With baby Nubia's discharge from hospital, there are now no known Ebola cases in Guinea and the country is counting down the days until the all clear can be declared. Liberia and Sierra Leone are both free too. Continued vigilance is necessary but the focus now turns to a whole host of health challenges for citizens and visitors alike.
Since early 2014 clients have been asking for advice on the worst Ebola outbreak in history: on risk mitigation, reassurance regarding the assistance we can provide, for bespoke Pre-Deployment research and even help evacuating an Ebola patient. The human and economic cost to West Africa has been huge, and the impact on the countries' medical infrastructure dramatic. A great number of doctors and nurses lost their lives, facilities closed and staff and supplies couldn't get in. Would-be patients stayed away from medical facilities in fear of virus. Malaria went un-treated and women were forced to give birth without access to midwives.
Some foreigners stayed in the region for a while, getting increasingly nervous until a tipping point was reached. All of a sudden there was a scramble to get out, complicated by neighbouring countries closing their borders and airlines cancelling routes. Only gradually did the world commit sufficient resources, time and attention to the crisis. Aid groups and the armed forces of various governments went back in and new infrastructure was created. The focus was understandably and rightly on treating Ebola, and as detection and survival rates improved, as triage systems became more efficient, other facilities were eventually able to provide limited assistance in non-Ebola cases once again.
During this time, visitors faced a dilemma: should they risk entering a local hospital in a medical emergency, or not? CEGA was there to assess the risks, weigh up the probabilities and offer guidance on the options and consequences of action versus inaction. We constantly reviewed the capabilities and limitations of providers and regularly discussed with clients where they were and what resources they had access to. We produced many Pre-Deployment Reports to enable clients to understand the risks they faced in the regions they were operating in and to guide their implementation of robust and realistic medevac plans.
The danger now is that global attention drifts again and resources dry up. It remains to be seen if all the roles filled by the medical personnel who died during the crisis - local national and expatriate alike - can be replaced. New, modern clinics are opening up, but by local standards they are very expensive and exclusive. Public hospitals are as inadequate as they ever were. The hope is that as UN and governments scale down their operations, access to medical services won't recede with them.