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"When I got to Liberia the situation was really bad, the government couldn't provide basic things like a car to transport dead bodies from the communities. It was also difficult to investigate and to identify victims of Ebola because communities were retaliating. They were frustrated because they didn't know what was killing their people and the government was not doing anything to help," said Dr. Medina-Marino.
Dr. Median-Marino is the head of research unit and a senior technical advisor, disease surveillance and laboratory systems at Foundation for Professional Development. He is also a trained infectious disease outbreak investigator; he was asked by Doctors without Borders to go to Liberia to investigate the Ebola outbreak. While in Liberia he specifically worked to support disease surveillance, case investigations and contact tracing activities, as well as supporting epidemiologic data flow from the two Ebola Treatment Units in Liberia.
"Ebola is a disease that has no vaccine and no drugs to treat it and that is why it is so scary. As an analogy, South Africa has a similar bacteria called Drug-Resistant Tuberculosis (XDR TB) which has no vaccine and no drugs meaning that the person who is exposed to these viruses can't be given an anti-biotic or anti-viral to treat the disease. A study has been realised about the outbreak of the disease and in that study it is indicated that a 2 year old boy who contracted the disease infected his mother because she was taking care of him, the mother infected her sisters because they had to take care of her so that is how it started to spread throughout the community," said Dr. Medina-Marino.
Ebola can be contracted through direct contact with:
1.Bodily fluids of a person who is infected with or has died from Ebola. (blood, vomit, urine, poop, sweat, semen, spit, other fluids)
2. Objects contaminated with the virus (needles, medical equipment)
3. Infected animals (by contact with blood or fluids or infected meat)
Ebola can't be cured by medication. Patients are treated by being given IV fluids, keeping their blood volume equal, giving them pain medication and making sure that they are getting enough nutrients so that they can be able to survive long enough to recover. Doctors can only manage the pains and symptoms but they can't kill off the virus, a person's immune system has to kill the virus if it doesn't kill them first. People die because they start bleeding out, their organs shut down and they become dehydrated; and towards the end it gets very painful, their blood volume drops so much that their heart just gives up.
"Ebola destroys human organs. We know that it causes a person's blood vessels to be more permeable and that is when they start bleeding. It also attacks the liver and that is where blood clotting proteins is produced so by killing a lot of a person's liver cells, it is also killing the production of proteins that stops them from bleeding. The immune system produces cytokines proteins to help people to kill viruses but what happens with Ebola is that the immune system releases too much cytokines proteins at once that attacks the body system. This also causes a cytokines storm which causes the patient to go into shock," shared Dr. Median-Marino.
There is not much that the Liberian government can do currently to ease the increasing cases of Ebola except to identify people who have been infected and place them in isolation so that they can be treated. The least that the state can do for the families of those infected and survivors is to give them new beds and bedding because everything that belonged to the victim has to be burnt. "When I left Liberia the situation was still the same, my colleagues from Doctors without Borders confirmed that the virus continued to spread and claimed more lives. Once the government or international partners such as Doctors without Borders, World Health Organisation or Centres for Disease Control put systems in place, it can take at least another 3 months to bring down the number of the people infected and to get things under control. Dr. Medina-Marino hopes to return to West Africa in December to continue supporting outbreak response efforts.
