David P Southall honorary medical director, Rhona MacDonald honorary executive director
Southall D P, MacDonald R.
Transferring patients with Ebola from west Africa to “isolation hospitals” in well resourced countries for treatment
BMJ 2014; 349 :g6250
doi:10.1136/bmj.g6250
Re: Transferring patients with Ebola from west Africa to “isolation hospitals” in well resourced countries for treatment
I support Prof Southall and Dr MacDonald in their call for a more radical response to the Ebola crisis in West Africa.
The recent escalation in response from the British government is of course welcome, however, the reality is that the Ebola epidemic is completely out of control in Liberia and Sierra Leone. Teams on the ground are overwhelmed and the majority of patients continue to die in their homes or on the streets thereby placing their communities at risk of infection.
The only answer is to remove infected patients rapidly from their communities and focus on appropriate contact tracing and isolation. The number of isolation centres available for this purpose is inadequate and the proposed escalation will both take time to be operational, and is also likely to still fall short of what is necessary.
I believe the idea of rapidly deploying medical ships for this purpose is both sound and realistic.
Options would include the deployment of purpose built navy hospital ships such as the Royal Navy’s RFA Argus or the US navy’s USNS Mercy or Comfort . Alternatively, or indeed in addition, cruise ships could be commandeered and adapted for purpose. There is a precedent for this. During the Falklands war, a cruise ship, The Uganda, was commandeered as a medical ship, its passengers discharged at short notice, and the ship re-fitted ready for purpose in just 3 days.
Not only would the deployment of medical ships enable the rapid escalation of the structural facilities required to control this crisis, but also as Prof Southall and Dr MacDonald state, it would be safer and more acceptable to international medical volunteers.
As a doctor who has worked in Liberia for both MSF and MCAI, I feel compelled to help contain the tragedy that is unfolding in West Africa, but have to balance this desire with the risk to myself and the concerns of my family. The deployment of floating hospitals would potentially provide a more controlled environment that would go some way to alleviating these fears. It would also provide much more effective medical treatment for African patients who are currently dying without proper symptom relief, and at a rate much greater than would be expected should optimal care be given.
Dr Alice Clack - Obstetrician
Competing interests: No competing interests