By Thabile Maphanga

JOHANNESBURG, Oct 15 — Fear about contracting Ebola has gripped the world, seemingly faster than the spread of the disease itself.

Humanitarian organization Médecins Sans Frontières (MSF, Doctors Without Borders) is sceptical about the World Health Organization’s (WHO) estimated death toll from Ebola.

The WHO says more than 4,000 people have died of Ebola out of about 8,400 reported cases in West Africa but Doctor Juli Switala, a South African paediatrician based in Bo in Sierra Leone since June this year, disagrees.

“Don’t be fooled by the numbers; 4,000 is really not a lot, we don’t trust those numbers. We know that people are hiding bodies. We know that 4,000 is an under-estimation,” she says.

She says the real picture in Sierra Leone is that of a collapsing health system and poor roads making it impossible to travel to health facilities.

Dr Switala says nurses are terrified to go to work and members of communities refuse to seek medical help, until it’s often too late.

“Parents are really terrified to bring their kids to hospital. The problem for us is that these children were coming in so late. So they were just arriving in a worse and worse condition even though we were getting less and less children,” she said in an interview with the South African Broadcasting Corporation (SABC).

“One of the cases that really shocked me was – we had a little boy who was unconscious and I was really trying to get things sorted out as quickly as possible, just getting the history from his father. And I was surprised by how calm the father was, given the state of this child and after getting a bit more history he told me: ‘This child has been unconscious for ten days’. That’s how desperate people are; they don’t want to bring their kids because they are that scared.”

Dr Switala says she has had to make some of the toughest decisions in her career as a health professional. She says the hardest decisions are related to what she calls 50-50 patients.

“There really are tough choices. I’ve had a situation where I was expecting one child to be dropped off at our unit opened the ambulance and there were two kids and due to logistical reasons I could take one. To explain to that mother that her child had to go to a government hospital and she is sitting crying saying, ‘My child is going to die if we send them there, you just have to do what you have to do’,” says Dr Switala.

A Humanitarian Affairs Adviser at MSF, Jens Pedersen, says they were overwhelmed by Ebola cases. He was based in Monrovia in Liberia between August and September this year. He said that no matter how hard they worked, they were always two steps behind the deadly disease.

Pedersen said it was not impossible to contain Ebola if the global community would only commit to the fight.

“Working in an Ebola centre as a health care professional is very frustrating because you are dealing with a disease of which we have no treatment available and also everything takes so much longer,” he added.

“The main focus is to protect yourself and your colleagues from contracting Ebola, let alone the physical side of working in a PPE (Personal Protective Equipment) or protective suit in 35 degree heat, you easily loose two to three litres of body fluids in 60 – 90 minutes. It’s mentally challenging and it’s physically exhausting.”

Dr Stefan Kruger, who was based in Sierra Leone from July to August this year, said it was impossible to give great medical care working with limited resources.

“The three main frustrations that I found are that firstly despite your best efforts and your hardest work, most of the time they still pass away. You soon realise that you repertoire of support of management is very limited. The truth is we will never know if our treatments really make a significant impact on the survival rate but it would be unethical not to try.”

The humanitarian organization has been directly affected by Ebola — 16 of its staff contracted the disease and nine have since died.


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