History of Ebola and Nursing
Submitted by Dr. Chinazo Echezona-Johnson, RNC-MNN, LLB, MSN, PCC
Chinazo Echezona-Johnson, Ed.D, LL.B, MSN, RNC-MNN is the Assistant Director of Nursing/Women and Children Nursing Education at the Metropolitan Hospital Center.
Many healthcare providers and the public are paying very special attention to the outbreak of the Ebola Virus in West Africa and the subsequent infection of the two critical care nurses at Texas. Many healthcare professionals expressed their confusion about the virus and the seeming stigmatization of nurses. Currently with the outbreak in Texas, nurses and other healthcare providers were encountered the same dilemmas as Central Africa nurses years ago.
Ebola and African Nurses
When the Ebola Hemorrhagic fever outbreak happened in Central Africa in 1995, 2000 and 2003, initially there were limited information about the virus. Many people made assumptions based on fears and ignorance. Many accusations and anger tend to be directed to the victims and the direct caretakers. Culturally, the Africans perceived the disease as sorcery and disease from the gods (Hewlett, & Hewlett, 2005). They instituted cultural measures such as using the medicine man to burn away the disease; and social isolation of people and villages with the disease. Unfortunately, many people still died from the outbreaks (Guimard, Bwaka, Colebunders, Calain, Massamba, De Roo, ... & Kipasa, 1999).
Due to the political economy of the African countries, there were a lack of protective equipment and medical resources for the healthcare workers. Healthcare providers could not help many of the people who became sick. Healthcare workers also became victims and vectors of the virus. Many nurses succumbed to the illness. There was a high rate of nosocomial infections. As a result, the nurses were stigmatized by their communities, families and even other healthcare providers. Since people were not sure how about the transmission of the virus, many accusations and blame were directed to the nurses because the nurses were the people who were treating the infected patients. Many nurses lost their families, their friends and even their lives. Many healthcare providers were physically, psychologically and emotionally attacked and killed (Hewlett, & Hewlett, 2005; ).
However, many nurses continued to care for the Ebola infected patients. The nurses endured limited education, poor pay, lack of support from the community and political arenas about the virus, and limited provision of infection control barriers such as adequate PPEs, soap and running water. Nonetheless, many nurses, health-care professionals and patients continue to survive the virus against all odds (De Roo, Ado, Rose, Guimard, Fonck, & Colebunders, 1998).
Nursing and healthcare education should be modified to include the interventions for the management of biological infectious outbreaks. Healthcare education should include the new Centers of Disease guidelines about the correct way of removing protective equipment after caring for Ebola. Nursing training, education and competency should include learning about management of possibilities of future outbreaks. Nurses at all levels, need to get more involved in the enactment of federal, state and local governmental policies and laws that govern healthcare.
There are still so many things to learn about the Ebola virus. What is the vector or reservoir of the virus? What is the source of infection? What are the modes of transmission? Are there any cure/treatment? What is the history, the pathogenesis and virology of the Ebola virus? (Peters & LeDue, 1999, p. ix). Apparently, after the societal reaction to the Texan Nurses’ contraction of Ebola, it is apparent that the society has a lot to learn about the Nursing profession in this country.
De Roo, A., Ado, B., Rose, B., Guimard, Y., Fonck, K., & Colebunders, R. (1998). Survey among survivors of the 1995 Ebola epidemic in Kikwit, Democratic Republic of Congo: their feelings and experiences. Tropical Medicine & International Health, 3(11), 883-885.
Guimard, Y., Bwaka, M. A., Colebunders, R., Calain, P., Massamba, M., De Roo, A., ... & Kipasa, M. A. (1999). Organization of patient care during the Ebola hemorrhagic fever epidemic in Kikwit, Democratic Republic of the Congo, 1995. Journal of Infectious Diseases, 179(Supplement 1), S268-S273.
Hewlett, B. L., & Hewlett, B. S. (2005). Providing care and facing death: nursing during Ebola outbreaks in central Africa. Journal of Transcultural Nursing, 16(4), 289-297.
Peters, C.J, LeDuc, J.W. (1999). An introduction to Ebola: The virus and the disease. Journal of Infectious Diseases, 179 (1999), pp. ix–xvi
Tomori, O., Bertolli, J., Rollin, P. E., Fleerackers, Y., Guimard, Y., De Roo, A., ... & Ksiazek, T. G. (1999). Serologic survey among hospital and health center workers during the Ebola hemorrhagic fever outbreak in Kikwit, Democratic Republic of the Congo, 1995. Journal of Infectious Diseases, 179(Supplement 1), S98-S101.