The world is facing one of the deadliest viruses in its modern history as Ebola outbreak has been set heavily in West Africa (countries affected are Guinea, Liberia, Nigeria and Sierra Leone). It’s a viral hemorrhagic fever which is transmitted by exchanging bodily fluids (Blood, cough, sputum, saliva etc) from the infected patients.
According to WHO Ebola Response Roadmap Update, 8399 confirmed, probable, and suspected cases of Ebola have been reported and 4033 deaths have occurred up to the end of 8 October 2014. Due to its high fatality rate (from 50% up to 90%) and unavailability of specific treatment and/or vaccine, the World Health Organization (WHO) has already declared it as “International Public Health Emergency of International Concern- PHEIC.”
What will happen if this deadly virus affect Bangladesh? Is Bangladesh health system ready to tackle Ebola with its current manpower and infrastructure?
- WHO held an emergency committee meeting regarding Ebola on 8 August and there they categorized countries into 3 levels according to the intensity of Ebola outbreak. Bangladesh had been put to “least threatened countries” category.
- Ministry of Health and Family Welfare (MoHFW) has started a 90 days surveillance starting from August 11. Special medical teams have been placed in 25 entry points e.g. Hazrat Shah Jalal International Airport, Chittagong sea port, Khulna sea port and other land entry points. Travelers are screened for Ebola symptoms if they travel from affected countries and/or someone reports symptoms similar to Ebola virus disease. No such case has been detected yet.
- Interestingly, there is no direct flight from Ebola affected countries to Bangladesh. Even if any traveler travels from those countries, it’s easy to identify them at the immigration from their nationality, boarding place and airline information.
- One of the potential way of Ebola transmission in Bangladesh is through our UN Peacekeepers working in those countries. “The UN peacekeepers are ordered to keep their movement restricted and 200 protective suits and other equipment have been sent to those troops” said Professor Mahmudur Rahman, Director of Institute of Epidemiology, Disease Control and Research (IEDCR) to the local news correspondents.
- Professor Mahmudur Rahman also added that Bangladesh has recent experiences to tackle Nipah virus and Avian influenza and we can utilize those experiences for tackling Ebola. He confirmed that doctors and nurses are being trained for possible Ebola outbreak.
- An isolation ward of 20 beds has been prepared at Kurmitola General Hospital, Dhaka (a Military-run hospital) and almost all the district hospitals have isolation facility in place.
- Health education about Ebola virus and how to avoid is ongoing in the country. IEDCR website has published a pamphlet in Bangla about all necessary information regarding Ebola, but no information has been found on the MoHFW website. The document can be found at this link: http://www.iedcr.org/images/PDF/Ebola%20Virus%20Disease%20-%20FAQ.pdf
- In general, Bangladesh health system is much more responsive and effective than that of affected African countries. Though there are many shortcomings in primary healthcare delivery system, it is better than many other LMICs.
- Though Bangladesh is considered as one of the least threatened countries for Ebola, it will have a real hard-time to control this infection if somehow it attacks here.
- As our country is more densely populated (around 1000 population per 1 square kilometers) than the affected African countries, the infection can spread more rapidly here. Also the religious (Muslim) rituals of burial of deceased pose big threats to spread the disease if the Ebola infected person is not diagnosed as such.
- One of the most weak points in Bangladesh healthcare system to combat Ebola is its weak infection control system. Most of the public hospitals lack effective infection control system in place and also there is shortage of human resources.
- Ebola patients need critical care management in Intensive Care Unit (ICU). Most of the public ICUs are situated in capital and other cities. They are also less in total number and often occupied heavily. These will make Ebola patient management more difficult if we ever have an outbreak.