BBC: DR Congo gunmen say health workers 'brought Ebola' (7) Transmission of Ebola within the health system (3)

3 May, 2019

[Note from HIFA moderator (NPW): This message was originally sent on 1 May but appears to have been overlooked during handover between moderators. Apologies for the delay in processing.]

Thanks to Garance Upham (on HIFA and in her blog for providing one of the missing links in the discussion of why people do not trust health workers. If most of Ebola transmission occurs within the health system, in hospitals and care centres, then it is not surprising that people tend to stay away from them in affected regions - nor is it surprising that the level of trust in the health workers themselves sharply declines.

Taking a step back, all this stems from another missing link - the poor transmission of knowledge within the health system. Health workers should know safe case management principles. While it is true that, givn the present state of knowledge about Ebola, a substantial proportion of people suffering from the virus will die, irrespective of what a care centre does, nevertheless there should be zero transmissison within the centre. Healthy people should not go to hospital and catch Ebola there.

And yet this is what seems to be happening in DRC (and, no doubt, elsewhere). There is an urgent need for a knowledge-based effort to educate healthcare workers in the safe teatment and management of Ebola, and particularly in the avoidance of its further transmission.

WHO has a Pocket guide: Clinical management of patients with viral haemorrhagic fever

This seems to be a comprehensive guide, with over 200 pages, 33 tables, 10 Annexes and 95 references. It comprises five chapters, the fifth of which is "Infection prevention and control". The book is wonderful - but is it appropriate for field use? Surely what is needed are short illustrated manuals for wide circulation and practical application? Such booklets are not shown on the WHO Ebola website. Has someone developed them, and translated them into all the reslevant local languages?

If not, I would be glad to volunteer assistance for such an adaptation project, and I'm sure others on HIFA would do the same.



Chris Zielinski

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Research publications:

HIFA profile: Chris Zielinski: As a Visiting Fellow in the Centre for Global Health, Chris leads the Partnerships in Health Information (Phi) programme at the University of Winchester. Formerly an NGO, Phi supports knowledge development and brokers healthcare information exchanges of all kinds. Chris has held senior positions in publishing and knowledge management with WHO in Brazzaville, Geneva, Cairo and New Delhi, with FAO in Rome, ILO in Geneva, and UNIDO in Vienna. Chris also spent three years in London as Chief Executive of the Authors Licensing and Collecting Society. He was the founder of the ExtraMED project (Third World biomedical journals on CD-ROM), and managed the Gates Foundation-supported Health Information Resource Centres project. He served on WHO’s Ethical Review Committee, and was an originator of the African Health Observatory. Chris has been a director of the World Association of Medical Editors, UK Copyright Licensing Agency, Educational Recording Agency, and International Association of Audiovisual Writers and Directors. He has served on the boards of several NGOs and ethics groupings (information and computer ethics and bioethics). UK-based, he is also building houses in Zambia. chris AT

His publications are at and and his blogs are and