Ebola treatment in Sierra Leone and United States: Who decides where doctors are treated?

Why Do Sierra Leonean and American Clinicians With Ebola Get Such Different Care?

Why Do Sierra Leonean and American Clinicians With Ebola Get Such Different Care?

Health and medicine explained.
April 6 2015 1:37 PM

All Lives Matter

Why do Sierra Leonean and American clinicians with Ebola get different care?

Ebola Treatment Sierra Leone.
Kim Sprayer, a nurse for Partners in Health, manages the triage area of the Maforki Ebola treatment center, where clinicians and sprayers receive patients during the night shift on Jan. 9, 2015, in Port Loko, Sierra Leone.

Photo by Rebecca E. Rollins/Partners In Health

I was there.

I was there when our clinician collapsed at the Port Loko Government Hospital in Sierra Leone a few weeks ago. And I was nearby when we were informed soon after that a Sierra Leonean colleague was suspected of having Ebola. As head of the medical team in Port Loko for Partners in Health, a global health nonprofit, I worked alongside these two clinicians.

When our American colleague fell ill, he was initially transferred to Kerry Town, a first-class Ebola treatment center run by the British Defense Ministry, and from there flown to the National Institutes of Health clinical center in Bethesda, Maryland. When our Sierra Leonean colleague, an employee of the Ministry of Health, fell ill, we helped secure his admission to the same British-run treatment facility—the best option available to Sierra Leonean health care workers.

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In these differences in options for care, the stories of these two colleagues abruptly split, with one receiving arguably the best Ebola care in the world and the other receiving the best Ebola care available in one of the poorest countries in the world.

A recent article called into question Partners in Health’s commitment to fighting Ebola shoulder to shoulder with our Sierra Leonean colleagues from the Ministry of Health. I have been deeply involved in the day-to-day activities of the organization in Sierra Leone and know this can’t be further from the truth. All of us at Partners in Health worked hard to ensure both men had prompt access to the best care available. We understood the potentially fatal complications of Ebola all too well.

I joined Partners in Health in November to be a part of its Sierra Leone Ebola response team, when the Ebola epidemic was raging and the international community was terrorized. Partners in Health, whose mission is to provide world-class health care for the poor, was the only nongovernmental organization working in the ravaged Port Loko district, fighting the disease alongside our Sierra Leonean counterparts from the Ministry of Health at the Maforki Ebola treatment center.

Despite incredibly difficult conditions, despite risking our lives day in and day out, there was an unwavering commitment from everyone in the organization to do our best to care for the sick. And when Partners in Health co-founder Paul Farmer visited us on Thanksgiving and told us we could save more lives with more aggressive care, we pushed harder to do so. It was absolutely clear to everyone that Sierra Leonean lives mattered as much as ours.

Ebola Treatment Unit, Port Loko, Sierra Leone.
Partners in Health recruit Dr. Dana Clutter tends to a patient in the triage area of the Maforki Ebola treatment center on Jan. 15, 2015.

Photo by Rebecca E. Rollins/Partners In Health

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Despite that commitment, not everyone’s life-threatening illness receives the same care. More than 800 health care workers across West Africa who contracted Ebola were unable to receive the same level of care our American colleague is receiving. It simply wasn’t, and isn’t, available. Horrifyingly, some 500 of them died.  

They died not because we at Partners in Health didn’t care. Or because we cared less about our Sierra Leonean colleague than our American colleague. Rather, they died because Ebola afflicts and kills a disproportionate number of people in poor countries. Spare-no-expense medical care, available in the West, would certainly enable the vast majority to survive.

So who is to blame for this iniquity? What can we do differently? Should we have sent the 800 infected West African health care workers to the United States for care? What about all 25,000 Ebola patients?

These are profoundly tough and troubling questions. Ebola demands soul-searching discussions—on access to treatment, on standards of care, on how much one person’s life is worth compared with another’s.

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Let’s get that discussion started.

I don’t have readymade answers. But Partners in Health is committed to improving the health of all Sierra Leoneans. I am in the field working on that very mission every day, helping the Ministry of Health create permanent, premier health facilities in Sierra Leone over the next decade.  

Thankfully, today both of our colleagues are improving. Our Sierra Leonean friend was discharged a week ago from the Kerry Town facility, and our American clinician was upgraded to “fair” a few days ago. We are doing our best to make sure everyone with this horrible disease has a chance to recover.

Karin Huster is a registered nurse with a master’s in public health. She has worked on humanitarian emergencies in Liberia and Sierra Leone, Gaza, and with Syrian refugees in Lebanon.