Unprepared for Ebola

Use fear of it to boost public healthcare

With the global death toll from Ebola crossing 4,000, it has become vitally important for India to be adequately prepared to deal with it. This is because, according to the World Health Organization, as many as 50 per cent of cases have turned fatal. The disease is now endemic in three West African countries. Two cases have been detected in the United States and Spain. No cases have been detected in India so far, but it is important to ensure that an afflicted person does not get into the country and move around freely unknowingly. But India's preparedness on this score is inadequate. Screening facilities, introduced at a couple of major international airports and a few other entry points, are not enough. Reflecting the government's lack of preparedness, the ministry of external affairs has already postponed the India-Africa Forum Summit that New Delhi was to host on December 4. Until now no advisories have been issued by the Union health ministry and so, with the exception of a few leading hospitals, the healthcare system in the country neither knows what to be alert against nor how to deal with a person who could be afflicted. The most vulnerable are healthcare workers, and so they must know what to guard against and what to do in case of need. Preventing entry and isolating a victim are vital, as there is no cure or vaccine for Ebola. What is more, private diagnostic centres cannot detect it; only two leading government health institutions can.

The risk around Ebola is high because initial symptoms such as fever fatigue, muscle pain, headache and sore throat are no different from those for malaria and typhoid fever, which are widely prevalent in the country. Early symptomatic care and rehydration are the only weapons available to fight it. It is important to remember that human-to-human transmission takes place through body fluids and infected bedding. Public awareness going beyond healthcare workers is critical, as at the end of the day, it is the community as a whole that has to shoulder the responsibility of tackling the disease. The strategies to be adopted are case management, contact tracing, taking the help of a good laboratory service (India does not have one), and when it comes to the worst, safe disposal of the dead.

Britain has just launched a national exercise to test preparedness, in which actors pretending to have the symptoms have turned up before emergency services providers to find out if they react the right way. For India, such fears of an epidemic offers an opportunity. It can be used to create a sense of urgency to give a boost to public health services, which are woefully inadequate.