Sierra Leone loses 4th doctor, Cuba responds to Ebola crisis

In this undated photo, Dr Roberto Morales Ojeda, Minister of Health of Cuba,  addresses the plenary of the World Health Assembly. Credit: WHO/Violaine Martincaption

Almost a month to the day Dr. Modupeh Cole died at an Ebola treatment center in Kailahun, officials at Sierra Leone's health ministry have announced the death of another doctor, bringing the total to four since Dr. Sheikh Humarr Khan, the virologist who was leading the fight against the disease in eastern Sierra Leone, died on July 29.

Sierra Leone's Chief Medical Officer Dr. Brima Kargbo confirmed to The Associated Press (AP) Sunday that Dr. Olivette Buck died late Saturday, hours after the World Health Organization (WHO) said it could not help medically evacuate her to Germany,

Sierra Leone had requested funds from WHO to transport Buck to Europe, saying the country could not afford to lose another doctor. WHO had said that it could not meet the request but instead would work to give Buck "the best care possible" in Sierra Leone, including possible access to experimental drugs, the AP report said.

Three weeks ago, Presidential adviser Ibrahim Ben Kargbo said  Dr. Sahr Rogers had been working in a clinic in the eastern town of Kenema when he contracted the virus,  marking a setback in the country’s fight against the virulent disease. Rogers was the third doctor to die from Ebola related symptoms.

Speaking to the New York Times August 13, Dr. Amara Jambai, director of prevention and control at the health ministry, said Dr. Cole had apparently been infected while seeing a patient at the country’s leading hospital, Connaught Hospital.

Connaught, where Dr. Cole worked, is Sierra Leone’s leading referral hospital, so Ebola patients inevitably go there, initially at least. But it does not have a treatment center for them or an isolation ward.

It was one such patient who apparently passed the deadly disease to the doctor. “He was trying to see a patient, and the patient was falling,” Dr. Jambai said. “The patient was trying to help himself to the couch, and the patient fell.” The patient was positive for Ebola, he added.

About a week before died, Dr. Khan told his sister how he was infected. He'd done a routine medical check on a patient without gloves. A week later, the unnamed woman and her husband died of Ebola-related complications.

According to the World Health Organization, more than 130 health workers have died fighting the disease in Sierra Leone, nearly half of over 300 health workers who have died in Liberia, Sierra, Leone and Guinea since the start of the outbreak in Guinea last December.

Sierra Leone has one health worker for every 5,260 people. The nation also has one of the lowest doctor-to-patient ratios in the world and has been categorized as one of the 57 countries having crisis-level shortage of health workers. The country is faced with a challenge of retaining its workforce in country. It is estimated that more than half (about 52 percent) of the doctors that graduated from the College of Medicine and Allied Health Science (COMAHS) from inception to 2007 left the country to work abroad.

“You can imagine what this does to the younger cohort. It’s like having a general falling in battle. It just brings more misery. It’s not good. When you have a health system that’s constrained, it’s a bit too much.” -- Dr. Amara Jambai, director of prevention and control at the health ministry

In an appeal that went viral this week, Dr. Esé Thomas-Macauley, a colleague of Dr. Buck, wrote that Buck had worked for over 20 years as a teacher before entering medical school and finally graduating in 2002.

On Twitter, one of Dr. Buck's students, biochemist Aminata Kanu wrote:

@SewaNews Please save Dr Buck my science teacher now a doctor - who gave me my love for science is now infected with ebola @MSF_uk @WHO

 "Further to this," Dr. Esé Thomas-Macauley noted, "she is soon to be (or perhaps already) a member of the West African College if Physicians. One of the few to recently challenge this position. She also unfortunately happens to be the first female physician  infected in Sierra Leone. We all need her to win this battle! ...Other countries have recorded victories amongst doctors"

Recently Bruce Ribner, medical director of Emory University Hospital in Atlanta's Infectious Disease Unit, sat down with Scientific American to explain how two Americans who had contracted Ebola while working in Liberia were cared for, and the lessons that could be applied to help patients across Africa.

At a World Health Organization press conference on Friday in Geneva, Minister of Public Health of Cuba, Dr. Roberto Morales Ojeda, announced the island nation will be sending 63 doctors and 102 nurses, epidemiologists, specialists in infection control, intensive care specialists and social mobilization officers to set up World Health Organization-funded Ebola clinics in Sierra Leone. The workers will deploy in the beginning of October and stay for six months.


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