BBC: DR Congo gunmen say health workers 'brought Ebola' (4)

2 May, 2019

Dear David Gesslequist and HIFA colleagues,

David, you said: "In previous outbreaks, people avoiding healthcare facilities helped to end the outbreaks." This is counterintuitive and contradicts current advice to seek medical attention. Please can you provide some evidence for this statement?

You also said, "WHO is making a big mistake in DRC by not reporting ebola cases acquired from health facilities." But it was a senior person at WHO who reported that most of the transmission (specifically in the Beni outbreak) was occurring "inside the health system".

Dr Michael J Ryan, WHO Assistant Director-General, Emergency Preparedness and Response said: "If we look at the intense outbreak we had in Beni City... we estimate that 80-85% of the transmission in that outbreak was occurring inside the health system.. nosocomial transmission in a health system where workers are not adequately protected and not adequately trained" (see testimony at 48 minutes into the video of the 2nd session, 28 January 2019, available at: https://www.who.int/news-room/events/executive-board-144th-session ).

The implication is not that citizens should stay away from health facilities, but that health workers should be adequately protected and trained.

It would be helpful to have more explanation from Dr Ryan and WHO Emergency Preparedness and Response about the details (patient-to-healthworker? patient-to-patient) and implications of the statement that 80-85% of tranmsission was ocurring 'inside the health system' (what is meant exactly by 'health system'? does this include first contact with community health workers and traditional healers etc?), as this statement appears to have caused confusion and misinterpretation.

Best wishes, Neil

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HIFA profile: Neil Pakenham-Walsh is coordinator of the HIFA global health campaign (Healthcare Information For All - www.hifa.org ), a global community with more than 19,000 members in 177 countries, interacting on six global forums in four languages. Twitter: @hifa_org FB: facebook.com/HIFAdotORG neil@hifa.org