Africa

Redemption of an Ebola-hit hospital in Monrovia

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Media captionAnne Soy reports from Liberia's Redemption Hospital: ''Staff take no chances''

Redemption Hospital in Liberia's capital, Monrovia, was a frontline health facility at the peak of the outbreak of Ebola in 2014.

The first case of Ebola in Monrovia was treated there and shortly afterwards infection spread through the facility - claiming the lives of 12 doctors and nurses, including the head surgeon.

The World Health Organization says more than 800 health workers were infected in Liberia, Sierra Leone and Guinea, the three countries most affected by the disease, with 509 of those - mainly local staff - dying.

It has been a major blow to countries that had very few qualified health workers in the first place.

"It was bad because every day you get up, you hear this person is Ebola-positive and you keep going through the motions - I touched that patient too," recalls Dr Nouuieh Gorpudolo, who worked closely with the surgeon who died.

Image copyright AFP
Image caption Liberian Red Cross health workers wearing protective suits arrive to carry a body of a victim of the Ebola virus on 12 September 2014 in a district of Monrovia

Mistrust grew within the community of the nearly 500,000 people whom the hospital was serving, and, at one point, some people besieged the facility and pelted it with stones, saying it was the source of Ebola.

The hospital was subsequently closed, like many others across the affected countries.

During the time it was shut, the facility was refurbished, but it has now reopened to the public and more people are confident of getting treatment there.

The changes are visible - at the entrance, a staff member wearing protective gear and a knapsack sprays the soles of the shoes of every person entering the hospital, then there is a temperature check and a hand-washing point with chlorine solution.

The hospital has also introduced a triage form with a checklist of Ebola symptoms.

"We go through the form and send a health worker to conduct an interview again... and check the temperature again," says Dr Gorpudolo.

On an average day, the hospital's lobby is full of patients waiting to be seen.

"Before the Ebola epidemic we used to see about 500 patients at the maternity wing a month. At the peak of the outbreak around July last year it dropped to 31 but this past month we've seen 531," adds Dr Gorpudolo.

He is among a handful of doctors serving the West African state, which has one of the lowest doctor-to-patient ratios in the world.

Fund-raising

In all, the Ebola outbreak killed more than 11,000 people and on Friday, the presidents of Liberia, Sierra Leone and Guinea are meeting donors in New York to raise funds for their countries' post-Ebola recovery.

The meeting was organised by UN Secretary-General Ban Ki-moon to help the three countries, who have a total combined budget of $2.1m (£1.3m), to rebuild their health systems over the next two years.

"Guinea, Liberia, and Sierra Leone entered the Ebola epidemic with severely underfunded health systems," said Matshidiso Moeti, the WHO's regional director for Africa.

"After a year of handling far too many severely ill patients, the surviving staff need support, better protection, compensation, and reinforcements. The existing facilities need a complete overhaul, and many new structures need to be built. If another outbreak strikes, the toll would be far worse."

Ebola has exposed the need to have more health workers - not just doctors.

Liberia's minister for health Bernice Dahn says many doctors fled the country during the civil war.

Now, she says, the ministry's recovery plan post-Ebola prioritises increasing the health workforce.

"The package includes bringing in foreign medical practitioners and we're giving priority to Liberians who are willing to come back home," Ms Dahn adds.


Ebola virus disease (EVD)

Image copyright SPL
  • Symptoms include high fever, bleeding and central nervous system damage
  • Spread by body fluids, such as blood and saliva
  • Fatality rate can reach 90%
  • Incubation period is two to 21 days
  • There is no proven vaccine or cure
  • Supportive care such as rehydrating patients who have diarrhoea and vomiting can help recovery
  • Fruit bats, a delicacy for some West Africans, are considered to be virus's natural host

She hopes to employ about 4,000 more health workers.

"Our plan is to scale up the community health workforce to be able to do health promotion and dispense (medicine) and treat minor diseases."

The WHO's representative in Liberia, Alex Gasasira, says part of the reason Ebola overwhelmed the country was because of weak health systems.

There was no laboratory to test samples of the virus.

"The specimen would have to be collected, transported to Monrovia then flown out of the country to be tested."

The local community told the BBC there were only two privately owned ambulances.

But following the intervention of the international community during the outbreak, many shortcomings have been rectified.

"We now have 45 ambulances," says the health minister.

There are also more supplies like personal protective equipment and essential drugs provided mainly by aid organisations in response to the Ebola crisis.

But they will not be sufficient in the long term because the organisations will wind up their operations as the outbreak ebbs.

"Many Liberian health workers have been trained in (testing of viral haemoragic fever samples) and laboratories have been built," adds Dr Gasasira.

Compared with developed economies, Liberia, as well as Sierra Leone and Guinea, still has a long way to go to having resilient health systems that won't crumble again in the face of a large outbreak of an infectious disease.

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