A health worker fills in a child’s immunization booklet during an immunization clinic at Phebe Hospital in central Bong County, Liberia. (Cindy Shiner/MSH)

After losing both her parents to Ebola, Liberian nurse Salome Karwah recovered from the virus herself. Protected by her new immunity, she returned to work to care for countless other victims. Time Magazine recognized her as a 2014 Person of the Year for her compassion and tirelessness. In February of this year, Nurse Karwah was rushed to the hospital with seizures following a cesarean delivery of her son. Her garish symptoms frightened the hospital staff that knew she had survived Ebola. They would not touch her. They let her die without treatment.

That is what stigma looks like.

Even after being declared free of Ebola, many survivors found themselves alone, as the International Federation of Red Cross and Red Crescent Societies reported. A chilling new normal replaced the terror and death in the isolation wards: rejection by family, friends, and neighbors, even by their places of worship. Employers fired them. Customers abandoned them. There was no carrying on with the lives they knew before Ebola. There was only more loss.

The July 2014 arrival of Ebola virus in Nigeria could have been yet another tragic chapter in the spread of a deadly wave of disease that swept across West Africa. Many in the global health world credit Nigeria’s ability to quickly set up a public health emergency operation center (PHEOC) as key to preventing the emergence of Ebola virus across the country. The Nigeria public health emergency operation center effectively mobilized the expertise, infrastructure, and partner organizations from its polio eradication campaign to prevent the emergence of Ebola. Below I offer some resources for those interested in public health emergency operation centers as a front-line response to emerging infectious diseases.

 {Photo credit: Cindy Shiner/MSH}A mother waits for the nurse to vaccinate her baby during an immunization clinic at Phebe Hospital in central Liberia.Photo credit: Cindy Shiner/MSH

Stronger health systems are critical to preventing outbreaks from becoming epidemics. In fragile states, systems already weakened by conflict, disaster, or instability can crumble under the weight of an outbreak -- devastating access, availability, and quality of basic health for women and their families.

{Photo credit: Warren Zelman}Photo credit: Warren Zelman

This post appears in its entirety on HuffPost Impact.

Pandemics are back on the agenda for the 2016 G7 Summit, which convenes this week in Ise-Shima, Japan. The Group of Seven is expected to further its commitments to global health security.

Look what has happened in less than one year since the G7 last met (June 2015), just after the Ebola crisis peaked at over 26,300 cases, 10,900 deaths.

 {Photo credit: Associated Press/Aurelie Marrier d’Unienvil}Women celebrate as their country is declared Ebola free in the city of Freetown, Sierra Leone, Saturday, Nov. 7, 2015.Photo credit: Associated Press/Aurelie Marrier d’Unienvil

When 18-year-old Ianka Barbosa was 7 months pregnant, an ultrasound showed the baby had an abnormally small head, a dreaded sign of microcephaly due to Zika infection.  Upon hearing the news, Ianka’s husband fled. In her poor neighborhood of Campina Grande, Brazil, Ianka soon became a young mother alone.

As Ianka’s baby Sophia grows, she may never walk, or talk. She could develop seizures before she reaches six months.  By the end of the year there may be a staggering 3,000 Sophias in Brazil – mostly in the poorest places.

Epidemics erase the gains women have achieved.

The world has suffered a series of “Zikas”—virtually unknown diseases that seemed to come from nowhere and explode with devastating consequences for families and entire countries – before Zika, Ebola, SARS, AIDS, and others.

Epidemics don’t just leave behind a death toll.  They can demolish the gains women have made in maternal, newborn, child, adolescent, and reproductive health—gains that have been propelled by women’s rights and empowerment. 

An Accredited Medicines Stores (AMS) seller receives an infrared thermometer to use in Ebola and other outbreak surveillance.

by Arthur Loryoun

Editor's note: This post originally appeared on the Bill & Melinda Gates Foundation's blog, Impatient Optimists. Funded by the Gates Foundation and led by Management Sciences for Health (MSH), the Sustainable Drug Sellers Initiative (SDSI) project worked to ensure the sustainability of public-private drug seller initiatives in Tanzania and Uganda, and to roll-out the initiative in Liberia.

{Photo credit: Frank Smith/MSH}Photo credit: Frank Smith/MSH

On Sunday, September 27, 2015, Management Sciences for Health (MSH), and its partners Save the Children US and International Medical Corps (IMC), along with African Field Epidemiology Network (AFENET), committed to bringing together key partners from the global public health, private, public, and civil society sectors to build the No More Epidemics™ campaign that will advocate for stronger health systems with better disease surveillance and epidemic preparedness capabilities to ensure local disease outbreaks do not become major epidemics.

Launching later this year, the No More Epidemics campaign will build a broad and inclusive partnership that will engage multiple sectors to share knowledge and expertise and provide the public information and political support for the right policies and the increased funding to ensure people everywhere are better protected from infectious diseases.

 {Photo credit: Rachel Hassinger/MSH}L to R: Dr. Jonathan D. Quick, Stefanie Friedhoff, Dr. Peter PiotPhoto credit: Rachel Hassinger/MSH

On March 27, 2015, Dr. Peter Piot of the London School of Tropical Medicine and Hygiene and Dr. Jonathan D. Quick, MSH President and CEO, sat down at the Boston Public Library with Stefanie Friedhoff of The Boston Globe to discuss Ebola, epidemic preparedness and rebuilding public health systems. 

Watch the video of the whole program:

Here are some excerpts from their conversation:

Stefanie Friedhoff: What did countries do that worked well in the Ebola fight?

Jonathan Quick: There were 6 things that worked well in three of the rim countries of Nigeria, Mali and Senegal.

  1. Leadership: Ministers of Health were on top of the first cases and declared national emergencies.
  2. Preparedness of public health systems.
  3. Rapid action in getting the index case identified and case detection system for subsequent cases.
  4. Good communications campaigns.
  5. Mobilizing the community.
  6. Heroism of local health workers.

SF: Why was the international response so slow? What should be done?

MSH President & CEO Jonathan D. Quick says: "Let this be a loud call to action for greater investment in strong local health systems and global networks..." in today's The New York Times.

"Let this be a loud call to action for greater investment in strong local health systems and global networks to prevent, detect and respond to public health threats. We know how to prevent the next local outbreak from becoming the world’s next major epidemic," says MSH President & CEO Jonathan D. Quick in a Letter to the Editor, published today in The New York Times.

Dr. Quick responds to “Yes, We Were Warned About Ebola,” an April 7 opinion editorial by Bernice Dahn, Vera Mussah, and Cameron Nutt, saying:

Dr. Dahn, the chief medical officer of Liberia’s Ministry of Health, and her colleagues express dismay that missed information from 1982 contributed to the gravely flawed conventional wisdom that Ebola was absent in West Africa. An even greater error of conventional wisdom was the longstanding misjudgment by experts that Ebola was a “dead-end event,” killing its human host too quickly to spread out of control.


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