Ebola – nothing more than my ramblings

So the WHO have published a roadmap to stopping worldwide Ebola transmission in the next six months. $490m is all they’re estimating is needed! That’s about half of what we paid for the Glasgow Commonwealth Games, or a third of the Edinburgh tram system. And its all relatively straight forward. That’s the thing. The public health nerd in me loves that this is so understood. That there is best practice waiting to be rolled out. And as a nurse, that I have a very limited knowledge of Ebola, yet the treatments that can make such a massive difference to patient outcomes are providing basic nursing care (I don’t mean the experimental antibody serum which has been given to four so far, but the hygiene measures and symptomatic treatment such as rehydration, pain control and coagulation support that is available locally).

My alarm bells went off reading about the metrics – obviously measuring ebola incidence is essential to evaluating the response, and that’s quite right. That is the only thing that matters. But achieving metrics and targets have a habit of damaging the actual thing to be improved. An easy example is how achieving the 4 hour wait in A&Es led to patients being kept in ambulances outside the unit, and I think have led to other stupidities within hospitals, such as non A&E units set up that are really nothing more than holding pens for patients, meaning they frequently end up in 3 different settings, including destination ward, leading to disorientation and chances for errors due to lack of continuity of care. In terms of Ebola I worry that the metrics could become localised as targets, as they’ll be passed down through chains of officials, each also wanting to individually look good, and then pressure put to not diagnose in order to reduce official transmission figures in that way.

So yes, as you might have guessed, I was doing some early feasibility research on going out to volunteer. In general, loose cannon volunteers are worse than useless in disaster areas. And due to the massive personal risks involved, I would only want to go with an organisation I trust to have sufficient capability and experience to keep healthcare workers as safe as possible. Anyway, the good news for my mum is that MSF are actively looking for medical staff to go out, but not nurses. And I’d be more useful after my tropical nursing diploma anyway, which is due to be completed end of January. So my existing plans for next 5 months aren’t changing at this time.

I’m glad that I chose to study nursing, that I got myself to capable general nurse status, have my public health masters, and am on track to have tropical nursing diploma within 6 months. I like it that I have found a way to make a meaningful difference in the world that fits well my nerdy/science brain, together with my other characteristics such as liking to have work that is physical as well as mental, and practically help people and problem solve. I haven’t the capability or temperament for counselling, or emotional trauma work, but I do like to help people. I like that I have made myself into a person that can be useful in crises because that is what I’ve wanted since watching M.A.S.H. as a kid :)

Yeah, ebola. So, probably 20 000 people will die because economic inequality and war and power and racism mean that this epidemic was able to get so horrific. But it is well within our human capabilities to bring it under control, and we probably will.

  1. NickP
    August 29, 2014 at 9:02 am

    Inspired to do nursing by watching M*A*S*H!

  2. dolphin
    August 29, 2014 at 3:07 pm

    Reblogged this on Dolphin and commented:
    I would add that many will die because we have been so brainwashed to believe that cures come in pills instead of good, organic food in its original form (not processed), grain-free; clean water, and fresh air to breathe. And that cures can come in the form of dandelions, plantains (the weed, not the fruit), etc….

  3. February 12, 2015 at 7:06 pm

    the nhs is so very,very screwed by the lack of money. as fellow brit i can relate on so many levels

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