by Farouk Martins Aresa
This writer is one of those against Home Healthcare for Ebola patients until a Liberian student nurse proved us wrong. As hospitals rejected her four relatives, her home treatment of deadly Ebola accomplished three survivals. Even more important was her homemade plastic garbage bags turned into Tyvek suits, regular local food, bleach and clean water with sugar and little salt.
Reality in the field demonstrated that hospital beds are full and care givers are so overwhelmed that patients are being turned away in Liberia, Sierra Leone and Guinea. Many families have no place to take those struck by Ebola virus. Some have been abandoned on the streets and places where their bodies posed greater risk and might likely infect others. This is why cremation of dead bodies is a public health issue in the interest all. A lady defied odds See Fatu Kekula Story.
Usually nobody wants to take chances with infectious diseases and in cases of those as serious as Ebola, just like tuberculosis, it is better treated in sanatorium. As we learn more about Ebola and fear of exponential spread materializes, there are just not enough doctors, hospitals and no reliable and HIV drugs or immunization guaranteed cure yet. In the midst of all these is terrible news that some health workers are being attacked by a few local folks or blamed for Ebola.
– The World Health Organization claimed Liberia had 315 bed spaces for Ebola patients and aid agencies have promised to set up 440 more, but the country needs a further 1,550 beds that nobody has yet offered to provide. In Sierra Leone, 297 planned new beds would almost double existing capacity, but a further 532 were needed – See Ebola spread.
As a result of the pressing and immediate needs, home health care and halfway centers, though not ideal, are gaining temporary acceptance until more beds are available. Rooms are shared in most African homes by more than one person making home care difficult but probable in face of the wild spread, where rooms can be temporarily obliged for treatment of sick Ebola patients.
Liberia Médecins Sans Frontières distributed kits contain bucket, chlorine, gloves, gowns, masks, garbage bags soap and a spray bottle to families that cannot gain immediate access to hospital.
Some Africans are afraid of going into hospitals for Ebola or any illness. They simply do not trust nurses, physicians and aides thinking they may come back home infected by other diseases. Authorities may have to go out and introduce home healthcare in the training of the children of traditional Babalawo, crash train more community health officers and aides in schools of health technology. African countries like Nigeria must deploy them to those countries in need.
Africans like the rest of the world mourned and feel attached to their dead. Actually, there are people in the western and eastern world still seeking the bones of their dead from World War I and II. Some Korean and Vietnam wars families that lost loved ones still seek reburial of their own at home. They force their governments to seek and retrieve those that have perished in different places. So it is not only Africans that are attached to their dead, we all are.
Another disadvantage of home health care is the visits paid by relatives and friends. By now we all know, Ebola is one of the exceptions. The room the Ebola patients are kept must be isolated and properly ventilated to the outside. All the precaution taken at the hospitals must be strictly adhered to at home to prevent cross contamination and the plastics used must be carefully disposed of. This can be cheaper if local plastic garbage bags are converted to suits as our sister.
Bodies of Ebola dead must not be washed, hugged or seen in open caskets to be blessed with holy sprinkle water in Church. The Muslim buried their dead immediately or as soon as possible. That is why you cannot fool around with Lemomu and play dead. You will find yourself under, in the burial ground. So as far as Ebola dead bodies are concern, cremation is the best way to go. We do not have to worry about the survival or mutation of the virus in the dead bodies.
The lessons we learn from Nigeria is that old fashioned medical management, enough food and clean water with pain killer drugs worked in Lagos where most Ebola patients were quarantined and treated. The Governor also credited existing law that made it possible to detain people that became risky and contagious while another law made cremation possible. The infrastructure existing in Lagos saved most patients that were sought and admitted for medical management.
Consequently, treatment of Ebola patients at home must be under strict supervision with at least one professional around to supervise pain drugs, food and water. The nursing student that accomplished the task must be congratulated for her ingenuity when she had nowhere else to turn to, after rejections from hospitals. But for her unique abilities, other people could have been infected, losing all her four Ebola infected relatives and more, including herself.
We already know that nursing care is very important in the hospitals. Unfortunately, in the case of Ebola, the close proximity of doctors, nurses and aids to patients also exposes them to risk. The Liberian student nurse was able to show love and empathy to her relatives while at the same time protecting herself with homemade Tyvek suits from plastic garbage bags, cloves and bleach she bought from the corner stores and markets.
It is true that at some point, Ebola patients are too sick to eat but they must be urged to drink from one liter of clean water with half tea spoon salt and six tea spoons sugar to replenish lost element during frequent stooling and urine output. Many home health cares may not be able to administer intravenous care. So it is very important to feed them well while they can still eat. Indeed, the food we eat before we are sick is more beneficial than when we have lost appetite.
We cannot wait until all that is needed are provided; we must improvise to stop Ebola spread.