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EDITORIAL - Needed: clarity on Ebola strategy

Published:Thursday | October 30, 2014 | 12:00 AM

If America has taught us anything about the management of Ebola it is that the strategy must be clear and its articulation precise and consistent. Stakeholders, particularly front-line health workers, individuals and communities, must know the plan - what to do, when to do it, where and how.

In the absence of such clarity, you get the confusions that have attended the Ebola issue in the United States since Thomas Eric Duncan, the Liberian man, became the first person to be diagnosed with Ebola in the United States and eventually died at the Dallas Presbyterian Hospital in Texas.

There was failure of the hospital's treatment protocol that led to two of its nurses contracting the disease, as well as the conflicting guidelines for the handling of health workers who return to the United States from treating patients in the West African countries facing an Ebola epidemic. The governors of New York and New Jersey wanted, and for a time implemented, a 21-day (the incubation period for the virus) quarantine for such returnees. The Centers for Disease Control and Prevention recommends their monitoring of such persons, the degree of which is based on their level of exposure to the virus. But the US Army says that it will quarantine its personnel anyway.

The potential danger when faced with such a serious disease is public panic. And this situation is likely to be exacerbated if fearful health workers, ignorant of the disease and untutored in the protocols for its management, hightail it out of the room when confronted with a suspected case, as happened recently in Jamaica at the Mandeville Hospital.

Notwithstanding the welcome financing by private-sector firms of monitoring equipment and help to be provided by Cuba in planning an Ebola policy, it is urgent that Jamaica has an immediately implementable strategy - to handle the cases now, not in a month's time after the health authorities have had the benefit of the Cuba's expertise.

In other words, all the agencies and institutions that have a part in monitoring the country's borders against Ebola, treatment of cases in the event there are any, and generally keeping the society safe against an epidemic, must know the best practices and function in a coordinated manner. Someone has to make this happen and the voice articulating the strategy has to be credible.

Jamaica has two problems in this regard. While there are many statements from public-health officials about Ebola preparation, these have been short on specifics. No one knows, for instance, where the isolation facilities exist and neither do health professionals have definitive information about sufficiency of protective gear at their facilities. Nor is the health ministry's Ebola management regime universally known, assuming that one is prepared and written. Further, a public-education programme in Ebola, if one is planned, is yet to be rolled out.

But perhaps more critically, the voice of the Ebola strategy, the health minister, Fenton Ferguson, lacks credibility. His management of the chikungunya epidemic means that no one listens to him. He was doing better when he was quiet on Ebola.

In America, President Obama has attempted to solve that problem of dissonance and credibility by naming an Ebola czar in Ron Klain. It is a strategy we recommend to the Government. The job should go to someone from the Jamaica Defence Force, which enjoys credibility, a reputation for getting things done, and people trained in management and logistics.

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