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Ebola outbreak highlights need for IU-Liberia health collaboration

The Ebola outbreak in Liberia provides a dramatic illustration of the importance of an Indiana University initiative aimed at strengthening the public health and medical infrastructure of the West African country, say IU faculty members and administrators involved with the collaboration.

Launched in early 2012, the Center for Excellence in Health and Life Sciences seeks to build up Liberia’s capacity for meeting health care needs by providing training for the public health workforce and strengthening the curriculum and instruction in medical and nursing education programs.

Liberian students

Liberian students learn to take blood pressure readings in the Certificate in Public Health training program, part of an IU partnership.

The partnership brings together Indiana University with the University of Massachusetts Medical School, the University of Liberia, and the Tubman National Institute of Medical Arts in Liberia. The partnership is supported by a grant from Higher Education for Development, funded by the U.S. Agency for International Development.

“The Ebola crisis is a perfect example of why this project is so important,” said Michael Reece, associate dean of the IU School of Public Health-Bloomington and IU’s coordinator of the public health component of the project. “It’s a textbook example of the value of IU’s global emphasis and leadership.”

More than 1,300 people have contracted the Ebola virus in Liberia, Guinea and Sierra Leone since the outbreak began in March, and more than half of them have died. There is no vaccine or cure for Ebola, and past outbreaks have been fatal in 60 percent or more of cases.

The World Health Organization warned today that the outbreak could spread further. The Peace Corps and nongovernmental organizations withdrew volunteers and staff from the region. Liberia closed schools and most hospitals, and President Ellen Johnson Sirleaf said areas could be quarantined.

The infection spreads through contact with bodily fluids, with health care workers often at high risk. U.S. medical missionaries Kent Brantly and Nancy Writebol, who contracted the illness in Liberia, were being flown to Atlanta for treatment. Brantly is an IU School of Medicine graduate.

With IU’s support, the Center for Excellence in Health and Life Sciences trained selected community workers in a Certificate in Public Health program through a partnership with Liberia’s Ministry of Health and Social Welfare. The initiative has also provided advanced education for leaders in Liberia’s nursing profession and upgraded curriculum, equipment and textbooks for medical education.

With the Ebola outbreak, the public health students have become “trainers of trainers” and served as a bridge between health care facilities and local communities. Others involved with the IU project have dived into basic public health duties, such as sharing information about how Ebola is spread and systematically tracing the contacts of people who have contracted or been exposed to the virus.

But the efforts face challenges as a result of Liberia’s underdeveloped transportation and communications systems, which were left weakened by many years of civil war.

“The feedback from people on the ground is that there has been a real challenge in getting access to everything from medical supplies to diagnostic tests to basic things like latex gloves,” Reece said.

Amos Sawyer, a faculty member at IU’s Ostrom Workshop in Political Theory and Policy Analysis, chairs the Governance Commission of the Liberian government and was in the country two weeks ago.

He said Liberia is a small country, with only about 3.6 million people, and the impact of Ebola is impossible to overstate. “Just about everybody in the country would have known, or known of, somebody who’s been stricken with the virus,” he said.

Sawyer said the crisis has cast a harsh light on the country’s lack of public health capacity.  “Clearly Liberia needs many more health professionals in the area of preventive care,” he said. “The work that Indiana University is doing is very, very important.”

Reece said a valuable lesson from the experience – and a focal point of the IU collaboration — is that Liberia desperately needs stronger academic institutions that can provide training for doctors, nurses, educators and it needs public health professionals who can take the lead in responding to a crisis.

“If we want these approaches to be sustained, our belief is that we really need to help them train their own people,” he said.

Read about Tiawanlyn Gongloe, a graduate of Indiana University and its School of Public Health-Bloomington who is working on Ebola education and contact tracing in Liberia, on the IU Health & Vitality Viewpoints blog.

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