Why nurses died of Ebola

Ebola is not very forgiving. One little mistake is enough to infect an individual By Charles Wendo Fifteen health workers have died of ebola since the outbreak in October. These include one doctor, a medical assistant, nurses, an ambulance driver and a cleaner. Another twelve have either recovered or are still sick. The death of the ebola fighters including Dr Lukwiya, the 'field commander', alarmed the whole world at a time when the chief killer was supposed to be diminishing. This is despite local and international efforts to safeguard the health workers from the disease that is transmitted by direct contact with patients, dead bodies or their fluids. Besides, the health workers were the first to be armed with the information that you can prevent ebola by isolating the patients, using protective wear, disinfecting contaminated materials and washing hands. Two separate investigations by the Ministry of Health and workers' MP Sam Lyomoki point fingers at understaffing and fatigue. Prof Francis Omaswa, the Director General of Health Services, says they had identified four reasons why so many health workers got infected with ebola. "A group got infected when we did not yet know we were dealing with ebola. Even when we knew ebola had come, two patients in Lacor were in the general medical ward and we had not yet known. They infected health workers and other patients," he says. Unsuspecting medical workers exposed themselves to fluids from the two ebola patients in the general wards, who did not show the typical ebola signs of bleeding accompanied by fever. Another category of health workers got infected after ebola was recognised but before experts flew in to train Ugandan staff on how to prevent the spread of the virus in a health care setting. The other possibility, Omaswa said, is a lapse in concentration when one is tired or carried away by the work. "For example you might rub your eyes when you shouldn't," he says. The WHO Ebola coordinator in Gulu, Dr. Ray Arthur, supports this view. "Ebola is not very forgiving. One little mistake is enough to infect an individual," he said in an interview with the Reuter news agency. The families of the medical workers who lost their lives while trying to save others are to be compensated. Those who have recovered will also be compensated. However, health ministry officials say more emphasis will be placed on preventing any more health workers from being infected. They are using several ways to reduce the working hours in order to eliminate fatigue-induced exposure to Ebola. "Ebola is a very intense condition that needs 100% concentration every second. To remain alert for many hours is difficult," says Dr. Alex Opio, assistant commissioner for national disease control. Strategy number one to reduce fatigue has been an appeal for volunteers from other districts so that the medics can work for fewer hours. Some volunteers have been sent to Masindi while over 20 more are waiting to be deployed in both Masindi and Gulu. The second strategy is to have Lacor and Gulu hospitals admit Ebola patients in turns, giving each hospital a two-week rest. Officials said all health workers in the hospitals that receive ebola patients would wear protective clothing. Previously protective efforts were mostly focussed on the Ebola wards, but some health workers got infected outside the ebola ward. In addition, the medics have been undergoing training to enhance their skills in identifying suspected Ebola cases. Omaswa says though the world has only known it because of ebola, health workers have always acquired diseases from their patients. "We are living with professional hazards all the time. AIDS has killed many doctors who have caught it during the course of their work. I am a surgeon and many times I operated upon people and got my gloves perforated and my fingers pricked," he said. He says the medics are already aware of the professional hazards by the time they enroll for the profession and therefore cannot run away from it. However, he says, the difficult working environment should be appreciated by paying them well. "What I hear a lot is people attacking health workers. They are under-paying health workers and sometimes not paying them at all, but they concentrate on attacking us. We are all under-paid starting with me," he said. Ends