Training in Liberia. Photo by P. Desloovere, courtesy of WHO
Only people who have been sick with Ebola virus disease and recovered from this traumatic experience can explain what it was like and what their needs were during the illness. That is why a group of six Ebola survivors were asked to play a critical role in a new training program for healthcare workers on Ebola care, which was established by the World Health Organization (WHO) in consultation with the Ministry of Health and with support from USAID.
The work with the Ebola survivors takes place in a specially constructed mock Ebola treatment unit where trainees simulate the work they will do with patients who are actually ill with the disease. Before proceeding to this step, they complete a course on clinical management and water and sanitation.
With the number of people infected with Ebola escalating at an alarming rate in Liberia, the Ministry of Health, WHO and other partners are racing to train a sufficient number of health workers to care for Ebola patients while avoiding the risk of becoming infected themselves.
“We realized that we need a new training program that will be able to prepare 400 healthcare workers over the coming weeks to be rapidly deployed into the new and existing Ebola treatment units,” explains Dr. Abdikamal Alisalad, training coordinator for the WHO. “This first training course is planned to be replicated in future in other training centres in different parts of the country.”
The first group of healthcare workers began the course, which is designed for 50 participants, in early October. Participants are being selected by the Ministry of Health, and many healtcare workers have volunteered to be considered.
The training courses run on a rolling schedule. During the second week of the training program (following the exercises in the mock treatment unit), participants are deployed to functioning Ebola treatment units in Monrovia where they work under supervision of qualified medical personnel. At the end of the second week, they receive a certificate qualifying them for employment in Ebola treatment units.
While the group starts their mentored work the second week, a new group of 50 trainees begins the course. The best-performing candidates from each group will be asked to serve as facilitators in future sessions.
Healthcare workers have been among the people at highest risk of getting infected with Ebola since the beginning of the current outbreak. In Liberia, 184 healthcare workers across the country were infected and more than half of them died.
At the same time, a number of health centers have closed because of fears – in the community and among healthcare workers – that they were hot zones for infection spread. For many healthcare workers, enrolling in the Ebola training program is an opportunity to work again and to be trained to protect themselves.
“In our hospital we did not work much with infectious diseases. We did not know how to use protective equipment. The last few months we worked in fear and, after two of our colleagues got infected, the hospital closed. Both patients and health workers are scared,” explains Zainab Sirleaf, a nurse at the Seventh Day Adventist Hospital and participant in the WHO Ebola training program. “This training will teach me how to help my people and at the same time I will better understand what Ebola is and how I can protect myself while caring for others” she says.
In Monrovia, five Ebola treatment units, including the Island Clinic unit – which opened in late September with support from WHO – are now operating. Liberia’s Ministry of Health is planning to open two more units in Monrovia, and the United States has committed to building another 17 units across the country.
This increased capacity requires a substantial number of doctors, nurses, support staff and cleaners fully trained in Ebola treatment, infection prevention and control and water and sanitation issues. For a 35-bed unit, about 24 healthcare workers are needed per shift, including doctors, nurses, cleaners and other support staff.