Ebola & failure of for-profit medical care

Oct. 13 — With the death of Thomas Eric Duncan in the Texas Health Presbyterian Hospital Dallas on Oct. 8, the political dynamics of the Ebola Virus Disease outbreak have taken on wider dimensions.

Nina Pham, a nurse who was providing care for Duncan, has tested positive for the virus and is being treated in Dallas. Hospital officials say she was wearing protective gear while working with the deceased victim.

Relatives of Duncan say he was not given proper attention at the hospital, which turned him away on Sept. 25. When he was finally admitted three days later, his health had deteriorated to the point where he was placed on breathing and dialysis machines.

The case of the Dallas nurse represents the first known transmission of EVD in the United States. In Spain, a nurse was reported in critical condition after treating a priest flown from Liberia to Madrid for hospitalization. He later died.

The Texas hospital has been defensive in responding to criticism surrounding Duncan’s care. Public pressure forced the facility to release Duncan’s medical records. Based on information provided by the Associated Press, Duncan should never have been refused admission to the hospital on Sept. 25, particularly after informing personnel that he had recently travelled from Liberia, the center of the deadliest outbreak of Ebola since it was first recognized in 1976.

Impact of spreading outbreak

According to the World Health Organization, over 4,000 people have died from EVD since March. Most fatalities have occurred in three West African states: Liberia, Sierra Leone and Guinea-Conakry. WHO reports that 8,400 have fallen ill with EVD over the last seven months.

Data on other cases are based on projections from health care departments and hospitals in the West Africa region. It is safe to say that tens of thousands more in this region could be infected if the outbreak is not halted. And millions have already been impacted socially and economically.

Reduced growth rates are anticipated in the three most impacted states. Mining, tourism and transportation are already showing substantial revenue losses.

Strikes demand safety measures and protocols

Workers are demanding action from their bosses in private industry and government. Labor organizations representing health care workers and service employees have spoken out forcefully against what they see as a lack of concern for those on the frontlines of the fight against EVD. Burial workers are insisting they be given the information and protective gear needed to safely dispose of victims.

Liberia has been the hardest hit in the EVD outbreak, with more than 2,300 deaths reported. On Oct. 13, Liberian nurses threatened to strike, demanding protective gear and more pay for working in hazardous conditions. The Health Workers Association, representing 10,000 employees, of whom 1,000 provide services in Ebola wards, accused the Liberian government of intimidating workers to make them return to their jobs. (Associated Press, Oct. 13)

The government in Monrovia said a strike would further hamper the health care system’s capacity to provide treatment for patients. Many people have been turned away from hospitals and clinics due to lack of beds and trained personnel.

Hundreds of health care workers, including doctors and nurses, have been infected. Others have refused to come to work because of the dangers associated with treating infected patients.

The impact of EVD has also been felt in Liberia’s armed forces. Nine soldiers have already died from the disease. “Following the death of the soldiers, and for fear of the further spread of Ebola in the army, regular daily training, a core activity of the military, has been suspended indefinitely. ‘We no longer train, neither do we receive visitors, nor are we allowed visits outside of the barracks,’ a soldier lamented when the Daily Observer toured the Kesselly Barracks over the weekend.” (Daily Observer, Oct. 12)

In Guinea, a private clinic that served much of the city’s elite, including many expatriates, stopped accepting new patients after a woman there showed symptoms of Ebola.

The British government’s resumption of commercial flights to Sierra Leone was cancelled on Oct. 13. The decision not to fly into London’s former colony drew protests from the government in Freetown and from humanitarian organizations such as Doctors Without Borders.

“It’s extremely difficult to get much-needed staff into the region, and at a time that we need more people on the ground than ever, this is very unhelpful,” said a spokesperson for the medical group. The freight transport company Redcoat said that its scheduled Oct. 17 flight was to have carried four tons of humanitarian assistance, including 1,000 protective gear suits essential for treating infected patients. (Guardian, Oct. 13)

In the U.S., a demonstration by Delta Airlines cabin cleaners at LaGuardia airport in New York on Oct. 9 and a press conference by the National Nurses United three days later highlighted the failure of the travel and health care industries to provide basic safety information, training and protective gear.

People before profits!

Dr. Thomas Frieden, director of the Centers for Disease Control and Prevention, had suggested that the infection of the Dallas nurse was a result of not following medical protocols issued by the health care establishment. NNU leaders took exception to this. They said that no official medical protocols have been issued to the 185,000 health care workers they represent. (nationalnursesunited.org) Frieden later retracted his statement, but the damage had already been done.

Decisions regarding health care treatment, workplace safety and insurance coverage in the U.S. are made largely by private firms that profit to the tune of billions of dollars every year. The lack of adequate health insurance or no coverage at all is a direct result of the capitalist economic system.

The underdevelopment of the states in West Africa is a direct result of the legacies of slavery, colonialism and neocolonialism. Until the needs of the people are placed before those of the corporations and international financial institutions, there will be ongoing periodic outbreaks of infectious diseases that will impact broad segments of societies throughout the world.