British Obstetrician Recounts 2014 West African Ebola Outbreak – Lessons For How To Cope With Current Crisis In Uganda

Healthcare British Obstetrician Recounts 2014 West African Ebola Outbreak – Lessons For How To Cope With Current Crisis In Uganda Joshua Cohen Contributor Opinions expressed by Forbes Contributors are their own. I write about prescription drug value, market access, healthcare systems, and ethics of distribution of healthcare resources Following New! Follow this author to stay notified about their latest stories. Got it! Oct 1, 2022, 11:00am EDT | New! Click on the conversation bubble to join the conversation Got it! Share to Facebook Share to Twitter Share to Linkedin An MSF medical worker, wearing protective clothing relays patient details and updates behind a .

. . [+] barrier to a colleague at an MSF facility in Kailahun, on August 15, 2014.

Kailahun along with Kenama district was at the epicenter of the world’s worst Ebola outbreak. AFP PHOTO/Carl de Souza (Photo by CARL DE SOUZA / AFP) (Photo by CARL DE SOUZA/AFP via Getty Images) AFP via Getty Images In the past 10 days, Uganda has been struck by a new Ebola outbreak. This particular strain of the virus has no approved vaccine.

The current Ugandan health crisis is a graphic reminder of the persistent threat of Ebola across the African continent. Perhaps lessons can be learned on how to cope with the situation in Uganda from a British obstetrician’s account of what it was like to be a doctor on the front lines of an unfolding Ebola epidemic in Sierra Leone in 2014 while struggling to save the lives of expectant mothers and their babies. Worldwide, a woman dies every two minutes from a pregnancy-related complication.

Sierra Leone is ranked the country with the highest death rate of pregnant women in the world. This is the country where we find the author – Benjamin Black – of Belly Woman: Birth, Blood, and Ebola, The Untold Story , at the beginning of his compelling story. In May 2014, Ebola, one of the deadliest known infectious diseases known to humans, crossed into Sierra Leone from neighboring Guinea.

Arriving in July 2014, Black found himself at the epicenter of a deadly and steadily growing Ebola outbreak. There have been quite a number of books written about Ebola, whether from a purely scientific perspective about phenomena such as zoonotic transfer, or as a disease thriller of sorts. Black’s book isn’t like these.

It’s a much more personal narrative, akin in some ways to Paul Farmer’s Fevers, Feuds, and Diamonds: Ebola and the Ravages of History . The late Paul Farmer was a physician and medical anthropologist, who founded Partners in Health, an organization that for many years has been fighting outbreaks of infectious diseases across the developing world, from tuberculosis in Peru, to AIDS in Rwanda, to Ebola in Western Africa. MORE FOR YOU CDC: Salmonella Outbreak Has Left 279 Ill, 26 Hospitalized In 29 States Canadians End Up In ICU After Attending ‘Covid Party’ White House Mandates Pfizer Vaccines for Millions of Citizens .

. . Before the FDA Clinical or Safety Reviews Have Been Made Public By the time Black arrived in the capital city of Freetown in 2014, “Western Sierra Leone was ground zero of the epidemic, and Upper West Africa was just about the worst place in the world to be critically ill or injured.

” This includes of course pregnant women experiencing emergencies that require immediate intervention. Black chronicles the lack of healthcare essentials and the implied failure to have properly invested in basic health infrastructure and supportive care in Sierra Leone. The author reminds us that the causes of such neglect are multifactorial – political, socioeconomic, cultural – and therefore not easily solvable.

Black also cites persistent issues that prevent optimal maternal care from being delivered as well as Ebola, such as a fundamental distrust of both the healthcare system and Western medicine. Medical ethicists often describe the very hard choices which must be made in times of crisis, in terms of triage, as well as the attendant moral dilemmas in situations in which there are severely constrained resources. While illustrative, such ethical thought experiments can be quite far removed from reality.

Black throws this into stark relief by demonstrating what the real world of Western Africa in 2014 was like, in which crisis mode was a constant and the choices facing healthcare providers extraordinarily difficult. Specifically, Black was tasked with providing healthcare to pregnant women who present at the hospital with a host of pre-natal crises stemming from infections, diabetes, and eclampsia, while Ebola struck. As Black points out, the dual crises – one temporary in nature, the other a permanent fixture in many developing nations – invariably test our conscience, ethics, and clinical judgment.

As an obstetrician and gynaecologist, Black is based in London and currently a specialist advisor to international aid organizations. He teaches medical teams around the world about how to improve reproductive healthcare among the most vulnerable sub-populations in the most challenging of environments. As a working member of Doctors Without Borders Black is uniquely qualified to provide a detailed, sobering story of what it was like to be on the ground as multiple crises emerged.

The author writes about balancing fears of contracting Ebola against the desire to treat patients coming through the doors of hospitals with a variety of obstetric emergencies. He doesn’t sugarcoat the situation. While there are mothers he saves from dire conditions such as eclampsia, he also sees many die, including their fetuses and babies.

At the same time, he offers a grim reminder of the horrors of Ebola. He even loses a physician colleague to the disease. While the book’s emphasis is maternity care and the Ebola epidemic in 2014-15 in Western Africa, it also flashes forward periodically to delve into the Covid-19 pandemic as experienced in London, as well as other more mundane situations that doctors like Black are faced with in a wealthy nation like the United Kingdom.

Black puts a human and profoundly humane face on what it’s like to be a doctor, working in teams in which problem-solving can often only be done on the fly. Some things cannot be prepared for. There’s little time for reading through manuals and the peer-reviewed literature.

or devoting resources to adequately prepare or plan for alternate scenarios. In this context, Black’s narrative extends beyond a recounting of his experiences. He seeks to help chart a path forward and establish proper guidance for organizations like Doctors Without Borders.

Ultimately, the overarching aim is to reduce global disparities in maternal health, and to assist in preparing for future epidemics. Follow me on Twitter . Joshua Cohen Editorial Standards Print Reprints & Permissions.