In spite of government press releases, health workers are worried that four months after Ebola was declared a global threat, the government has yet to prepare hospital and community health workers.
By ANNE MARXZE D. UMIL
MANILA – Health workers from different hospitals and communities stormed the Department of Health office in Manila on Wednesday, Nov. 12, denouncing the inadequate preparations against the threat of Ebola and demanding safety and protection for those tasked to face it.
They said the government’s declaration that the Philippines is ready to combat Ebola, the training held in October, and the full-body hazmat suits shown to the media are all but press releases.
Jossel Ebesate, chairman of the Alliance of Health Workers (AHW) said meticulous preparations such as training on the proper donning and removal of the personal protective equipment is lacking. The hazmat suits in the referral hospitals such as San Lazaro Hospital and the Lung Center of the Philippines are not up to the standards of the World Health Organization (WHO), as well as the facilities where Ebola patients will be confined.
Health workers expressed alarm not only for their safety but also of the general public.
“Health workers are in the front line of handling the possible Ebola patients. If health workers are not equipped by the right personal protective equipment (PPE) against Ebola, then there will be a chance for the disease to be transmitted,” said Ebesate, who is also chief nurse at the Philippine General Hospital.
On Nov. 12, strikes, protests and other actions were held by registered nurses as part of the Global Ebola awareness Day. It was supported by the National Nurses United (NNU) in countries such as the United States, Australia, Canada, Ireland and Spain.
“Nurses are demanding patient safety. They are heroes. Hospitals should be forced to spend the money on patient safety that they spend on public relations,” NNU Executive Director Rose Ann DeMoro said in an article.
Inadequate Personal Protective Equipment
Pol Margallo, a nurse at the San Lazaro Hospital said they have no PPE that is within the standards of the WHO. The hazmat suits that they have in their hospital are thin suits, which water can penetrate and reach the skin. Employees of the Lung Center of the Philippines also complained of the inadequate hazmat suits for the treatment of Ebola patients.
The Ebola virus is transmitted through body fluids, which can be spread by a patient’s cough, sneeze, or vomit and infect those exposed to them. That is why a full body hazmat suit with its own respirator is needed in treating Ebola patients.
During the protest action, acting DOH Chief Janet Garin went out and talked to the protesting health workers. Garin said there are full body hazmat suits as prescribed by the WHO in the DOH headquarters, however, these cannot be distributed to the hospitals yet as there are no confirmed Ebola patients.
Ebesate, however insisted that these should already be made available so health workers can have a comprehensive training on the proper donning and removal of the hazmat suits, which is very important to contain the spread of the virus. At present, no comprehensive training has been held by government for hospital workers.
“There is a suspicion in the US and West Africa that the reason why there is an outbreak of the disease is due to the improper removal of the hazmat suits. Every health worker who treated an Ebola patient should be sprayed with an anti-septic with their hazmat suits on because the hazmat suits carry the virus,” Ebesate told Bulatlat.com in an interview.
That is why, he said, it is important to have a repeated training on how to wear hazmat suits as prescribed by the Center for Disease Control and Prevention (CDC).
“Prior to working with Ebola patients, all healthcare workers involved in the care of Ebola patients must have received repeated training and have demonstrated competency in performing all Ebola-related infection control practices and procedures, and specifically in donning/doffing proper PPE (personal protective equipment),” the CDC said in its website.
“We demand that a full body, impermeable hazmat suit with powered air purifying respirator should be the default personal protective suit to used by all public health personnel in carrying any suspected or confirmed cases of Ebola virus,” Ebesate said.
The laboratories, he added, of the Research Institute for Tropical Medicine (RITM), San Lazaro Hospital as well as private hospitals in the Philippines have biosafety level two capability only. According to www.labmanager.com, a very specialized research laboratory that deals with infectious agents is the biosafety lab. “Biological safety levels are ranked from one to four and are selected based on the agents or organisms on which the research or work is being conducted.”
A biosafety level four facility, according to Ebesate, is needed to deal with the Ebola virus. “Up to now, there is no facility like that in the Philippines.” He also stressed the facility should have a separate entrance and exit for the health workers who would treat an Ebola patient so that the virus would be contained.
He added that isolations rooms are few, there are eight isolation rooms in RITM, in Lung Center there are eight but only six are functioning.
“Up to now there is no re-echoing of the training that was given to selected health personnel last October. Equipments and facilities are inadequate as attested by our health workers on the ground.”
He also pointed out the importance of information dissemination on the dangers of Ebola virus not only to health personnel but most of all to the general public who would be affected by the disease. “A survey showed how the people have little knowledge of the virus, and that shows the ineptness of the DOH on the prevention of the disease.”
No concern for the health workers
Margallo said in San Lazaro Hospital, health workers have initiated their own preparation against Ebola virus.
“As a hospital that specializes in infectious diseases, we have always prepared our staff on how to deal with the disease outbreak. But for the possible Ebola cases in the Philippines, we are still lacking in terms of facilities, most especially of the personal protective equipment,” Margallo told Bulatlat.com in an interview.
Margallo said even though health workers in San Lazaro has no training on how to handle Ebola patients, they have plans on the evacuation of patients although they still have limited resources.
He criticized the DOH for not showing concern over the welfare of health workers whose duty is to take care of patients carrying the deadly disease. “We should also be protected against the virus so that we can also protect our loved ones, families and people we encounter. Instead of getting the virus contained, health workers might become its instrument for spreading.” He said the concerns of the health workers should not be dismissed by the DOH.
“We, the health workers are aghast that up to this time, four months since the WHO declared Ebola as a global threat, and in spite of the boastful declaration by the DOH almost two months ago that we are ‘ready’ to respond to the Ebola threat, concrete preparations are almost absent at the hospital and community levels. Worse, we are completely fooled by DOH in terms of preparations,” Ebesate said.