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• W2410364513 abstract "PREFACEPartners In Health (PIH) is an international charity that delivers health care by working with governments and communities in settings of poverty. In September 2014, PIH began working with local partners Last Mile Health in Liberia and Wellbody Alliance in Sierra Leone, and with the governments in both countries, to fight Ebola and help build and improve the domestic health systems. Between September 2014 and March 2015, PIH has supported more than ten specialized facilities to care for Ebola patients in the two countries, which have provided care for more than 2,000 patients. The authors of this article, as PIH employees, have been engaged in the design, implementation, and evaluation of the PIH response. The following reflects our work not only in addressing Ebola but also in the restoration of the health system.INTRODUCTIONThe preamble to the 1946 constitution of the World Health Organization (WHO), states:Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. The enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition. The health of all people is fundamental to the attainment of peace and security and is dependent upon the fullest co-operation of individuals and States. The achievement of any State in the promotion and protection of health is of value to all.1The 2014 Ebola epidemic has laid bare the truth that the health care system in West Africa is skeletal at best, and certainly not able to fulfill the fundamental right to health for the people of the region. The rampant spread of Ebola in Liberia, Sierra Leone, and Guinea, is a symptom of weak and inadequate health systems. As global discussions of travel, quarantine, and the transnational spread of the epidemic loom,2 it has never been clearer that the promotion and protection of health is of value to all.Sadly, the health systems of the three West African countries burdened by the epidemic are not unlike other poor countries in the world, which have inadequate numbers of health workers, insufficient supplies of essential medicines, and which lack systems for waste management, epidemiological surveillance, and infection control. These gaps in the health care system have impeded the control of Ebola and have further amplified the epidemic within health facilities.3 As the epidemic worsened, health workers feared going to work and patients became afraid to use health facilities. Thus, utilization of even basic services dropped, and non-Ebola health outcomes also worsened.4,5Maternal mortality has always been closely associated with weak health systems, and the case is no different here. In fact, the further deterioration in health care services as a result of the Ebola epidemic has impacted pregnant women disproportionately, and further illustrates the need for renewed efforts to strengthen health care systems in these countries. Because maternal mortality is an indicator of the sturdiness of a health system, we believe it can serve as a report card for health systems strengthening in the context of Ebola.WEAK HEALTH SYSTEMS SET THE STAGE FOR EBOLAWhen asking health workers whether the most recent Ebola outbreak has weakened the health system in rural Liberia and Sierra Leone, we hear, again and again, that the health system was very weak before Ebola, and that Ebola itself is not the problem but a symptom of the dysfunction. Examples abound. In one health center in Liberia, nurses complained of shortages of all drugs, except oral rehydration salts, for months preceding the Ebola crisis. In a 170-bed hospital serving half a million people in Sierra Leone, the X-ray machine had never been connected and just two doctors were on the staff.6To truly understand the Ebola crisis is to place it in a context in which very little health care is actually delivered, because of insufficient staff, inadequate medications, broken supply chains, and decaying infrastructure. …" @default.
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• W2410364513 date "2015-07-01" @default.
• W2410364513 modified "2023-09-30" @default.
• W2410364513 title "Excess Maternal Death in the Time of Ebola" @default.
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