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Mon Oct 13, 2014, 02:40 PM

Pregnant women in Liberia becoming victims of the ebola outbreak

I found a couple articles talking about the problems pregnant women, and people with other non-ebola health issues, are having in Liberia. They help explain how awful things are.

If you can't prove you don't have ebola, you are not admitted to a hospital, if you can find one open, and if they have an open bed. If you can't prove you do have ebola, you are not admitted to an ebola ward.

If you are having pregnancy/birth complications, more common if you have not had prenatal care which is getting more and more difficult to find, you give birth in unsanitary unsafe places unattended by medical people. Or you die. Or both.

http://www.huffingtonpost.com/2014/09/30/ebola-outbreak-pregnant-women_n_5901816.html
How Pregnant Women Are Becoming Victims Of The Ebola Outbreak

In an effort to keep the virus contained, Fatumata Fofana was denied access to a hospital in July because she didn't have Ebola.

Amid being transferred to two different clinics, the pregnant Liberian woman developed medical complications while still in labor. Fofana and her baby died.

Unfortunately, Fofana's story is not uncommon in Liberia's capital city of Monrovia. Pregnant women without the virus are suffering the consequences of the region's increasingly detrimental Ebola outbreak, as the nation's overwhelmed health care system continues to buckle, The Washington Post reported. When compared to the summer months of 2013, Liberia experienced a 14 percent drop (52 percent to 38 percent) in infants delivered by a skilled birth attendant, according to the World Health Organization (WHO).

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“If you stub your toe now in Monrovia, you’ll have a hard time getting care, let alone having a heart attack or malaria,” Sheldon Yett, the Liberia representative for UNICEF, told The Washington Post. “It’s a tremendous threat to children and a tremendous threat to families.”....


http://www.washingtonpost.com/world/africa/with-ebola-crippling-the-health-system-liberians-die-of-routine-medical-problems/2014/09/20/727dcfbe-400b-11e4-b03f-de718edeb92f_story.html
With Ebola crippling the health system, Liberians die of routine medical problems

While the terrifying spread of Ebola has captured the world’s attention, it also has produced a lesser-known crisis: the near-collapse of the already fragile health-care system here, a development that may be as dangerous — for now — as the virus for the average Liberian.

Western experts said that people here are dying of preventable or treatable conditions such as malaria, diarrhea, pneumonia and the effects of high blood pressure and diabetes, such as strokes. Where services do exist, Ebola has complicated the effort to provide them by stoking fear among health-care workers, who sometimes turn away sick people or women in labor if they can’t determine whether the patient is infected. And some people, health-care workers said, will not seek care, fearful that they will become infected with Ebola at a clinic or hospital.

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When compared with 2013, the period of May to August 2014 saw a sharp drop in the percentage of infants delivered by a skilled birth attendant (52 percent to 38 percent); the percentage of women who received prenatal care within six weeks of confirming their pregnancies (41 percent to 25 percent) and women who receive treatment for malaria (47.8 percent to 29.4 percent), among other measures.

For a few weeks in August, the government ordered all health facilities nationwide closed because so many nurses were becoming infected with Ebola. “If you broke a leg and you needed surgery, sorry,” said Sister Barbara Brillant, national coordinator of the Liberian Catholic Church’s health council. “If you had appendicitis and needed surgery, sorry. It’s not available.”

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Pregnant women are especially vulnerable in the new environment. While treatment of some kinds of problems can be deferred, the arrival of a child cannot. As a Washington Post photographer watched one day last week, a woman in labor arrived at the JFK Ebola treatment center in a taxi, sent by workers at the hospital’s recently reopened maternity ward because she had no evidence she was free of Ebola. But no one came to the Ebola facility’s gate — and even if someone had, the woman’s chances of gaining entry were next to zero. With no evidence that she had Ebola, the isolation center would not bring her inside among those who have the virus...

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Response to uppityperson (Original post)

Mon Oct 13, 2014, 02:43 PM

1. Good info. I think this explains why Duncan didn't know he had been exposed.

A report from his home in Liberia stated that those who helped the pregnant woman, including Duncan, thought she was suffering complications from pregnancy, and was treated as such when she was taken to the clinic. She wasn't diagnosed with Ebola until after she had passed away, and Duncan was already in Dallas.

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Response to Avalux (Reply #1)

Mon Oct 13, 2014, 02:57 PM

3. Yes, the whole family thought it was acute malaria

Throw in some buggy water and it definitely could have been.

Bush hospitals with one open ward and beds separated by screens have been hard hit since the arrival of ebola into that open ward means no one else can be treated there.

One of the great things Doctors without Borders has been doing is setting up tent hospitals for the ebola cases, giving them shelter without compromising the hospitals. Yes, that's a plug for my favorite charity.

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Response to Warpy (Reply #3)

Mon Oct 13, 2014, 04:44 PM

6. There are lots of people sick with not-ebola. MSF is one of my favorite charities also, always donat

to them.

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Response to Avalux (Reply #1)

Mon Oct 13, 2014, 03:00 PM

4. I was looking for information that might begin to explain what happened with MrDuncan and found a

lot worse than I imagined.

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Response to uppityperson (Original post)

Mon Oct 13, 2014, 02:49 PM

2. Liberia is a bad, bad place to live...

I count my lucky stars that, by complete accident, I was born and live where I do.

Vice did a documentary that was posted at DU a couple years ago. It's long, and horrifying, but worth the watch.




Edit: now, imagine an Ebola outbreak amongst that poverty, chaos and overcrowding.

Sid

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Response to SidDithers (Reply #2)

Mon Oct 13, 2014, 03:02 PM

5. Their civil war was exceptionally vicious

because there were no law and no rules of engagement.

People were just beginning to rebuild their lives when ebola hit.

This video is about a neighboring country, also hard hit, and what some of its poorest people are capable of:



All these lives are precious.

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Response to Warpy (Reply #5)

Tue Oct 14, 2014, 12:26 AM

8. I was going to join the Peace Corps in 80, in Liberia. Friends who went got evacuated due to

the civil war starting. It is a fascinating mixture of a place, modern to very tribal, city to jungle/forest, Africo-American to varied tribal.

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Response to uppityperson (Original post)

Mon Oct 13, 2014, 06:33 PM

7. kick for the afternoon/evening crew as learning about what other countries are like is good

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Response to uppityperson (Reply #7)

Tue Oct 14, 2014, 03:30 AM

11. Thanks for kicking it. I read a similar article the other day...

I can't find it now, but it was about a woman who had complications and gave birth prematurely and died while her parents were driving from place to place trying to get help for her and the baby. They ended up at an ebola centre and because no-one was sure what the mother had died of they wouldn't take the baby and found out they had nothing in place to deal with suspected cases of ebola in newborns. So they sent the baby home with her grandparents and she died a few days later, probably because a really premmy baby doesn't stand much of a chance without medical treatment. It's a really sad situation and I hope that foreign assistance is extending to setting up at least a few medical centres for people who don't have ebola...

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Response to Violet_Crumble (Reply #11)

Tue Oct 14, 2014, 04:13 AM

12. I'm hoping the same, since troops are building treatment ctrs, normal health-care...

seems to be desperately needed also. Surely someone in charge will recognize the lack of care for non-Ebola people.

I read that same heartbreaking article:

Heart-Rending Test in Ebola Zone: A Baby

http://www.nytimes.com/2014/10/10/world/africa/heart-rending-test-in-ebola-zone-a-baby.html?_r=0

SUAKOKO, Liberia — Peering inside a red Nissan hatchback that had pulled up to the gate of an Ebola treatment center here, a guard saw an older woman holding a tiny newborn, a young woman sprawled in the back seat and a man in his 60s crouched in the rear, gripping her clothing so she did not slide off.

The woman, the couple told aid workers who quickly gathered Saturday afternoon, was their daughter. She had been sick for a week and was bleeding profusely after giving birth prematurely about two hours before. Her boyfriend, the baby’s father, had recently been treated for Ebola, they added.

Workers asked the couple to wait outside the gate, where a masked man with a chlorine sprayer soaked the ground around them. Before sending the car to the triage area, a doctor opened a back door and saw no movement. Realizing he needed protective gear, he went to suit up, then examined the woman and pronounced her dead.

For her child, there were no clear protocols. No one touched the tiny girl, aside from the grandparents holding her. No one at the center had any experience in dealing with babies in the Ebola crisis, nor could they fully evaluate the dangers. They were caregivers, after all, at a place of last resort. In a country devastated by a terrible disease, where the fear of it is pervasive, what do you do with a vulnerable infant?

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Response to countryjake (Reply #12)

Tue Oct 14, 2014, 08:03 AM

13. That's the article. Thanks for posting it...

I've been reading a lot of truly heartbreaking stuff happening in that part of the world, but that article stuck with me...

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Response to Violet_Crumble (Reply #11)

Tue Oct 14, 2014, 11:22 AM

14. Exactly.Having birth complications, go to hospital where you aren't admitted as you can't prove

you don't have ebola, so drive to place that cares for ebola and too late or they won't admit you before you prove you have ebola so go home and doe there or just die.

And, if you ended up having ebola, maybe you were never diagnosed and exposed others caring for you, driving you around and off it goes again.

There are not enough facilities, even tent hospital beds, for those with ebola, much less those without. And ebola free places really don't want to take any suspected people, only if you can prove you don't have it.

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Response to uppityperson (Original post)

Tue Oct 14, 2014, 01:42 AM

9. I can't even imagine what any kind of health care that's not Ebola

would be like trying to get. Everywhere is so overwhelmed with Ebola patients with so few hospitals and clinics as it is it's got to be just impossible to get care for anything.

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Response to uppityperson (Original post)

Tue Oct 14, 2014, 03:22 AM

10. Thanks for this thoughtful post

The ripples spreading out from this are creating multiple dangers.

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