Those curious what fighting Ebola in West Africa would look like need wonder no longer.
In an email to a business development listserv, an agency called Canyon Concepts Services, Inc (CCSi) outlined the U.S.’s plans for Liberian intervention in a roadmap aimed at recruiting medical personnel.
The mission calls for 34 teams of approximately 24 people who will be compensated with net salaries ranging from $8-10K. Excluding a few unlisted technical roles, the team calls for: one medical coordinator, one infection-control doctor, four physicians, four chief nurses, eight nurses, and one social worker.
Each 21-week rotation begins with a two-week training session before a six-week rotation in the Ebola Treatment Units (ETU's). Following one week of “R&R,” the team will spend one more six-week rotation in the ETU before entering a three-week isolation. The tentative location of the quarantine (which is “still to be defined”) is Casablanca. Beyond medical board or nursing association certification, candidates must have a valid passport and yellow fever vaccination.
Specific job descriptions imply a meticulous attention to detail will be necessary in the mission. The sole medical coordinator of each team will be responsible for the “overall coordination of medical operations at ETU” as well as “planning, medical supplies supervision, and safety.” An infection specialist will “establish, advise, and supervise on strict application of EBOLA safety and infection prevention measures at ETU.” Four physicians will be in charge of managing “triage procedures” and supervising patient care.
Four chief nurses will be asked to “assist with staff health status monitoring, staff risk exposure in community, and coordinate in-patient wards nursing,” while eight standard nurses will watch over triage procedures and manage patient care. The social worker will “assist staff and public with counseling and psychosocial support and communications.”
On top of the $8-10K salary, visa and transit costs will be covered. The benefits also consist of “insurance death/disability cover” for $250,000 and a medical aid plan through British based medical aid (BUPA). Liberian taxes will be initially be deducted, but “MAY be comp'd” considering the “high priority International situation.”
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With the World Health Organization reporting more than 7,000 Ebola cases and 3,338 deaths, the implications of offering medical support grow heavier each day. According to new data from the Centers for Disease Control and Prevention (CDC) released Tuesday, so does the urgency.
The paper, published as a part of the CDC’s Morbidity and Mortality Weekly report, assesses the health care infrastructure of four Liberian counties battling Ebola over the course of nine days in August. The sobering report provides a forbidding look at the feeble defense system in place—and adds weight to CCSi’s call for personnel.
Just six physicians were serving all four of the focus counties in Liberia before the outbreak. By the time of the study in early August, just three remained—the rest having fled the country. The nurses too, the authors found, were few and far between at the health centers. “In two of four hospitals assessed, nursing staff members were not coming to work or had abandoned facilities,” the paper reads. “In another hospital, health care providers had not been paid for three months but were still providing basic care.”
On top of staff deficiencies, the CDC found the health centers operating without even basic of medical supplies. “Nonsterile gloves and sterile obstetric and surgical gloves were depleted or absent in all four counties,” the report reads. “Supplies of soap, bleach, or alcohol-based hand gel also were depleted.”
With Ebola only transferable through human contact, the ability to sanitize hands is a key necessity—yet hand-washing stations were reportedly “rarely” available. Those that were, most often consisted simply of water jugs. Some facilities had begun erecting “bamboo hand washing stations” at the entrance to hospitals, but not enough.
The isolation wards, too, were classified as “rudimentary” lacking water, electricity, and waste disposal facilities. Internet availability was “intermittent” and other forms of communication scarce. In all, the counties had one referral hospital each (approximately 100-150 beds) and 17-24 health centers.
The report says that interventions since August have led to “improvements in the level of Ebola preparedness,” but suggests that more actions are required to bolster this support.
For medical personnel who find these conditions deplorable enough to offer their own support, there is finally a clear option of what can be done. The question about medical intervention now no longer revolves around what the U.S. will be doing—but who will be brave enough to do it.
Editor's Note: An earlier version of this article incorrectly cited the source of the listings as the Creative Computing Solutions, Inc., (CCSi). The correct entity is Canyon Concepts Services, Inc.
