References to emerging diseases is something we hear more and more about these days. But nothing strikes fear in the heart quite like Ebola, technically Ebola Virus Disease or EVD. Because of its uncertain sources, probably from wild animal hosts, its highly contagious nature, and a very high case fatality rate of nearly 90%, it can cause panic among susceptible populations.
Two of our AHI affiliated hospitals are now in the vortex of the EVD outbreak in West Africa. Cooper Adventist Hospital was purchased by the church in 1986 and joined AHI several years ago. With 45 beds and an associated Eye Hospital, it is located in the heart of Monrovia, the capital of Liberia. Of Liberia’s four million people, nearly one-third live in Monrovia.
Both Liberia and its next door neighbor, Sierra Leone, have recently suffered through 15 years of brutal civil war, and have only been back on the path to development for the last five years. The Church lost its leprosy hospital in Sierra Leone during the civil war, but we are now restarting another hospital, Waterloo, on the outskirts of Freetown, the capital.
As the news of the Ebola outbreak started surfacing, we kept in close contact with these institutions and our staff over the past few weeks. This past Thursday, July 31, as the crisis intensified, most hospitals in Monrovia had to close because their staffs refused to come to work. There are now over 700 deaths reported from EVD in Guinea, Liberia, and Sierra Leone, including some physicians and nurses. Panic is clearly settling over the area and it was clear we were facing a major decision for our own hospitals, particularly Cooper. Should we close Cooper Hospital and send our staff, including our missionary doctors, home for their own protection?
Gillian Seton is a young surgeon at Cooper who had just arrived in Monrovia in February after completing medical school at Loma Linda University and her 5-year surgery residency at the University of Utah. She and the rest of the staff recognized the danger, though they have not had any Ebola patients admitted yet at their hospital. I reached them by phone early Friday morning, August 1, just as they were going into a staff meeting to make the final decision on what to do.
We discussed several critical aspects of this epidemic. One of the most concerning is where patients can seek care for non-Ebola illnesses and emergencies? With all the hospitals in Monrovia now closed, there was no place for them to go. What do you do with an obstetrical emergency, acute appendicitis, serious trauma, or life threatening malaria? Our staff recognized the critical need for this type of care and felt a strong sense of commitment to serve their population. At the same time, they needed a clear way to prevent exposure to Ebola through strict screening of patients and use of careful infection control techniques. This requires special gloves, masks, and other supplies that are in short supply. It also requires funding, since the commerce in the city has ceased and bills are not being paid.
I had a long and serious discussion with Dr. Seton and Lucinda Carter, our administrator. They fully recognize the danger they are in, but also feel a deep sense of duty and compassion for all the patients they serve. We agreed on four key points: 1) AHI would financially subsidize the hospital operations during this crisis to keep them operational; 2) only those staff who voluntarily decide to remain on duty should work; 3) AHI would keep adequate supplies coming into the country, and 4) we would find additional professional help to send to Liberia as necessary and as quickly as possible. With that agreement, the staff subsequently voted overwhelmingly to remain on duty and keep serving the non-Ebola patients who come. This decision has been made with the support of the local and international church authorities. I am proud of our staff at Cooper, particularly Gillian, who has chosen duty over safety and has chosen to stay with her hospital team. A special infectious disease unit has now been established at another hospital to care for suspected Ebola patients, providing a critical referral option for Cooper Hospital.
With this courageous decision by our staff in the field, I turn to you to help implement this strategy. We are wiring an initial $25,000 to their bank account immediately and sending additional infection control supplies by air freight. We are also recruiting additional medical personnel willing to go and work in this environment. The Centers for Disease Control is sending 50 specialists into the area, and we expect to coordinate our efforts with them. Though the crisis is not quite as severe at Waterloo Hospital in Sierra Leone, we are working with them on a strategy as well.
You may find additional information on either the AHI (www.ahiglobal.org) or LLU (www.llu.edu) websites, where we intend to keep updated accounts of activities posted. This crisis will use AHI’s limited unrestricted funds quickly. Please assist us in answering this call to service by donating to this effort. Just indicate Ebola Crisis in the memo part of the check, after making your check out to Adventist Health International or AHI. If you access the AHI website, please click on “Donate” to make your gift. Should you wish to make a credit card gift quickly, please call us at 909-558-4540. Thank you for your assistance and pray that God will guide and protect our team in the field and that this epidemic may quickly be brought under control.
Richard H. Hart, MD, DrPH
Thank you for your donations and support. Our prayers go out to those in West Africa during this time of crisis.