News analysis
The deadly, terrifying and still expanding Ebola outbreak in West Africa has claimed another newsworthy victim: Dr. Olivet Buck, a physician in Sierra Leone who was among the courageous health workers who put their own lives at great risk while trying to save others.
People in West Africa are dying from Ebola on a daily basis, of course, but Buck made the news by name because she is now the fourth doctor (not to mention the 50 nurses) from Sierra Leone to die from the viral infection in this outbreak.
Unlike what has been done for foreign health workers who become infected with Ebola, Buck was not evacuated to a Western hospital to receive treatment.
As the AP reported a few days ago, Sierra Leone’s President Bai Koroma had asked that the World Health Organization organize a medical evacuation for Buck to a hospital in Hamburg, Germany, where Koroma said he was assured “they are in readiness to receive her.” The WHO said it could not assist with the evacuation, but didn’t really explain why.
“WHO is unable to organize evacuation of this doctor to (Germany) but is exploring all options on how to ensure best care,” said WHO spokesman Tarik Jasarevic. “WHO will facilitate the best care possible in country for Dr. Buck, including access to experimental drugs.”
But now Buck is dead, a notable death among the 2,400 known to have been killed so far in this surprisingly fierce outbreak that some predict will continue to grow in scope, possibly leading to some 20,000 deaths or even many more, before it can be contained.
With Buck’s death came outrage from those who saw in it yet another grotesque inequity in this most-inequitable situation. Sick Western health workers like American Kent Brantly, Brit William Pooley or, more recently, two Dutch doctors get flown out to receive top-notch medical treatment or even experimental drugs while African health workers are left behind to die in comparatively poorly run hospitals and clinics in the afflicted communities.
An editorial at The Guardian fumed: Why are western health workers with Ebola flown out but locals left to die? The author and Guardian editor Joseph Harker, who does disclose he has a personal connection to Buck, wrote:
“The death of Olivet, a 59-year-old mother of three, raises wider questions about how the world responds to the Ebola crisis, and how it protects those working closest to stop its spread.”
Other news reports, or commentaries, like this from NBC and Buzzfeed said that WHO refused to airlift Buck out of Sierra Leone because of cost. Now, it can be pretty expensive to do a medical evacuation, but WHO did not say that was the reason. WHO hasn’t actually given a reason. Humanosphere has asked Geneva-based WHO for an explanation, but the time zone thing likely means it won’t be today.
One possibility is that Buck was already too ill. A medical evacuation can kill a seriously ill patient. Another possibility is that the arrangement by President Koroma with the Germans was less firm that he made it sound. Koroma issued a statement saying the deal was all set, but there appeared to be no comparable statement from the Hamburg hospital. Have the Germans expressed concern or outrage as well with WHO’s response?
The problem with deadly disease outbreaks, as someone once said, is that fear can be more deadly than the disease. Fear prompts politicians to do things, like imposing large-scale involuntary quarantines (which almost always makes things worse) or, say, blaming some international agency or outsiders for not doing more.
Fear can promote the search for scapegoats, for someone to blame (or worse). Ebola is especially good at creating fear because it is so deadly and we have no good treatment to combat it, whether the fighting is done in a rich country hospital or a poor African clinic.
The bottom line here is that medical evacuations are not ever going to be a solution to this ongoing catastrophe. If the international community were to start evacuating only health workers with Ebola, how would that fly? What about the police or soldiers who get exposed trying to prevent the chaos? What about the people who bring food and water into the devastated communities? Those at risk for this disease, and those needed to fight the outbreak, are not just doctors and nurses.
The real solution here, as WHO has repeatedly been calling for, is to fly in more brave and dedicated doctors, nurses, epidemiologists and many others who can assist these poor countries with disease control, treatment and support services. Fortunately, that appears to be the solution now getting the most support from the international community, as Humanosphere also reported today and as indicated by the recent announcement from USAID (U.S. Agency for International Development) to build an Ebola-dedicated clinic for Liberia.
WHO has made a lot of mistakes in this outbreak, from initially failing to appreciate its explosive character to its sometimes stunned deer-in-the-headlights look in some of its official responses. But not pushing for more airlifting of the afflicted is not one of them.
