in Guinea and Sierra Leone. Liberia however, is a tight contact socially and economically with the US. It is an eight hour flight away. The poor health care system and no infrastructure is why Ebola spread. Locals do not trust the hospitals because the death rates and complications are so high. The hospital is their last resort. The hospitals are dirty, hot, smelly, without power or water or pain meds. Patients get operated on without any post-op pain control and sometimes very little intra-op pain control. A shot of Ketamine if there is some and a spinal or some local and that is it. There are no gloves or dressings at times so no one gets operated then anyway.

Now is our chance to improve conditions in Liberia. Liberia is ready and the world sees it and knows it. We need a coordinated effort to get roads and power and clean water. Without these basic things, all the great education and surgical skill in the world will not make much difference. The country is surviving in an emergency state of existence.

So this is why Ebola spread in Liberia. This is why western medicine is not trusted. This is why 1/10 infants die and 1/100 mothers die there. Childbirth is a deadly undertaking. Children who do survive face 60% malnourishment with 40% being growth stunted due to vitamin deficiencies. This is 2015. The world is small. What happens there affects us here. Ebola is a wakeup call. Are we going to hear it?