Much of the talk recently has been about how American doctors and nurses who volunteered to treat Ebola patients in West Africa should themselves be treated when they arrive back home.
But they are not the only U.S. workers and volunteers serving in Liberia, Sierra Leone and Guinea, the three countries ravaged by the epidemic. About 30 U.S.-based charities and service organizations are responding to a range of needs in West Africa, including helping to safely bury the victims of Ebola, building badly needed clinics and educating people about ways to halt the virus’ spread.
Leaders of those organizations say their efforts will continue, regardless of whether their workers and volunteers come home to quarantines and a fearful U.S. populace that views them as a threat. But the recent debates triggered by the decisions of New Jersey, New York and other states to issue their own quarantine rules for those returning from West Africa have added new challenges to the goal of getting more Americans to help fight an epidemic that has overwhelmed the fragmented health systems in the three impoverished nations.
“We’ve heard from members this week that some people who were about to deploy to the region pulled back,” said Julien Schopp, director of humanitarian practice for InterAction, a Washington-based umbrella group of international aid organizations.
West African Medical Missions, a small non-profit that brings in American health professionals to help educate and improve the health system in Sierra Leone, had seven of eight prospective volunteers drop out last week, said co-founder Gabriel Warren. Those would-be volunteers were turned off by some of the vitriol in the debate over quarantines, and some were threatened with losing their jobs at home if they signed onto one of the group’s weeks-long volunteer stints, Warren said.
“The impact has been really horrible,” Warren said Saturday in a Skype call from Sierra Leone. “Once a lot of those statements were made, people just pulled out.”
A variety of charities serving in a number of support roles have been closely following the events of this past week — as New York responded with alarm to its first Ebola case and Governor Christie verbally warred with President Obama and a nurse returning from the region over New Jersey’s three-day quarantine of her after she landed at Newark Liberty Airport.
The debates that have played out as nurse Kaci Hickox challenged her forced isolation in a Newark hospital, and then efforts to quarantine her in her home in Maine, have revealed how little agreement there is among U.S. authorities on the steps needed to contain the spread of the deadly virus.
The Obama administration and prominent organizations like Doctors Without Borders have criticized the 21-day quarantines that New Jersey and other states intend to impose on anyone exposed to Ebola in Africa, whether or not they have symptoms. Those critics say it will deter health and aid workers from volunteering at a time when their service is desperately needed.
But others in the medical community seem more open to such quarantines, even though the leading science indicates that an individual is contagious only when showing symptoms.
The Medical Society of New Jersey on Friday called decisions on quarantine “the province of state public health authorities.” And an online survey of 3,500 nurses by allnurses.com, a social network site that has 4 million visitors each month, found that more than 80 percent agreed that health care workers who treat Ebola patients should agree to be quarantined until the virus’ incubation period is over.
But even the medical groups that support quarantines express the same concerns as others about the need to compensate health care workers for any lost time from work and for the public to treat their sacrifice with the same respect given to a military reservist dispatched in a time of crisis.
“That’s certainly something we would support at the medical society,” said Larry Downs, the chief executive officer of the group, when asked about a new policy in New York to give returning medical workers the same job and lost income protections military reservists get. “Doctors regularly and without fanfare assist patients in other countries. We have a cadre of doctors here in New Jersey that do that. It would be reassuring to make sure they had the same protections in place.”
In many cases, medical personnel and aid workers are less worried about the time they might spend in quarantine than they are about the treatment from the public and their employers when they get home, several organization leaders said.
“People who go there do it out of a sense of service, and then they fear they will end up stigmatized,” said Schopp, of InterAction. “It’s hard for them psychologically to think that they might be treated as a pariah for that.”
Beyond those morale-affecting concerns are some pragmatic questions that have yet to be fully answered as fears of Ebola spreading in the United States mount, and employers and insurance companies grapple with the potential financial impact, Schopp said.
If states enforce 21-day quarantines, who will pay a volunteer’s lost salary while he or she stays home from work?
And as the fears and costs of treating the disease grow, some non-profits are finding that they are unable to buy emergency evacuation insurance policies that don’t have provisions excluding Ebola cases, or that some health policies are now excluding the disease from coverage, Schopp said.
“It puts organizations in a bit of a bind,” Schopp said. “One thing an organization wants to know is that, if we put people in these roles, we can take care of them if they do get sick.”
The U.S. government may need to be lobbied to in some way guarantee such protections for those who agree to serve in the region, he said.
In the meantime, many charities — particularly smaller ones — will have to figure out how to keep their missions flourishing while travel to the region becomes more fraught with risks and challenges.
One New Jersey-based charity — Morethanme.org — used to run a school in Liberia that it has turned into the headquarters for an Ebola awareness coalition. The founder, 32-year-old Katie Meyler of Bernardsville, is in Liberia helping coordinate a program to train teams of community members to blanket neighborhoods in Monrovia with information about stemming the spread of the disease. She was supposed to return home to New Jersey in December.
Instead Meyler will stay in Liberia indefinitely, not wanting to risk being sidelined by a potential quarantine, said Emily Bell, a spokeswoman for the organization. Another New Jersey charity that aims to rebuild 40 clinics destroyed by war in Sierra Leone has canceled a planned visit by two of its workers this month, for fear of missing the holidays with their families if they were ordered into isolation upon their return.
“Our travel right now has been put on hold,” said Benjamin Parra, executive director of Healy International Relief Foundation, who was supposed to attend a conference in Ghana, then visit the site of a clinic in Sierra Leone that the organization is trying to open by this spring.
The foundation, based in Lumberton, canceled even the Ghana portion of the trip, not wanting to face any stigma from simply having traveled to any part of Africa. Ghana has no cases of Ebola. “Right now the way the perception in some people’s minds is that it’s all of West Africa that is affected by Ebola,” Parra said.
The prospect of facing bias upon return just adds another layer of risk and worry to those who consider serving in developing nations, where there is always a greater risk of contracting disease, getting into accidents on substandard roads, being sickened by poor sanitation, and, in some places, getting caught up in an outburst of civil unrest, points out Dr. Ziad Sifri, a surgeon at Rutgers New Jersey Medical School.
Sifri is president of the International Surgical Health Initiative, an organization that has arranged for surgical teams to go into rural impoverished regions in several underdeveloped countries, including Sierra Leone. The organization had a mission to Ghana in August, and two volunteers dropped out at the last minute because their families grew concerned about the Ebola epidemic reaching into that country, Sifri said. “The people who are going on these types of missions are risking their lives and need to be treated with the utmost respect when they return. What they are doing is honorable.”
Sifri, however, expects that the antipathy that some who volunteered to fight the Ebola epidemic say they are experiencing will fade away soon enough.
“It’s not surprising to see such strong reaction from the public when there is a new fear like this,” said Sifri, who said the growing anxiety was reminiscent of some of the misconceptions held about the AIDS epidemic in the 1980s. “Eventually we’ll come to a more realistic and scientific response to this.”
Staff Writer Lindy Washburn contributed to this article. Email: diskin@northjersey.com
http://www.northjersey.com/news/ebola-fears-complicate-efforts-by-new-jersey-based-volunteers-1.1125019?page=all
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