Ebola risk management from Liberia

A picture from Dr. Flanigan’s blog: One of my colleagues, Thomas, an excellent Ebola trainer in front of the goats at the Liberian Mission[/caption]

Quickly this week, my fears of Ebola were put into perspective somewhat after speaking with Dr. Timothy P. Flanigan—one of the many doctors who have gone into West Africa while we debate whether to keep anyone from this area from our borders.

From Monrovia, Liberia Flanigan is treating patients and educating locals to battle the Ebola outbreak.

I encourage anyone to spend time reading his blog. In it, you’ll find amazing risk management efforts under some difficult circumstances. He likens the outbreak to a California wildfire.

“One lightning strike in dry conditions, and you’ve got a fire,” he said. “You think you get it under control—that it could be under control. But if the wind blows, the whole hillside is in flames.”

Where there are signs the virus is under control, there follows word of another village with an explosive increase in patients.

Interestingly, a post picturing a hand-washing station with details of the proper mixture of water and bleach solution is followed by another post describing how this doctor gets his hands dirty to improve safety.

It’s surprising what one learns in unusual situations like this.

• How to set up or adapt or build triage tents at the entrance of the hospital or health centers
• Making sure the water pressure and the septic are good enough to keep the “WASH” (water and sanitation) folks happy
• How to build extra latrines for isolation buildings
• How to easily and quickly and safely bust through walls of a structure to open new doors for safe flow 

These challenges, along with continuously adapting training, keeps life hopping and busy. 

Unlike here in the US, a strict no-touch policy is implemented in West Africa. Flanigan admitted it took some getting used to. But his group travels to preach this policy—to urge locals not to touch the sick while praying, not to lay their hands on the dead.

“This has had an amazing impact,” he said. “We haven’t seen any new cases the last few weeks. Suspected patients are quarantined. They stay at home. No visitors.”

When asked about his interpretation of how the US is handling Ebola, Flanigan was loyal, diplomatic. Plus, he’s a bit too busy in Africa to be completely up-to-date on US news. He’s aware the CDC has been tremendously criticized but he says his experiences with the agency have been “very positive,” adding., “They are exceptionally careful. They have experience with multiple epidemics and have a good sense how to limit transmissions.”

He follows with hindsight, speaking of blown chances to get ahead of the virus, while remaining hopeful.

“Initial vaccine candidates were good,” he said. “But we didn’t invest. We were slow in responding. We didn’t pay attention. We’re playing catch-up.”

He maintains: “In 6-12 months it’s be a very different place. There are game-changing technologies. Vaccines will be total game-changers.”

Without the amenities enjoyed by workers in US healthcare institutions, doctors like Flanigan have developed protocol to keep people safe–so much so that recently issued guidelines from the CDC on personal protective equipment were based in large part to the practices of overseas medical staff in West Africa.