Ebola workers at risk: the tragic reality of the Ebola response in West Africa

Since the beginning of the Ebola outbreak in West Africa in March 2014, medical and non-medical staff from the health ministries of the affected countries, as well as the NGOs supporting them, have been on the front-line of the battle against the disease.

Despite very strict safety measures imposed by MSF in the workplace, risk zero does not exist. However, the biggest threat remains transmission within the community, not during working time. Since March 2014, 14 MSF staff members have become ill, among whom 8 have sadly passed away.

If not properly protected, medical staff directly in contact with patients are at risk of contracting the disease. It is believed that more than 240 health workers were infected –  120 have died – following infection with Ebola. Others have fallen sick and many more are now too afraid to come to work. In Sierra Leone and Liberia, few health centres have received the necessary materials for isolation, protection and disinfection, putting more staff and patients at risk. Today, several health centres are completely deserted, leaving thousands of people without medical care.

Strict safety procedures for MSF staff

In light of the high-risk nature of the work, MSF implements strict infection control measures including compulsory personal protective clothing for staff in contact with infected patients. The care of patients is carried out in well-designed Ebola management centres to ensure the safest possible working environment. There is sufficient space between patients, clear separation between high-risk and low-risk areas, sufficient lighting, secure waste management and regular cleaning and disinfection of the wards.

Administrative controls restrict the number of people who can enter the high-risk area, which limits the staff who could be potentially exposed. Only the staff who need to go in are allowed to enter, and we restrict how long people can stay inside for.

Our international staff members are rotated every four to six weeks to ensure they are not too tired, thereby helping to reduce risk. Our staff always work in pairs in a buddy system. This system is of paramount importance - they look out for each other to make sure the other is not making any mistakes or is too tired.

With years of experience in Ebola outbreaks, MSF is skilled at minimizing risk to its staff. However, we can never guarantee zero risk, and our staff are well-briefed and understand this before accepting to work in an Ebola project.

Outside of medical facilities, there are real risks in the community

Beyond the risks in medical facilities, Ebola exists within the communities in Guinea, Liberia and Sierra Leone and is therefore a potential threat to all. As in many other countries where MSF works, the reality is that our staff live in, and are in contact with, the community. Right now, this community is facing a huge threat with the spread of the disease, and MSF staff are not spared.

For MSF, despite all the safety measures put in place, training and information given to staff about behaviour to adopt both at work and in the community, risk zero is impossible to achieve . MSF’s primary responsibility is to maintain a work environment that can be as safe as possible.

Since MSF began working in response to the epidemic in March, 13 national and one international staff have fallen ill and were admitted to Ebola management centres. Eight of them have sadly passed away.

Although it is likely, after in-depth investigation, that most of our staff members were infected outside work, these tragic events are a constant reminder of the fact that Ebola is currently rife in communities and can affect anyone who is exposed.

Loss of health staff leaves a shocking gap
This tragedy of deaths among those fighting this deadly disease, alongside the loss of lives of so many others, is a terrible blow in the struggle against the epidemic and underpins the urgent need for immediate and concrete action to control its spread before it gets further out of control.

With almost 3,000 staff in the region and considering the quick spread of the disease within communities and the slow international response, it is unfortunately quite probable that more MSF healthcare workers or their family members will become infected with Ebola. MSF can only urge, once again, states to act immediately to help the most affected countries to contain the epidemic.