Care Differs for American and African With Ebola

NEW YORK TIMES  by Sheri Fink, MD                                                           March 17, 2015
    
The latest American aid worker to contract Ebola overseas, last week in Sierra Leone, was swiftly evacuated to a specialized treatment center for infected health workers run by the British Defense Ministry in the country’s capital, Freetown, then on to the National Institutes of Health clinical center in Bethesda, Md. Doctors at the center said Monday that his condition had worsened from serious to critical since his arrival on Friday.
Doctors wore protective suits last month in Mateneh, Sierra Leone.  Credit Bryan Denton for The New York Times

For a Sierra Leonean colleague who developed Ebola within days of the American, the course of care has been markedly different. The health officer, identified by his caregivers only by his first name, Usman, was first sent to a local treatment unit where roughly 50 percent of all Ebola patients die. He was told there was “no room” at the specialized British unit.

Public health officials said 11 of the American’s colleagues who might have had exposure to the virus, but had not tested positive for Ebola, were taken to that British unit before being transported to the United States, where the majority of the few patients treated for Ebola have survived. The last three of them arrived Monday for monitoring in proximity to medical centers prepared to care for Ebola patients, with the costs of private transportation borne by the charity they worked for, Partners in Health.

Before falling ill, both the American and Usman, an employee of the Sierra Leone government, worked at an Ebola treatment unit supported by Partners in Health. The group has distinguished itself by promoting the principle articulated by its co-founder Dr. Paul Farmer that people in poor countries deserve the same high standard of medical care as those in wealthy nations.

The paths taken by the Americans and their Sierra Leonean colleague have raised questions about whether the charity has been acting in concert with its stated values.

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http://www.nytimes.com/2015/03/17/world/africa/hospital-says-american-clinician-being-treated-for-ebola-is-worsening.html