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Health Services and Infrastructure Recovery of a Major Public Hospital in Liberia During the 2014–2016 Ebola Epidemic

Published online by Cambridge University Press:  17 December 2018

Paul Ochieng Ndede ,
Jude Kimbowa Senkungu ,
John K. Shakpeh ,
Theresa E. Jones ,
Rebecca Sky  and
Sharon McDonnell
Paul Ochieng Ndede
Affiliation:
International Rescue Committee, Kakuma Refugee Camp, Kenya
Jude Kimbowa Senkungu
Affiliation:
International Rescue Committee Ebola Response Project, Liberia, Ministry of Health of Liberia, Redemption Hospital, Monrovia, Liberia
John K. Shakpeh
Affiliation:
Redemption Hospital, Ministry of Health, Monrovia, Liberia
Theresa E. Jones
Affiliation:
International Rescue Committee, Nairobi, Kenya
Rebecca Sky
Affiliation:
University of New Hampshire, Masters of Public Health Program, Manchester, NH, USA
Sharon McDonnell*
Affiliation:
International Rescue Committee, Department of Health Management and Policy, Masters of Public Health Program, Manchester, NH
*
Correspondence and reprint requests to Dr Sharon McDonnell, University of New Hampshire Health Management and Policy, c/o 481 Sligo Rd., Yarmouth, ME 04096 (e-mail: Sharon.mcdonnell@gmail.com).
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Abstract

During the 2014–2016 Ebola outbreak, health services in Liberia collapsed. Health care facilities could not support effective infection prevention and control (IPC) practices to prevent Ebola virus disease (EVD) transmission necessitating their closure. This report describes the process by which health services and infrastructure were recovered in the public hospital in Monrovia, Liberia. The authors conducted an assessment of the existing capacity for health care provision, including qualitative interviews with community members, record reviews in Ebola treatment units, and phone calls to health facilities. Assessment information was used to determine necessary actions to re-establish services, including building and environmental renovations, acquiring IPC supplies, changing health care practices, hiring additional staff, developing and using an EVD screening tool, and implementing psychosocial supports. On-site monitoring was continued for 2 years to assess what changes were sustained. Described in the report are 2 cases that highlight the challenge of safely re-establishing services with only a symptom-based screening tool and no laboratory tests available on-site. Despite fears among the public, health workers, and the international community, the actions taken enabled basic health care services to be provided during EVD transmission and led to sustainable improvements. This experience suggests that providing routine medical needs helps limit the morbidity and mortality during times of disease outbreak. (Disaster Med Public Health Preparedness. 2018;13:767–773)

Keywords

Ebolaemergency managementepidemicepidemic responseEVDhealth care facilitiespatient screeningresource-poor hospitalstriage management
Type
Concepts in Disaster Medicine
Information
Disaster Medicine and Public Health Preparedness , Volume 13 , Issue 4 , August 2019 , pp. 767 - 773
Copyright
Copyright © 2018 Society for Disaster Medicine and Public Health, Inc. 

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References

REFERENCES

Centers for Disease Control and Prevention. State and local readiness. Published April 25, 2017. https://www.cdc.gov/phpr/readiness/healthcare/essentialhc.htm. Accessed November 9, 2018.Google Scholar
The United Nations. Protecting Humanity from Future Health Crises. Report of the High-level Panel on the global response to health crisis. Published January 26, 2016. http://www.un.org/News/dh/infocus/HLP/2016-02-05_Final_Report_Global_Response_to_Health_Crises.pdf. Accessed November 9, 2018.Google Scholar
Takahashi, S, Metcalf, CJ, Ferrari, MJ, et al. Reduced vaccination and the risk of measles and other childhood infections post-Ebola. Science. 2015;347(6227):1240-1242.CrossRefGoogle ScholarPubMed
Arwady, MA, Bawo, L, Hunter, JC, et al. Evolution of Ebola virus disease from exotic infection to global health priority, Liberia, mid-2014. Emerg Infect Dis. 2015;21(4):578-584.CrossRefGoogle ScholarPubMed
Nyenswah, TG, Kateh, F, Bawo, L, et al. Ebola and its control in Liberia, 2014–2015. Emerg Infect Dis. 2016;22(2):169-177.CrossRefGoogle ScholarPubMed
Nyenswah, T, Fahnbulleh, M, Massaquoi, M, et al. Ebola epidemic – Liberia, March to October 2014. Morb Mortal Wkly Rep. 2014;63(46):1082-1086.Google Scholar
World Health Organization. Geneva: WHO. Ebola Situation Reports. Published December 10, 2014. http://apps.who.int/ebola/en/ebola-situation-report/situation-reports/ebola-situation-report-10-december-2014. Accessed June 26, 2016.Google Scholar
World Health Organization. Geneva: WHO. Ebola Situation Reports. Published May 6, 2015. http://apps.who.int/ebola/current-situation/ebola-situation-report-6-may-2015. Accessed May 6, 2016.Google Scholar
Nyenswah, TG, Westercamp, M, Ashraf Kamali, A, et al. Evidence for declining numbers of Ebola cases: Montserrado County, Liberia, June–October 2014. Morb Mortal Wkly Rep. 2014;63(46):1072-1076.Google ScholarPubMed
WHO and Christian Medical Society of Liberia. Keep safe keep serving. Published October 3, 2014. https://www.medbox.org/ebola-training-material/keep-safe-keep-serving-standard-safety-measures-for-health-worker/preview. Accessed December 30, 2017.Google Scholar
Fink, S, Gladstone, R. Liberia reports first Ebola case in weeks. New York Times. Published March 20, 2015, Sect. A:4. http://www.nytimes.com/2015/03/21/world/africa/liberia-reports-first-ebola-case-in-weeks.html?_r=0_. Accessed November 9, 2018.Google Scholar
Abramowitz, SA, McLean, KE, McKune, SL, et al. Community-centered responses to Ebola in urban Liberia: the view from below. In: Bausch DG, ed. PLoS Negl Trop Dis. 2015;9(4):e0003706.CrossRefGoogle Scholar
Moschos, SA. Ebola check: delivering molecular diagnostics at the point of need. Hell J Nucl Med. 2015;18(Suppl 1):144.Google ScholarPubMed
World Bank. After Ebola, Liberia’s health system on path to recovery. Published June 7, 2017. http://www.worldbank.org/en/news/feature/2017/06/07/after-ebola-liberias-health-system-on-path-to-recovery. Accessed November 9, 2018.Google Scholar
Burkle, FM Jr, Burkle, CM. Triage management, survival, and the law in the age of Ebola. Disaster Med Public Health Prep. 2015;9(1):38-43.CrossRefGoogle Scholar
Dhillon, RS, Yates, R. Building back better: priorities for Ebola-affected countries. Lancet Glob Health. 2015;3(8):e435-e436.CrossRefGoogle ScholarPubMed