29 jannuary 2015
By Richard Jones
https://www.devex.com/news/training-health-workers-yet-another-challenge-in-battling-ebola-85367
While the World Health Organization declared this week that the Ebola epidemic has finally reached a “turning point,” international organizations working on the ground are struggling to cope with staffing challenges, including how to train the best foreign and local specialists to treat patients and — even more importantly — how to find time to do so.
The number of cases in the three worst-affected West African countries — Guinea, Sierra Leone and Liberia — is falling, WHO officials have confirmed, with just eight cases detected in Liberia in the past two weeks, down from more than 500 per week in September 2014.
One well-placed WHO official in Geneva told Devex the latest figures emerging were “promising,” given the sheer scale of an outbreak that has infected more than 22,000 people and resulted in nearly 8,800 deaths. But he “urged caution” to capitalize on the significant efforts — and notable successes — of international development actors and health workers in recent months.
In Guinea, which has to date had more than 2,500 confirmed Ebola cases and at least 1,900 resulting deaths, the Alliance for International Medical Action is implementing a new mixed model of international and local staff to respond to the emergency.
And the main lesson learned so far by the group? That more staff are needed not only to man the Ebola treatment centers and ensure the smooth running of logistical operations, but also to train more personnel.
Despite the lower number of new cases reported in recent weeks, having enough trained health professionals on the ground is crucial not just to ensure more infected victims can recover, but to also help bring down to zero the number of new confirmed cases.
Solenne Barbe, a coordinator at the French medical group’s Ebola treatment center in the Guinean city of Nzérékoré — one of three treatment centers across the country set up with funds from the European Commission’s humanitarian aid arm ECHO as well as its own private funds, and run in collaboration with six African nongovernmental organizations — told Devex they had been running the 40-bed center since November 2014 with a team of 22 international and 218 national staff.
Shortage of trained personnel bigger concern than funding
Training new staff is a very slow process, she noted, but it must be done in a way that the training sessions themselves can be conducted while on the job and without compromising care to any suspected case or confirmed patient.
“It takes time to train people, because you have to count on six to eight days minimum per person and you need to [conduct training] inside a center that is already up and running,” she said.
In Guinea this means in one of three centers: ALIMA’s own center in Nzérékoré, one in Guéckédou run by Médecins Sans Frontières, and another run by the same aid group in Conakry’s Donka district — which I visited in December, accompanying European Commissioner for International Cooperation and Development Neven Mimica on his trip to the Guinean capital.
“These are the only actors with the capacity to train health staff from the Ministry of Health, the Red Cross, everybody,” Barbe said. “So we are just taking things slowly … We’ve found a solution, but it takes a very long time and you can’t force or rush it at all.”
Rather than funding, the aid worker explained that the problem faced by groups such as hers is really a lack of sufficient trained personnel in Guinea and the time to train them properly so they can work in the clinics and specialist centers.
Fear and stigma, she pointed out, are not only affecting the local population terrified of contracting Ebola, but also much-needed medical personnel in the country.
“There are rumors around the disease, due to the lack of knowledge, but this even includes medical doctors, especially those who are treating people in private clinics — even in Conakry,” Barbe said.
This is compounded by the fact that many foreign health care workers and their aid groups are staying away.
“There are some other actors that are not coming here,” she said. “Ebola is scaring everybody — that is normal, we understand it — but we at least need some support in the logistics issues.” Case management, Barbe suggested, is a less-technical area for potential engagement by aid groups.
NGOs can open up all the Ebola clinics they want, she added, “but it is not the way to stop the epidemic. We need to communicate better and this is a really hard job, especially with Ebola because it is such a scary disease and causes a lot of second thoughts — even for Europeans.”