BBC: DR Congo gunmen say health workers 'brought Ebola' (5) Transmission of Ebola within the health system

3 May, 2019

Confusion, confusion, confusion!

That is the last thing that policy makers, point of care health workers, the patients, families, DR Congo society generally need at this point when the country is ravaged by apparently the most serious outbreak of this deadly disease - Ebola Virus Disease.

The health system like in most other LMICs was already weak before this latest epidemic started, meaning that most of The WHO Pillars of a strong health system were hardly functioning optimally: Governance, infrastructure, utilities,human resource, financing, research for development, communication / ICT, etc.

If poor personnel protection (physical and otherwise) is leading to '˜patient-to-patient' spread or '˜patient-to-staff' spread whether within facilities or outside in the community, that is no reason to stop encouraging patients (suspected or confirmed) to report promptly to health facilities.

The solution to such spread is to quickly train, equip and motivate staff to abide strictly to internationally proven infection control practices. Quickly engage the communities from their leaders (Traditional, religious, political, business- formal and informal, schools/colleges/universities, market women, etc) to ordinary citizens and other stakeholders local and international on the evidence and knowledge about Ebola and about infection control.

Emergency funding will be necessary and possible, from local and outside sources, because no country is safe until this Ebola epidemic in DR Congo is stemmed.

This quick and urgent approach was how Nigeria, the most populated country in Africa dealt with the Ebola epidemic in 2014. I recall that there was emergency release of N1.9 Billion or so, from the Federal Government outside the normal health budget to implement the immediate and drastic steps mentioned above.

The citizens of DR Congo must be encouraged to report to health facilities without delay if they suspect they or their kit and kin have Ebola infection. To do otherwise is to worsen an already fatal epidemic.

The messaging must be clear, unambiguous, evidence based and enforced.

Joseph Ana

HIFA profile: Joseph Ana is the Lead Consultant and Trainer at the Africa Centre for Clinical Governance Research and Patient Safety in Calabar, Nigeria. In 2015 he won the NMA Award of Excellence for establishing 12-Pillar Clinical Governance, Quality and Safety initiative in Nigeria. He has been the pioneer Chairman of the Nigerian Medical Association (NMA) National Committee on Clinical Governance and Research since 2012. He is also Chairman of the Quality & Performance subcommittee of the Technical Working Group for the implementation of the Nigeria Health Act. He is a pioneer Trustee-Director of the NMF (Nigerian Medical Forum) which took the BMJ to West Africa in 1995. He is particularly interested in strengthening health systems for quality and safety in LMICs. He has written Five books on the 12-Pillar Clinical Governance for LMICs, including a TOOLS for Implementation. He established the Department of Clinical Governance, Servicom & e-health in the Cross River State Ministry of Health, Nigeria in 2007. Website: Joseph is a member of the HIFA Steering Group:

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