United States Ebola death raises questions about quality of care

by Abayomi Azikiwe

There was a sense of shock and disbelief when news was released about the death of Thomas Eric Duncan on Oct. 8 at the Texas Health Presbyterian Hospital in Dallas. The Liberian-born 42-year-old was the first reported case of the Ebola Virus Disease (EVD) which emerged in the U.S. and resulted in death.

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Rev. Jesse Jackson speaks to the media with Nowai Korkoyah, the mother of Ebola victim Thomas Eric Duncan, and his nephew, Joe Weeks, at Texas Health Presbyterian Hospital on Oct. 7, the day before Duncan’s death. – Photo: Joe Raedle, NY Daily News

Reports during the week of Oct. 6 mentioned that Duncan’s medical condition was worsening and that he was “fighting for his life.” The patient was being treated at the same hospital where he was turned away on Sept. 25 after appearing to report symptoms associated with EVD and telling personnel that he had recently traveled from Liberia, located in the epicenter of the current outbreak.

The death of Duncan raises serious questions about the quality of care he was given in Dallas. Why was Duncan not transferred to the facilities at Emory University Hospital or the University of Nebraska Medical Center Bio-containment Unit where other patients had been treated successfully?

Racism and class bias charged

Duncan’s nephew released a statement on Oct. 9 suggesting that there was racial bias in the way in which his relative was treated by the hospital and the entire infectious disease establishment in the U.S. Was this case in Dallas evaluated and addressed as a national issue beyond the press conferences delivered by the Centers for Disease Control and Prevention?

Josephus Weeks said of his uncle’s plight: “Eric Duncan was treated unfairly. Eric walked into the hospital while the other patients were carried in after an 18-hour flight. It is suspicious to us that all the white patients survived and this one Black patient passed away. It took eight days to get him medicine. He didn’t begin treatment in Africa; he began treatment here, but he wasn’t given a chance.”

Weeks was making reference to the so-called alternative drug produced by a Canadian pharmaceutical firm which could be effective against combatting EVD. CDC Director Dr. Thomas Frieden said that the ZMapp drug was no longer available.

Frieden’s press conference on Oct. 6 indicated a hands-off approach to the overall treatment of Duncan. He said that it was up to the hospital physicians and family members to make decisions about his healthcare.

Obviously this first case of EVD diagnosed in the U.S. was not treated as a medical situation requiring national and international attention where the most qualified physicians in the country were mobilized to address Duncan’s condition. What type of preparedness did the Dallas facility have in approaching this case?

Duncan’s nephew released a statement on Oct. 9 suggesting that there was racial bias in the way in which his relative was treated by the hospital and the entire infectious disease establishment in the U.S.

On Oct. 9, CNN quoted Pastor George Mason of Wilshire Baptist Church in Dallas, who asked: “What if they had taken him right away? And what if they had been able to get treatment to him earlier?”

In attempts to contradict the claims of Duncan’s family, the hospital officials asserted that Duncan had received the best of care and that they did consult with specialists at Emory University and the CDC. They noted that it was not clear whether ZMapp and other drugs are really effective in treating the disease.

Other questions were raised over the reported lack of health insurance coverage of Duncan. Did this have an impact on the sense of importance and urgency exercised by the Dallas hospital, the CDC and the Barack Obama administration?

Civil rights leader Rev. Jesse Jackson has surfaced as the spokesman for the family of Duncan saying the deceased man’s health insurance status could very well have been a factor in the medical response. “I would tend to think that those who do not have insurance, those who do not have Medicaid, do not have the same priorities as those who do,” Jackson said, according to CNN.

Nonetheless, the officials at the medical facility denied this allegation, stressing that Duncan was treated on the same level as everyone “regardless of nationality or ability to pay for care,” Texas Health Presbyterian Hospital said in a statement.

EVD outbreak exposes lack of preparedness in the U.S. and internationally

On Oct. 9 several hundred workers at LaGuardia Airport who are responsible for cleaning cabins belonging to Delta Airlines set up a picket line demanding greater precautions related to the potential threat of EVD as well as overall exposure to unsafe and unsanitary conditions on the job. The workers were reported to be seeking recognition through the Service Employees International Union (SEIU) which organizes largely low-wage workers across the U.S.

These workers are employed by Air Serv which is owned by ABM Industries, Inc. They complained about the work load and the lack of training related to exposure to infectious diseases.

Despite statements made by Delta Airlines that they have provided training related to medical safety, Reuters reported on Oct. 9: “The striking Air Serv workers said they have not had adequate training to protect themselves and are not provided with durable gloves or face masks to use when cleaning with strong chemicals. They said in a statement their employer has halved the size of cleanup crews and reduced the time allotted to clean an entire plane to as little as five minutes instead of up to 45 minutes.”

Earlier in the week, National Nurses United (NNU), the largest labor union representing healthcare workers in the U.S., said that there were no official medical protocols for dealing with the Ebola outbreak. Consequently, this lack of readiness can potentially endanger healthcare professionals, patients and the general public.

The Associated Press reported on Oct. 9: “National Nurses United, representing about 185,000 nurses nationwide, has been surveying its union members and found that many don’t feel nurses are getting enough training to properly handle Ebola, union spokesman Charles Idelson said. Many nurses said they didn’t know whether their hospital had protective gear, he said. ‘It’s not enough to post a link to the Centers for Disease Control on the hospital’s website,’ he added.”

Earlier in the week, National Nurses United (NNU), the largest labor union representing healthcare workers in the U.S., said that there were no official medical protocols for dealing with the Ebola outbreak. Consequently, this lack of readiness can potentially endanger healthcare professionals, patients and the general public.

In Spain, 44-year-old nurse Teresa Romero is reported to be the first person outside of Africa to have contracted EVD from a patient. She was one of the people who provided care for a priest who was evacuated from West Africa after being infected and later died in Madrid.

The medical status of Romero deteriorated on Oct. 9 with very few details on her condition being released. Spanish residents are outraged that the nurse came down with the illness in Madrid and some have demanded the resignation of Health Minister Ana Mato.

Reuters reported Oct. 9: “In Madrid, health workers at a major hospital protested about inadequate training to deal with the virus while unions have demanded the resignation of Health Minister Ana Mato. A union official said training for staff to deal with expected Ebola cases was inadequate.”

“In some places they are carrying out drills, in others not; there is a lack of co-ordination,” Rosa Cuadrado a union official told Reuters. “News of the contraction of the Ebola virus in the country has deeply shaken Spaniards’ faith in their government and the health system, which has suffered deep spending cuts as part of austerity measures over the past years.”

Spain has been one of the hardest hit European nations in the overall world economic crisis. Unemployment is over 25 percent and massive cuts in public services have been instituted in order to pay debt service to the international financial institutions.

In both Liberia and Sierra Leone, healthcare workers and grave diggers have engaged in strikes demanding better safety precautions and a living wage. Liberian government officials signed an agreement with the nurses last month and in Sierra Leone similar protests have occurred.

Liberia and Sierra Leone have lost physicians and nurses working on the frontlines in the battle against EVD. At an International Monetary Fund (IMF) and World Bank meeting in Washington, D.C., on Oct. 9, presidents Ellen Johnson-Sirleaf of Liberia, Ernest Karoma of Sierra Leone and Alpha Conde of Guinea pleaded with the Western states to provide additional assistance in the combatting the disease.

Speaking via video conferencing to the meeting, “Karoma said Sierra Leone needed more than 5,000 medical workers, including 750 doctors and 3,000 nurses. The two treatment centers Sierra Leone had now were not enough and it needed 1,500 more beds just for Ebola patients. The four laboratories in the country were able to handle only 100 diagnostic samples a day, he said, and five more were urgently needed,” the Financial Times reported Oct. 9.

Source of world power must change

Even in the U.S., where the corporate media and the federal government promotes the false notion of an economic recovery, large-scale austerity measures have impacted public institutions including healthcare services that are becoming further privatized through the so-called Affordable Healthcare Act (better known as Obamacare). Inside the country there is no guaranteed national health insurance program and consequently millions remain without any coverage or inadequate safeguards.

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Thomas Eric Duncan

Therefore, the system of prioritizing healthcare and human needs must take priority over profits for privatized hospitals, insurance plans and pharmaceutical firms. Western states through the IMF, World Bank and other financial institutions have imposed structural adjustment programs on African states and similar policy designs are being carried out against cities, suburbs and state governments in the U.S.

With these economic programs guiding the policy imperatives of the dominant capitalist and imperialist states around the world, there can be no real fundamental shift in the quality of healthcare and social services in either the developing or developed countries. Only a radical transformation of political power in favor of the majority working class, nationally oppressed and poor can create the conditions for effectively attacking EVD and other infectious diseases throughout the planet.

United States militarizing response to Ebola crisis while Cuba pledges medical assistance

A team of eight experts and journalists visiting the southern region of the West African state of Guinea were found dead in the town of Nzerekore on Sept. 20. Reports indicate that they were there to educate people about the nature of the disease for the purpose of its prevention.

Reports from Guinea say that the delegation had met with elders in the community but were later attacked by youths. Investigations into the details of the killings are ongoing.

There is tremendous mistrust surrounding the spread of the Ebola Virus Disease in some West African states where the epidemic has had an impact. Doctors Without Borders reported in April that their teams were forced to withdraw from Macenta in Guinea after being stoned by youth who said they were there to spread the disease.

Newspaper articles and rumors have circulated that the outbreak is a direct result of biological warfare being waged by imperialist countries against the African continent.

Although no one knows what the motivations were of those who carried out the killings in Guinea, obviously there are many people who mistrust the motivations of foreign aid workers responding to the crisis. Guinea is the first country that was identified in the latest spread of the disease, which has periodically struck in Central and West Africa over the last three decades.

Biological warfare and economic underdevelopment

The most widely discussed and controversial article related to the spread of the Ebola Virus Disease was published by the leading newspaper in Liberia, The Observer. Dr. Cyril Broderick, a former professor of plant pathology at the university there, asserted that the spread of the disease is a direct result of U.S. Department of Defense bio-warfare against Africa.

Broderick’s article, published Sept. 9, stated: “Africa must not relegate the Continent to become the locality for disposal and the deposition of hazardous chemicals, dangerous drugs, and chemical or biological agents of emerging diseases. There is urgent need for affirmative action in protecting the less affluent of poorer countries, especially African citizens, whose countries are not as scientifically and industrially endowed as the United States and most Western countries, sources of most viral or bacterial GMOs that are strategically designed as biological weapons. It is most disturbing that the U.S. government has been operating a viral hemorrhagic fever bioterrorism research laboratory in Sierra Leone.”

This same author goes on to ask: “Are there others? Wherever they exist, it is time to terminate them. If any other sites exist, it is advisable to follow the delayed but essential step: Sierra Leone closed the U.S. bioweapons lab and stopped Tulane University from further testing.”

There is tremendous mistrust surrounding the spread of the Ebola Virus Disease in some West African states where the epidemic has had an impact.

Broderick has been attacked for publishing the article and, according to Health Impact News: “The Western pro-pharma media have chided Dr. Broderick, saying that such an inflammatory piece of writing is ‘irresponsible’ since so many Africans are already distrustful of Western medicine. They see Western medicine as the answer to Africa’s deadly diseases such as Ebola, while Dr. Broderick sees it as the cause. Dr. Broderick states, ‘African people are not ignorant and gullible, as is being implied.’”

Following the publication of this article, President Barack Obama announced on Sept. 16 that the U.S. would deploy 3,000 troops to the affected West African states as a means to combat the disease. Obama said in a press release: “The United States will leverage the unique capabilities of the U.S. military and broader uniformed services to help bring the epidemic under control. These efforts will entail command and control, logistics expertise, training, and engineering support.”

Washington is already heavily involved militarily in Africa. Several thousand Pentagon troops, Central Intelligence Agency (CIA) operatives and State Department functionaries are on the continent as part of the U.S. Africa Command (AFRICOM). This intervention since 2008 has created more instability and underdevelopment in Africa, as represented by the events in Egypt, Mali, Libya, Somalia, South Sudan and Nigeria where the ostensible partnerships aimed at curbing “terrorism” have prompted the intensification of conflict, dislocation and, in the case of the Horn of Africa, famine.

Pentagon and CIA drone operations have carried out numerous targeted assassinations in Somalia. In Mali, a U.S.-trained military officer returned to this former French colony and staged a coup, providing a rationale for internal destabilization as well as an ongoing occupation by Paris.

Cuba offers medical solidarity

Meanwhile the revolutionary nation of Cuba pledged to send medical personnel in the fight against the disease. Cuba has a profound history in providing unconditional solidarity with the African continent.

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According to the Washington Post, in its Oct. 4 story headlined, “In the medical response to Ebola, Cuba is punching far above its weight”: “On Thursday, 165 health professionals from (Cuba) arrived in Freetown, Sierra Leone, to join the fight against Ebola – the largest medical team of any single foreign nation, according to the World Health Organization (WHO). And after being trained to deal with Ebola, a further 296 Cuban doctors and nurses will go to Liberia and Guinea, the other two countries worst hit by the crisis.” Here, Raul Castro is proudly sending off the Cuban doctors as they board the plane for Africa.

In an address on Sept. 18 before the United Nations Security Council emergency session on Ebola reported in Granma Sept. 19, Vice Minister of Foreign Relations Abelardo Moreno told the participants: “Cuba’s response is part of our solidarity with Africa, Asia and Latin America and the Caribbean. Over the last 55 years we have collaborated in more than 158 countries, with the participation of 325,710 health workers; 76,744 collaborators have worked in 39 African countries. Today, in this sector, 4,048 Cubans are serving in 32 African nations, 2,269 of whom are doctors.”

Moreno went on the report: “The medical brigades which will be sent to Africa to fight against Ebola form part of the Henry Reeve International Contingent, created in 2005, composed of doctors specializing in combating disasters and large-scale epidemics. Cuba’s response confirms the values of solidarity which have guided the Cuban Revolution: not to give what we can spare, but to share what we have.”

This approach contrasts sharply with that of the White House and Pentagon. Cuba has built up considerable trust in Africa due to its consistent policy of international solidarity.

The revolutionary nation of Cuba pledged to send medical personnel in the fight against the disease. Cuba has a profound history in providing unconditional solidarity with the African continent.

The Ebola outbreak draws attention to the need for genuine independence and development on the African continent. The training of medical personnel and scientific researchers would contribute immensely to preventing future healthcare crises.

Cuban revolutionary foreign policy provides an example of how underdeveloped states which have a legacy of slavery, colonialism and neo-colonialism can transform through a process of class struggle and self-reliance. Despite over five decades of hostility from the U.S., Cuba has been able to make significant contributions to African liberation whether in the fight against settler-colonialism in Southern Africa in years past or through the contemporary challenges related to the Ebola outbreak, the training of African medical personnel and other healthcare issues.

Abayomi Azikiwe, editor of Pan-African News Wire, can be reached at panafnewswire@gmail.com. Pan-African News Wire, the world’s only international daily pan-African news source, is designed to foster intelligent discussion on the affairs of African people throughout the continent and the world.