Walking and Chewing Gum

More than four thousand, eight hundred people have died from Ebola in West Africa as of October 19^th. The outbreak of Ebola in West Africa is the deadliest in history. But Ebola may not be the worst problem for West Africa. Childhood vaccination rates have dropped significantly, HIV/AIDS facilities have been shut down, health education programs have been suspended, health care workers are in short supply, and there is an overall lack of trust in health officials. Liberia especially has been hit hard. Liberia has the highest mortality rate for Ebola and if the situation worsens, Ebola won’t compare to the mortality rate of the preventable childhood diseases that could surge.

Before Ebola, 97 percent of babies were getting vaccinated in Liberia, from the National Public Radio (NPR). Even with these many babies being vaccinated, 7 percent of children still died before reaching the age of 5. With Ebola, many mothers no longer trust health officials going so far as to claim that “the hospital [is] giving the people Ebola.” Now, only 27 percent of babies are being vaccinated. “That almost certainly means more children will die,” says Adolphus Clarke, who helps manage the immunization program.

The loss of trust in health officials is not the only reason these numbers are declining. Many children have become orphans after Ebola or another untreated disease took their parents.

“According to the United Nations Children’s Fund, around 3,700 children in Liberia, Guinea and Sierra Leone have lost at least one of their parents to the virus, which means Ebola orphan rates are climbing with the death rate. ‘Children are dying from measles and other vaccine-preventable diseases and pregnant women have fewer places to deliver their babies safely,’ the United Nations children’s agency UNICEF announced last month, noting that as many as 8.5 million people under the age of 20 live in Sierra Leone, Liberia and Guinea. Of these, 2.5 million are under the age of five and most susceptible to childhood diseases,” according to the Daily Beast.

In addition, health facilities are being closed. The closing of these clinics is not out of any malice, but the reality that the doctors and nurses there are at risk.

“It has been a very tough decision to make as we know that thousands of women and children rely on our services in the district and beyond,” Brice de le Vingne, Doctors Without Borders Director of operations said in a statement. “But the safety of our staff must remain our top priority and if we cannot guarantee flawless infection control in the hospital, we are putting our staff and patients at risk.”

Ebola requires a lot of health care workers to give the infected person any chance of survival. Removing so many of the hospitals and clinics for the safety of the staff expands the shortage of health care workers. In this reality, many patients could go untreated or be treated by a relative, serving as a way for Ebola to spread.

The scarcity of nurses doesn’t just effect the Ebola patients though. Other, more contagious diseases are more likely to spread. With childhood vaccines at only 27 percent, how many children will be able to fight of measles which spreads at a one to eighteen ratio? That means that for every one person who has the measles, on average, they will spread it to eighteen other people. Ebola only has a one to two ratio. Mumps is a one to ten ratio.

 Measles and mumps have a childhood vaccine that helps the immune system recognize the pathogens and fight them off. These diseases are preventable! Yet already there are signs of a measles outbreak. UNICEF's Sheldon Yett says, "We've already had cases of measles in Lofa country which was the original epicenter of the disease in Liberia," he says. "So that's already happening."

HIV/AIDS patients are going to be hit hard also. Even in 2012, with all the health systems, 1.2 million Africans died of HIV/AIDS according to the World Bank. Without enough care, more HIV/AIDS patients are going to die. If health care organizations pack their bags and leave, they are basically sentencing these people to their deaths. Abandoning hospitals may not be the best way for health care workers to regain the trust of West Africans though. If Africans are terrified that you infected them with vaccines, the best way to convince them otherwise is to stay and treat them. If doctors stick with the people through troubled times such as these then they might find more acceptance than initially.

Many doctors and organizations are aware of this and are searching for ways to keep doing their jobs.

"If we do not go out to them then we will be having a disaster,” Sonpon Blamo Sieh, head of Liberia's National AIDS Control Program, told The Daily Beast. “We made some gains and 70 percent of our patients who need treatment were getting it. But if we lose that edge, we risk losing the battle completely.”

The organizations are donating to help find a cure for Ebola. “The Bill and Melinda Gates Foundation, for example, have committed $50 million for research and prevention for Ebola, which has sidetracked much of their work to prevent malaria and polio in West Africa,” according to the Daily Beast.

“Ebola is shutting down the healthcare system,” Bill Gates, former CEO of Microsoft and current head of the Bill and Melinda Gates Foundation told The Guardian on the sidelines of the Sibos Banking conference in Boston last month. “More kids are dying of malaria in these three countries now than they were before Ebola came along. So it would be worth stopping the Ebola epidemic if the only benefit was that it put the health system back in place.”

In summary, “We, as a global health community, have to be able to walk and chew gum at the same time, ensuring that preventing a death from Ebola doesn’t mean a child dies instead from a vaccine-preventable disease like pneumonia or diarrhea.” (Erin Hohlfelder)

Sources:
http://www.npr.org/blogs/goatsandsoda/2014/10/23/358117900/ebola-is-keeping-kids-from-getting-vaccinated-in-liberia?ft=3&f=1001
http://www.thedailybeast.com/articles/2014/10/23/what-s-worse-than-ebola-in-west-africa-almost-everything.html
http://www.cnn.com/2014/04/11/health/ebola-fast-facts/