Ebola: A Call to Action from PIH's Dr. Joia Mukherjee

This week PIH Chief Medical Officer Dr. Joia Mukherjee, PIH Co-founder Dr. Paul Farmer, and a small team of specialists traveled to Liberia to assess the Ebola outbreak. PIH is working in close partnership with Last Mile Health in Liberia and Wellbody Alliance in Sierra Leone to respond to the outbreak in a way that addresses the immediate needs of patients while focusing on long-term systems building so that the right to health is realized in these countries. 

Ebola.

The very word strikes fear. Those paying attention to this outbreak have undoubtedly seen the gruesome media images from West Africa and the shocking number of deaths—more than 2,600 and climbing every day—from a scourge progressing unchecked. But the outbreak presents us with a critical—and lifesaving—opportunity: to globalize the notions of solidarity and of health care as a basic right.

Globalization has been the watchword for several decades—air travel, the Internet, trade policy, and flows of capital have brought humans into a proximity previously unknown. To be sure, the effects of globalization have a checkered impact on development, bringing opportunity to some and misery to others. If there is one thing the Ebola outbreak makes clear, it’s that access to modern medical care—the right to health care—has not been globalized.

Liberia, Sierra Leone, and Guinea, the three countries most affected by Ebola, are among the poorest and least developed on the planet. Because the virus spreads through direct contact with the bodily fluids of a person who is infected or has died from Ebola, it’s easy to understand how quickly it can spread in places without running water and adequate sanitation—places where people live in utter poverty.

It is within this egregious breach of basic services that Ebola has flourished.

These countries also have an appalling lack of health infrastructure and insufficient numbers of trained and equipped health care providers. It is within this egregious breach of basic services that Ebola has flourished.

This is why Partners In Health has decided to work shoulder-to-shoulder with two of our longtime partners, the grassroots organizations Last Mile Health in Liberia and Wellbody Alliance in Sierra Leone. Building and strengthening health systems and the capacity to respond to Ebola in rural Liberia and Sierra Leone will help ensure that people don’t have to travel hours to get help. This approach will help frontline health workers do proper contact tracing—a critical practice to contain the outbreak—because the patients will be from nearby towns. It is important that our response helps reinforce the primary care efforts of our partners. It’s still more common for children in any of these countries to die of malaria or pneumonia, and if the health system entirely collapses under the weight of this outbreak, the death toll will be far bigger than just Ebola alone. Linking Ebola diagnosis, treatment, care, and education with the ongoing provision of primary health care is key to saving lives.

In poor countries, health workers often work without soap and water and most certainly lack other necessary protections. More specialized protective equipment—gowns, gloves, and face shields—is routinely available in the U.S. and European facilities. In fact, much of the protection against Ebola for health care workers falls under the egis of “universal precautions,” the standard practices adopted in the U.S. in the late 1980s as a response to the HIV epidemic. Such precautions are considered an immutable standard of care in the U.S. and Europe. Yet these items aren’t available to health care workers in poor settings who try daily to stem the spread of highly transmissible diseases, whether Ebola or drug-resistant tuberculosis.

Without adequate protection, those charged with caring for the sick are at risk of contracting Ebola and often choose not to risk their lives by working in unsafe conditions. Health facilities attending to Ebola victims do not have the tools to diagnose, isolate, or treat people with the virus. As such, victims who make it to health centers die at unacceptably high rates. 

It’s imperative that we now demonstrate a different facet of globalization, the globalization of solidarity.

This is why it’s imperative that we now demonstrate a different facet of globalization, the globalization of solidarity, of the right to health, of justice and basic dignity. Can we use the globalization of transportation, communication, knowledge, skills, and resources to respond to this crisis?

As a medical organization that provides health care for the poorest in many challenging environments, we stand in solidarity with those trying to respond and pledge to leverage our expertise to directly support the prevention, control, and treatment of Ebola. We see this as a chance to strengthen health systems so that frontline health workers have steady access to basic safety equipment, proper diagnostic tools, and necessary medications—not just during the Ebola outbreak, but whenever they need.

But this crisis needs more: more global financing, more global medical staff to treat the sick, and more global advocacy for health care and Ebola treatment.

We must demonstrate our solidarity pragmatically, in the form of financial and human resources. We have put out a call for this solidarity, and so have others.

We seek trained clinical staff who are willing to fight for justice through care of the destitute sick. We seek partners who are willing to support this effort.

And we seek to spur a new face of globalization—one that prioritizes social justice and guarantees the right to health.

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Experienced clinical and non-clinical health sector workers interested in volunteering to help people affected by the Ebola outbreak are welcome to register here. At this time, PIH can only accept applications from U.S. citizens in accordance with evacuation guidelines set forth by the U.S. government. We are hiring long-term positions (ideally 12 months), and we are also recruiting short-term clinical and non-clinical volunteers (eight-week minimum).