July 30, 2014 4:12 pm

How Canadian docs are fighting Ebola during the world’s worst outbreak

WATCH ABOVE: The colleague of an American doctor receiving intensive medical treatment in Liberia after he was infected with the deadly Ebola virus said on Sunday he remained “optimistic that he will survive.” Dr. Kent Brantly contracted the disease while treating patients in the West African nation for the charity Samaritan’s Purse.

Two American aid workers are now fighting Ebola, the disease they were treating in West African patients. In Liberia, a well-known doctor died this week while treating it as well.

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A Canadian doctor who just returned from a seven-week stint in Guinea says the virus rattling Guinea, Sierra Leone and Liberia is the globe’s largest Ebola outbreak in history.

In his 12 years with Médecins Sans Frontières, Dr. Marc Forget has been to South Sudan, Haiti, Sri Lanka, and Congo. He’s come across cholera, malaria and typhoid fever.

But this was the Quebec physician’s first encounter with Ebola.

“The magnitude in terms of numbers of patients is already the biggest ever. It’s already the largest in terms of dispersion, too – it touches three countries with so many hot spots,” Forget told Global News.

READ MORE: Why health officials say the Ebola epidemic won’t spread into Canada

It’s the first time in 20 years that the virus has been reported in West Africa. It’s already killed more than 670 people.

Doctors without Borders, Red Cross and Samaritan’s Purse, among other organizations, are still facing an uphill climb in convincing local villages that they’re there for the right reasons.

Some villages threw rocks at aid workers’ vehicles, others shut them out completely. Forget has been told that it’s these NGOs that are bringing in the vicious disease.

“Before you guys came, we didn’t have it so you created this problem,” Forget says he was told.

“It’s hostile…when that happens, it means people don’t want us to be there, they don’t understand what we’re doing and they care for their own family members and they’ll get contaminated in doing that,” he said.

“It’s a war that’s very difficult to win and it’s a war that needs to be won in terms of diplomacy. We need a huge push for health promotion,” Forget explained.

READ MORE: 2 Americans contract Ebola while fighting deadly disease in Liberia

The trouble is, most villages are without television, Internet or phones. Getting the message out takes time, patience and perseverance. When health officials bring in a native speaker, locals are still skeptical.

Earlier this month, Dr. Tim Jagatic – also with the MSF mission – said his team of doctors and nurses had been chased out of villages. Their advice to stay away from deceased victims’ bodies is brushed aside and the survivors they’re curing are stigmatized by their community.

They’re convinced that witchcraft or government conspiracy is at play.

“These types of ideas come forth before basic public health ideas,” Jagatic told Global News.

Ebola haemorrhagic fever (EHF) is marked by the sudden onset of intense weakness, fever, muscle pain, sore throat and headaches.

Victims’ symptoms include diarrhea, vomiting, multi-system organ failure, and internal and external bleeding. In its final stages, some patients bleed from their eyes, nose, ears, mouth or rectum.

READ MORE: What you need to know about Ebola

Ebola isn’t easily transmissible. It spreads from person to person by direct contact with blood, bodily fluids or the corpse of an infected person.

With rigorous safety measures in place, Forget is unsure of what may have happened to the two U.S. health workers who tested positive for the disease.

For starters, the doctors are dressed in heavy, protective gear: scrubs and rubber boots are worn under a full body Tyvek suit (waterproof and used by industrial workers who handle hazardous materials). Two layers of gloves cover the hands, and a Tyvek helmet, hat and goggles worn with a mask to filter air and protect the face. Finally, the doctors wear plastic aprons in case blood or other bodily fluids are splashed on them.

The MSF doctors work in a buddy system at all times. They check to make sure no part of the skin is exposed before heading into clinic.

Clinics are also organized so that suspected, highly probable and confirmed cases are in three different regions. The doctors make their rounds on a route and they can’t backtrack – if they want to get to a certain section, they have to walk the entire circuit.

READ MORE: Calls for testing experimental Ebola vaccine in West Africa intensifies

Because the protective gear is so heavy and they’re working in extreme conditions – think, 35 C – the aid workers can only stay in the clinic for about 1.5 hours at a time. Thermometers worn inside their suits record temperatures as high as 48 to 50 C.

“It’s like wearing your own sauna,” Forget said. But these past few weeks are a distinct reminder to aid workers in West Africa that precautions are necessary.

“It’s a constant concern. We’re always thinking about possible contamination. I was very cautious and vigilance was very high,” Forget said.

He’s pretty sure the fight against the outbreak will continue for months. When asked what MSF and other organizations need to turn the situation around, Forget said it’s more people on the ground.

The aid workers are trying to cover ground with community outreach, education and training local doctors. In one case, his colleague persuaded a village to show the doctors where sick locals were. There might have been 200 people in the village – slowly, the doctors brought patients to treatment. About 50 patients were helped and 26 died.

READ MORE: Doctors Without Borders says Ebola ‘out of control’

Forget isn’t worried about the disease spreading in the same way in Canada.

“Our public health system here, and the type of surveillance we do is so good that I wouldn’t see an epidemic of that magnitude,” Forget said.

“We could have a case but the contact would be traced quickly, people would be isolated and that’s the end of the story,” he said.

“There’s very little likelihood someone will come into contact with a sick person and jettison off somewhere because the people who do come into contact with those infected are family members and health care workers,” Canadian microbiologist and author Jason Tetro told Global News last month. Sick patients, right now, also tend to be in rural areas of Africa where locals aren’t typically hopping onto planes for travel.

Even if a case made its way overseas, Canadian health officials have the safeguards in place to protect the public. Post-SARS, protocol for nurses, doctors and paramedics changed dramatically and surveillance is now in place brokering intelligence on rising diseases that could pose a threat.

READ MORE: SARS 10 years later – how has the health care system changed?

Patients are now screened for a fever, cough or trouble breathing. They’re asked a critical, telling question: have they recently returned from another country? Frontline health care workers assessing them don masks, gowns, gloves and any other equipment that acts as a safeguard.

Hospitals have better ventilation, single rooms, and plexiglass walls act as a barrier between emergency room front desks and sick patients.

carmen.chai@globalnews.ca

© Shaw Media, 2014

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