Saturday, September 27, 2014

Report on US Government Waste and Incompetence Fighting Ebola in Liberia

Dr. James Appel reports from Liberia:
Liberia is losing the fight against Ebola because they are depending on NGOs and an influx of Western money instead of traditional ways of dealing with epidemics.  The first few Ebola epidemics were in remote villages where the villages touched by Ebola were self-quarantined according to ancient traditions of dealing with plagues.  No one went in and out, and the surrounding communities brought them food.  The caregivers washed themselves and their clothes rapidly and frequently after each contact with the patient, just using simple soap and water.  Very few ever got sick, and the disease was controlled in a few months.


Here in Liberia, everyone is excited about the millions of US dollars being poured in to “fight Ebola,” and everyone wants a piece of the pie.  A certain NGO out in rural Liberia quarantined a village, claiming they’d tested and found three cases. They applied for and received US$ 250,000 to fight Ebola in this village.  They brought in a few sacks of rice and some chlorine.  The villagers mobbed the trucks and carried off the plunder.  And, miracle of miracles, not a single person died in the village.

Great effort at treating and controlling Ebola?  Or pretending there’s Ebola in order to pocket some easy cash?  I’ve never heard of a 0% fatality rate for Ebola, but you make the call.

Dozens of Land Cruisers

NGO’s spending hundreds of thousands of dollars to level earth with heavy equipment over a month in order to build tent cities capable of isolating and treating Ebola, but then not even giving them IV fluids or food, so that the Ebola patients sneak out of the tents and cross the street looking for food.

Dozens if not hundreds of US$70,000 Land Cruisers are taking foreigners around town to hotels, bars, clubs, and fancy guest houses so they can feel comfortable while they fight Ebola, and yet they can’t even collect the dead bodies that could expose so many more!

We’ve had bodies left for up to three days.  Others have stayed in the open for up to five days before being collected.  Patients are often turned away from the Ebola centers, and some have even refused to take anyone who doesn’t come in an ambulance.  How many of the poor in West Point slum can afford an ambulance, even if there were enough available to take them?

Low-Tech Solutions

I propose the following solution.  I got the idea from a seasoned MSF doctor named Cameron.  (MSF is Médecins Sans Frontières, or Doctors Without Borders.)

There are two reasons people call the Ebola hotline: they have a dead body they suspect of Ebola, or they have a live patient they suspect of Ebola.

If there’s a dead body, the hotline should alert some local drivers with old beat-up pickup trucks, and the first one to the site gets the body.  Of course, they will be given full protective gear.  If they bring the body in within 3 hours of the call they get US$50; if they bring it in within 6 hours of the call they get US$40; if within 12 hours, US$30; if within 24 hours, US$20; if after 24 hours, US$10.  If after 48 hours, US$5.  This will motivate people to quickly get the bodies and bring them in to be tested and buried appropriately, with minimal chance for contact and spread.

If it’s a live patient suspected of Ebola, a taxi can be called and for a few dollars take a nurse or lab tech out to the site in full protective gear.  They will draw blood for Ebola testing, take the address and contact info, give the family a box filled with gowns, gloves, masks, rubber boots, bottles of chlorine, antibiotics, anti-malarials, oral rehydration salts and anti-vomiting medications.  They will contact the community leaders, who will ensure that the family is not only quarantined in their compound, but also provided with food and water.

Local economy

All this could be done for a fraction of the current funds being used, and would be more effective, because the patients would all get the individual care that only a family member can give, including adequate food.  It would also be more effective because you’d be using local methods and using the money to invest in the local economy instead of paying the high costs of plane tickets, salaries, living expenses, transportation costs, etc., of foreign aid workers.

1 comment:

  1. This is why I am actually worried about ebola. The rampant corruption at all levels, the inherent ignorance of the organizations trying to help, the utter incompetence of our "leaders" and the millennia of government failure are NOT reassuring.

    I think ebola, with proper medical care in a modern facility, is probably 10% fatal, maybe higher, but probably not worse than the Spanish flu.

    It is hard to transmit. The sheer number of people that have worked around it that are not dead speaks to this characteristic. It apparently infects and sickens randomly. Many people who have never been deathly sick have ebola antibodies.

    An infectious disease doctor I know is worried...but not about the disease itself. He wishes we had a few dozen cases, with good contract tracing and low mortality and no subsequent infections, just to show that it CAN be controlled in a modern setting. His worry is that the infections in the rest of the world start AFTER a few hundred thousand (and God forbid after it reached over a million) of people in Africa are dead.

    Can you imagine being a doctor, or nurse, or EMT, or any profession that deals with skin to skin contact?

    The wheels of commerce would fly off. The panic would be worse than the disease.

    The government lies so blatantly, so frequently and so unashamedly that many people will not believe their propaganda about ebola no matter how truthful and accurate.

    THAT is the scariest part, and that is why I have been working on a plan to protect my family.