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Farmer Calls for Scaled-Up Medical Infrastructure to Address Ebola Outbreak

The Harvard Crimson
By Raghu Dhara
November 11, 2014

(Click here to view the original article.)

University Professor Paul E. Farmer named infrastructural failures, rather than the disease itself, as the main obstacles to addressing West Africa’s Ebola epidemic during an event at the Harvard Medical School Tuesday afternoon.

Farmer is the founder of the multinational nonprofit Partners In Health, which is associated with a club at Harvard College, and recently returned from Ebola-stricken Liberia. On Tuesday, he described what he feels is the optimal technique for approaching the current outbreak: healthcare providers must implement the “4 S’s,” staff, stuff, space, and supplies. The region’s weak healthcare systems, he said, are a major hurdle to that implementation.

Lipi Roy, a staff physician at Massachusetts General Hospital who attended the event, agreed, saying that Farmer accurately illustrated the big picture of Ebola.

“He is absolutely correct: the 4 S’s are vital,” Roy said.

According to Farmer, a big problem associated with Ebola is that caregivers to the sick are at great risk of contracting the illness themselves. However, Farmer said that aggressive and careful treatments can be an effective cure.

“There’s not a lot of evidence...that would suggest that this illness cannot be treated in a great majority of cases,” he said. “When Ebola has collided with Western medicine, which has not occurred in West Africa, most patients survive.”

Specifically, Farmer advocated for hiring more volunteers to aid the effort, especially intravenous therapy nurses.

“We need vital signs, we need electrolytes, we need the basics you would find in an emergency room,” he said.

Edward A. Nardell, an associate physician at Brigham and Women’s Hospital and a lung specialist with PIH, said Farmer’s talk changed his perspective on the outbreak.

“What I learned was that people are dying not because of irreversible pathology but rather lack of care,” Nardell said.

According to the Centers for Disease Control, the 2014 Ebola epidemic is the largest in history. The infection causes diarrhea and internal bleeding and has a mortality rate estimated in September by the World Health Organization at 70 percent.

Farmer said PIH has been a significant force in the Ebola outbreak, particularly in southeast Liberia and Sierra Leone. By teaming up with nonprofit distributors, PIH has provided medical supplies to the areas strongly affected by the disease, he said.

Meissa Jones, a senior clinical research coordinator for the Crimson Care Collaborative who attended the talk, said that PIH’s efforts represent a “greatly important initiative.”