Ethiopia: The risk of sending medical teams to ebola-stricken nations

OPINION

By Dr. Haile Michael Mamo

Ethiopia has a long history of showing solidarity with other African countries on strategic issues. Ethiopian peacekeepers were sent to United Nations missions since the 1950s and more recently to crisis spots in Africa such as South Sudan, Somalia, and Rwanda. Ethiopia feels a distinct responsibility for Africa as it is a founding member of the African Union (AU) and its capital Addis Ababa has been the seat of the African Union (formerly the OAU) since its founding in 1963. Successive Ethiopian governments have embarked on Pan African missions despite the economic difficulty in the country indicating how important it is for Ethiopia to take a stand on important Pan African matters.

Last week, the Ethiopian Ministry of Health announced its decision to momentarily send 210 health workers – doctors, nurses, and public health professionals – to Ebola affected West African countries where over 4,900 people have so far died to help combat the plague and curb the epidemic. In addition, Ethiopia has announced it will also contribute a nominal $500,000 US for the same mission.

Consequently, Ethiopia will soon join Cuba that has sent the largest number of doctors to the Ebola stricken West African countries. Cuba has 165 healthcare workers in Serra Leon and it will soon send another 300 healthcare workers to Liberia and Guinea.

Desiring to help African compatriots during times of crisis is laudable on its own right and is in line with Ethiopia’s tradition of wanting to do its share in major episodes that transpire outside its borders. Ethiopia could also benefit from similar gestures of kindness by the international community if it were on the receiving end. It can also be argued that if we don’t stop Ebola at its source, it is a matter of time before it gets to us and we have to deal with it. Indeed, as Medecins Sans Frontieres (MSF) that has so far sent 700 international staff to West Africa as part of its Ebola response pointed out “The best way to reduce the risk of Ebola spreading outside West Africa is to fight it there. Policies that undermine this course of action, or deter skilled personnel from offering their help, are short-sighted. We need to look beyond our own borders to stem this epidemic.”

However, the decision to send Ethiopian Healthcare Professionals to Ebola stricken West African nations is an entirely different issue that requires careful analysis of the implications. Such decision should not just be made on its goodwill potential for the country or out of a desire to do good but also in terms of its implication for the wellbeing of both the healthcare workers and the general Ethiopian public that these healthcare professionals will return to once the mission is completed.

As highlighted in a recent study by Oxford University, Ethiopia is one of the countries at risk of suffering from the Ebola epidemic by virtue of its geography. Most importantly, any government that is accountable to its people has responsibility for the safety and wellbeing of its citizens first and foremost and decisions must be made taking the public safety into account. For example, the Conservative Government of Australia recently announced that it will not send its medical professionals on harm’s way out of concern both the individual healthcare workers and the Australian general public. Of course, Ethiopia’s relationship with the rest of Africa is different from Australia’s. Australia’s response would have been different if it is one of its neighboring countries that is stricken with the Ebola plague.

In the event the Ethiopia healthcare workers contract Ebola in West Africa, as is very likely the case, does Ethiopia have the capacity to isolate and quarantine infected individuals, transport them back to Ethiopia on a timely fashion and provide them with proper medical care to help them recuperate fully from the infection? What kind of training and equipment are these healthcare workers provided with before they depart to help them accomplish their assigned mission to West Africa?

Probably working under and collaborating with groups like MSF that have been fighting this epidemic since March of this year is the best route if Ethiopia decides to go ahead with the deployment of the health care professionals to West Africa. Everything possible needs to be done to keep aid workers healthy because the implication is not only for the wellbeing of the healthcare workers but for Ethiopia as well.

Upon completing their mission and retuning home, are sufficient preparations made in advance to quarantine these workers for 21 days, if need be, as is the standard of precaution to ensure the returning healthcare workers are Ebola-free and the Ethiopian public is protected? Quarantining these health workers at home is not an easy option in the case of Ethiopia for logistic reasons because of the housing and living conditions in some parts of the country where several individuals typically share a residence.

If the returning health care workers are not quarantined, are there plans to ensure thorough health monitoring of the returnees from Ebola-affected countries? What kind of care will they be provided if the healthcare workers are put under forced quarantine for 21 days? Who will be in charge of the care for these workers? If some of these health workers die as a result of this assignment, what kind of assistance will their family members receive? Who will cover the funeral expenses of the deceased?

The questions above highlight the complexity of the situation and the decision. The United States that has a relatively well-established healthcare system than Ethiopia is struggling to properly handle Ebola cases; it is not clear why Ethiopia feels so bolstered to send hundreds of healthcare workers in the near future and risk bringing the epidemic home.

While a number of other airlines have suspended flights to West Africa, Ethiopian Airlines4 (EAL) is continuing its routine flights to the region. British Airways, Air France, Emirates, and a few others have halted flights to West Africa over concerns about the deadly Ebola outbreak. EAL has announced that it has taken precautionary measures but whether these measures provide the country the degree of safety it needs is the question. This makes one wonder whether the Ebola risk is properly assessed. That people traveling by plane could contribute to the spread of the virus is a legitimate concern. Ethiopia needs to move swiftly to enhance its domestic preparedness beyond the current level, employ state of the art screening measures, and put plans in place for active post-arrival monitoring of people from Ebola affected areas. A dedicated response team must be created to handle a confirmed patient with Ebola and provide assistance to the hospitals that are handling the known cases. Lessons learned so far from the fight against Ebola by all actors must also be shared with all stakeholders so that they can respond properly if a potential case is discovered.

The author, Dr. Haile Michael Mamo, can be reached at hmamo64@yahoo.com