International Medical Corps took a selection of the best questions from all of the AMA participants. See these questions below along with Sean and Jorge’s responses.
Sean: My name is Sean Casey, and this week my team from International Medical Corps opened the 6th Ebola Treatment Unit in the whole of Liberia. We began treating patients on Monday. I am joined by Jorge Castilla, the European Commission’s expert on Ebola.
Q: How big is the risk that the recent murder of several relief workers will lead to aid agencies withdrawing from impacted areas? If that happens, how will it affect the future of the outbreak?
Sean: I don’t think that this will stop agencies from responding, but it will definitely impact how and where they work. Staff safety is paramount for all of us, and we need to know that we can do our work without threat of violence. The violence in Guinea is worrisome, and hopefully the authorities there will do what they can to prevent this from happening going forward.
Q: First off- Kudos to you for stepping up to the plate and risking your lives to help fellow human beings in desperate need. What can the rest of us do to help bring this nightmare to a quicker end? Donations? Relief supplies? What will be most effective?
Sean: Definitely donations. All humanitarian responses require funding, and this one is particularly expensive, given the scale and all the inputs required. We especially want to raise funding to support training and equipment for Liberian first responders. This is something we integrate into all of our work, but it’s particularly important here, as this response requires enormous human resources. Around 90% of our staff here are Liberians, and our first priority is to support them to work safely and effectively.
Jorge: biggest needs are qualified staff, nurses that know how to control infection. Secondly, put pressure on your governments to help. Donations in kind are tricky because the need to respond to specifications. Money for buying those items is better
Q: Hi. Is the situation out there as bad as the media portrays it to be? Is there a possibility that ebola will spread to Southeast Asia?
Jorge: Situation is indeed very bad, several studies show that the number of cases double each 2 to 3 weeks. If you remember the story of the chess board and the grains of rice, we have already a lot of cases in the current square, next square will be 2 times bigger. This can arrive with some possibility everywhere but the question is can it be quickly managed. A successful containment stops the problem at square 1.
Q: How does local media react on Ebola spread? Or locals don’t read newspapers, watch TV… what then? Radio?
Sean: Ebola is almost the only thing anyone is talking about here. The media is obsessed with it, and with good reason. Most people rely on radio for their news, and the radio stations across the country are providing constant updates and hosting regular discussions on the situation.
Q: What is actually needed for the response now that those of us back in the US/Europe etc… can push for /provide? Is it supplies? Health staff? Money? Something else?
Sean: We need all kinds of things, but many of them are quite specialized – like doctors and nurses, and specific models of personal protective equipment. The most useful input that the average person with some interest in helping can provide is money to support the operations. Ebola response is very expensive – operating one 70-bed treatment unit can cost up to $1 million/month!
Q: Thanks for doing the AMA. What made you decide to help people there?
Sean: I’ve worked with International Medical Corps in a number of humanitarian emergencies – from the Cholera outbreak in Haiti to the conflict in Mali, from the typhoon response in the Philippines to the battlefields of eastern Ukraine. This is the kind of work that we do, and for which we have unique capacity. When I saw this situation getting worse and worse, I wanted to respond because I knew that we could make a substantial contribution to the effort.
Jorge: compassion, indignation and wanting to do something about it.
Q: How is the situation in Monrovia now? I assume hospitals are overwhelmed, but otherwise is there law and order and people going about their daily life?
Sean: It’s quite calm, but there is a sense of concern. There aren’t protests, and security is as usual. Hospitals are mostly closed, as health workers are not safe without personal protective equipment (PPE) and training on how to use it. As more ETUs open, hopefully hospitals will too.
Q: How do you feel seeing so many people die like this? Does it take an emotional toll on either of you? How do you deal with that?
Sean: It’s hard to see, for sure. I went to pick up a 12-year-old patient on Monday and spoke to him briefly before he boarded the ambulance. An hour later he was dead and the next day I saw his body being carried away for burial. The suffering is definitely difficult to see, but it also inspires us to do more, and to keep up the fight.
Q: Sean what does your ‘average’ day look like? What kind of support is offered to local staff and their families (to deal with risk, stigma etc )
Sean: Hectic! It usually starts at around 6am and ends at around midnight. In Monrovia, lots of coordination meetings. In Bong, troubleshooting at the ETU, coordinating with government representatives, and sometimes chatting with patients. No two days are ever the same – it’s one of the things I love about my job. We have a psychosocial team that provides support to our staff and their families.
Q: Are you scared?
Sean: I’m not scared for myself, but I do fear that this could continue to grow and potentially become endemic – a frightening scenario.
Q: Anything the media never tells us or fudges about potential medical outbreaks like these?
Sean: I think there are lots of untold stories about the very brave health workers here. They’re the real First Responders, and they’re continuing to work despite the fear and risk. One of our nurses saw six of her colleagues die from Ebola, but she’s continuing to fight the disease by working with International Medical Corps at the Bong Ebola Treatment Unit (ETU).
Q: Question from @lumia_glow on Twitter: I wonder how surgeries are being performed when there is a risk of Ebola contamination? Any special measures?
Sean: Almost none are being done. Hospitals are mostly closed. This is a big part of the problem here – secondary mortality is climbing because there aren’t normal health services to care for patients.
Q: Why don’t they close the airports and put military at all exits of the cities infected? It boggles my mind they haven’t done this yet.
Jorge: In my opinion closing an airport increases risk in bordering countries as people that want to travel, will, but not via official land crossings so the information cannot be collected, the temperature cannot be taken.