Ebola panel highlights IU expertise

The Ebola outbreak has overwhelmed West Africa’s fragile health-care systems and had a devastating effect on social and community institutions, Indiana University experts said in a public forum this week.

They also expressed concern that panic over the spread of Ebola could distract attention from other health priorities and make it harder to check the onset of infectious diseases in developing countries.

“Our stance with regard to Ebola is really a test,” said Chad Priest, assistant dean of the IU School of Nursing and co-director of the IU Disaster Medicine Fellowship. “And the question is, is the U.S. ready to step up and stop these outbreaks where they start.”

Panelists Joshua Mugele, left, Chad Priest and Ruth Stone discuss Ebola.

Panelists Joshua Mugele, left, Chad Priest and Ruth Stone discuss Ebola.

Joining Priest for a panel discussion focused on Ebola in Liberia were Joshua Mugele, assistant professor at the IU School of Medicine; Ruth Stone, an IU Bloomington folklorist who has worked extensively in Liberia; and Charles Reafsnyder, recently retired associate vice president for international affairs.

Michael Reece, associate dean of the IU School of Public Health-Bloomington, moderated the mid-day Monday program at IU Bloomington’s Whittenberger Auditorium. A video recording of the forum is available online.

Indiana University has longstanding ties to Liberia, which was left in shambles by a 14-year civil war that ended in 2003. Reafsnyder said the university made a commitment to help support Liberia’s health system when it awarded an honorary degree to Liberian President Ellen Johnson Sirleaf in 2008. That led to creation of the Center for Excellence in Health and Life Sciences, a program funded by the U.S. Agency for International Development and aimed at creating a modern system of training Liberian doctors, nurses and health workers. The project was under way, but Ebola put a stop to it for now.

Priest said the “shadow effect” of Ebola in a country like Liberia is nearly as worrisome as the disease. The outbreak has overwhelmed hospitals and clinics, leaving nowhere for patients to be treated for other illnesses and accidents. Incomes have dropped, and food security is a concern. Medical workers have borne the brunt of Ebola, reducing the capacity of an already weak health-care system.

Nurses have been criticized for missing work, Priest said. But critics should remember they are treating patients with a deadly, infectious disease in facilities that lack basic supplies and protective equipment.

“Those that do go back to work, we call them heroes,” Priest said. “Those that don’t, we might call them rational.”

Stone, an ethnomusicologist who studies artistic performance in Liberia, pointed to a consequence of Ebola that has received little attention – its effect on the rituals of community life. In particular, concern about infection has made it impossible to conduct normal funerals.

And funerals are an all-important part of Liberian life, lasting for days and featuring washing of the bodies of the deceased, ritualized mourning, music, dance and food. She suggested an initiative to restore the all-important sonic dimension to grieving over the loss of loved ones, by hiring musicians and groups to provide Christian spirituals and Muslim prayers and chants.

Mugele and Priest were in Liberia this summer as the Ebola outbreak began to pick up steam. They saw first-hand that the health care system wasn’t equipped for the challenges it would face. (Listen to an NPR interview with Mugele about being present when the first Ebola patient arrived at a hospital in the capital of Monrovia. Two Liberian doctors who were with him contracted Ebola and died).

“Yes, they need doctors,” Mugele said. “Yes, they need nurses. But they absolutely need supplies.”

Priest had this advice for people who fear the disease will spread uncontrolled in the U.S.: “Take a breath. Relax.” While Ebola may be unusually deadly, he said, the best countermeasures are familiar ones: Hand-washing and protective clothing for infection control in medical settings. Tracing of contacts of infected patients. Good nutrition and sanitation. Education and outreach about public health.

“A flu vaccine is well in order for everyone,” Priest said. “And that is a good way to demonstrate your solidarity with battling infectious disease.”