The federal government and the states are still figuring out just what they should do with health workers who return from treating Ebola patients in West Africa.
And while that question is part logistics and part politics, there is a pretty big human resources question in there, too. How do groups like Doctors Without Borders recruit healthcare workers who are urgently needed to contain the outbreak?
“From the beginning of the outbreak until now, it’s been difficult to find people who have the experience, the willingness and the flexibility. It’s not an easy ask,” says United Nations spokesperson Nyka Alexander.
The U.S. and Britain both plan to build Ebola treatment centers in West Africa. Countries and individuals like Paul Allen along with Mark Zuckerberg and his wife Priscilla Chan and Bill and Melinda Gates are pledging millions in aid. And Cuba, China and Ethiopia are among the other nations who are sending teams to West Africa.
But still the World Health Organization says several hundred more foreign medical workers are needed. Guinea, with the highest proportion of doctors among the three affected West African nations, has just 10 physicians per 100,000 people, compared to 240 in the United States.
Everyone agrees the way to keep the American public safe is to beat this virus over there. But no one agrees who should travel across the Atlantic to fight it. Most healthcare workers in the U.S aren’t going. Some may worry about getting sick, or wonder whether they have the right skills or think they’ll be treated like a pariah when they come back.
Those like Johns Hopkins bioethicist Zackary Berger are sympathetic to the cause. But he questions how much value he would bring, compared to the risks involved.
“I have obligations to my patients. I have obligations to my family. I think I would do most good here,” Berger says.
Berger, who is also an epidemiologist, is more qualified than the average healthcare worker to volunteer. Intellectually he gets it; if not him, then whom?
Boston University’s Dr. Nahid Bhadelia understands convincing people to do something like this is tricky. Her approach is simple. She tells stories about her 12 days in Sierra Leone, including one about an old man who was so ill he could barely speak.
“I went back in to see if there was somebody to help me move him,” she recalls. “And the minute I walked into the ward, this mother walked up to me with her six month old and said, this baby is not feeling well can you help me. And by the time I was done taking care of the child, the old man was already dead.”
Bhadelia believes these anecdotes wash away over-dramatized images of people with “blood pouring out of every orifice,” and instead capture the daunting reality on the front lines. More than the fear of contacting Ebola, which she experienced, Bhadelia remembers the feeling of helplessness.
When Bhadelia urges people to volunteer, which she does every chance she gets, she doesn’t talk about “boots on the ground.” Instead, she talks about hands – the lack of hands to help.
That message came through to Dr. Berger at Hopkins. After I mentioned the anecdote about the old man, Dr. Berger said, “it’s stories like that that make people shift how they see their obligations,” he says, suggesting that he might like to get in touch with Bhadelia.
Bhadelia says perhaps what health workers fear the most about volunteering in Guinea or Liberia is the unknown, whether they really could help stop the spread of Ebola.
She says when she goes around trying to recruit people to join the fight she reminds people that the survival rate is over 50 percent if you catch the virus in time.
You just need enough hands to do it.