healthmedicinet

13 October 2014
Last updated at 16:08

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“Most people in Liberia do not believe the virus is real”

Nurses and medical assistants fighting the Ebola outbreak in Liberia have largely ignored a call to strike over danger money and conditions.

Most health workers were working as normal on Monday, the BBC’s Jonathan Paye-Layleh in Monrovia said.

A union official said the government had coerced workers to ignore the strike – but the government said it had simply asked them to be reasonable.

Liberia is the country hit hardest by the deadliest ever Ebola outbreak.

Health workers are among those most at risk of catching the disease. Ninety-five have died from the virus in Liberia.

The latest outbreak has killed more than 4,000 people in Liberia, Sierra Leone, Guinea and Nigeria since it was identified in March.

‘Potential state failure’

World Health Organization (WHO) Director-General Margaret Chan said the outbreak threatened the “very survival of societies and governments in already very poor countries”.

“I have never seen an infectious disease contribute so strongly to potential state failure,” she said in a speech delivered on her behalf at a health conference in the Philippines.

In the US, President Barack Obama has directed tighter safety procedures when dealing with suspected Ebola patients, after a health worker treating an Ebola victim at a Texas hospital caught the virus.

More than 4,000 people have died during the Ebola outbreak

The home of a US health worker infected with Ebola is disinfected

Liberia’s National Health Workers Association had called the strike to demand an increase in the monthly risk fee paid to those treating Ebola cases.

The union wants workers to be paid a risk fee of $700 (£434) a month. The fee is currently less than $500 a month, on top of basic salaries of between $200 and $300.

The association also wants more protective equipment and insurance for workers, and has accused the government of not providing enough protection from the virus.

On Monday, the association’s secretary-general, George Williams, said the government had put some health workers under “duress” and persuaded them to work.

‘Common interest’

Liberia’s Assistant Health Minister Tolbert Nyenswah said a strike would have negative consequences on those suffering from Ebola and would adversely affect progress made so far.

The government says the scale of the epidemic means it now cannot afford the risk fee originally agreed.

Information Minister Lewis Brown said the government had asked health workers to be reasonable.

“We are working with them the best way we possibly can, so that they understand we should have a common interest in saving lives by fighting this disease,” Mr Brown said.

Ebola deaths: Confirmed, probable and suspected

Source: WHO

Note: figures have occasionally been revised down as suspected or probable cases are found to be unrelated to Ebola. They do not include one death in the US recorded on 8 October.

How not to catch Ebola:

• Avoid direct contact with sick patients
• Wear goggles to protect eyes
• Clothing and clinical waste should be incinerated and any medical equipment that needs to be kept should be decontaminated
• People who recover from Ebola should abstain from sex or use condoms for three months

Why Ebola is so dangerous

How Ebola attacks

Ebola: Mapping the outbreak

‘Full inquiry’

Liberia has about 50 doctors to serve the country’s 4.2 million people – an average of 0.1 doctor per 10,000 people, according to data compiled by the Afri-Dev.Info health and social development agency.

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Mark Doyle reports on a new UN centre co-ordinating cases in Ghana

Six months after the epidemic began in West Africa, there are still only about a quarter of the treatment beds required to tackle it.

Food is now in short supply as markets are disrupted in some parts of Liberia, Sierra Leone and Guinea.

In other developments:

• A new UN centre to co-ordinate the fight against the epidemic is being set up in Ghana, which has avoided the outbreak. UN aid workers and logisticians are being flown to the capital, Accra
• The archbishop of Guinean capital Conakry has issued guidelines aimed at checking the spread of Ebola in churches – included avoiding the ritual shaking of hands

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Alastair Leithead, outside the hospital, said the investigation is on-going

Continue reading the main story

Surgical cap

Goggles

Medical mask

Scrubs

Overalls

Apron

Double gloves

Boots

Respirator

• Protective Ebola suit

  ×

• Surgical cap

  ×

  The cap forms part of a protective hood covering the head and neck. It offers medical workers an added layer of protection, ensuring that they cannot touch any part of their face whilst in the treatment centre.

• Goggles

  ×

  Goggles, or eye visors, are used to provide cover to the eyes, protecting them from splashes. The goggles are sprayed with an anti-fogging solution before being worn.

• Medical mask

  ×

  Covers the mouth to protect from sprays of blood or body fluids from patients. When wearing a respirator, the medical worker must tear this outer mask to allow the respirator through.

• Respirator

  ×

  A respirator is worn to protect the wearer from a patient’s coughs. According to guidelines from the medical charity Medecins Sans Frontieres (MSF), the respirator should be put on second, right after donning the overalls.

• Medical Scrubs

  ×

  A surgical scrub suit, durable hospital clothing that absorbs liquid and is easily cleaned, is worn as a baselayer underneath the overalls. It is normally tucked into rubber boots to ensure no skin is exposed.

• Overalls

  ×

  The overalls are placed on top of the scrubs. These suits are similar to hazardous material (hazmat) suits worn in toxic environments. The team member supervising the process should check that the equipment is not damaged.

• Double gloves

  ×

  A minimum two sets of gloves are required, covering the suit cuff. When putting on the gloves, care must be taken to ensure that no skin is exposed and that they are worn in such a way that any fluid on the sleeve will run off the suit and glove. Medical workers must change gloves between patients, performing thorough hand hygiene before donning a new pair. Heavy duty gloves are used whenever workers need to handle infectious waste.

• Apron

  ×

  A waterproof apron is placed on top of the overalls as a final layer of protective clothing.

• Boots

  ×

  Ebola health workers typically wear rubber boots, with the scrubs tucked into the footwear. If boots are unavailable, workers must wear closed, puncture and fluid-resistant shoes.

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