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As RI preps for Ebola, awareness remains low
The two-story isolation building at Persahabatan Hospital in East Jakarta was packed with visitors on Sunday afternoon
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The two-story isolation building at Persahabatan Hospital in East Jakarta was packed with visitors on Sunday afternoon. But despite the bustle, security remained tight to prevent any unauthorized person from entering.
'Sir, please use your mask before entering [the facility] or get one in the hospital's shop if you don't have one already,' a guard politely informed an authorized visitor.
Away from the hospital's main buildings, the facility has several large rooms to treat tuberculosis patients and a dozen specially designed isolation rooms to handle those suffering from highly infectious viruses such as bird flu and Ebola.
The isolation rooms are equipped with a ventilation system that can generate negative pressure to prevent air contamination. The facility can simultaneously handle up to 12 patients.
'Our bird flu isolation rooms have all met the required standard for handling Ebola patients. We also have the protective equipment needed,' Persahabatan Hospital president director Mohammad Syahril said recently.
After the recent outbreak of Ebola in western Africa, Persahabatan is among 100 hospitals across the archipelago that have been designated with handling the deadly disease, which has killed at least 1,500 people in western Africa since March this year.
With a fatality rate of up to 90 percent, local health authorities have set up comprehensive measures on treating Ebola patients.
Sukara, an attending doctor at the facility, said the hospital had recently briefed its medical staff on handling patients with Ebola and the Middle East respiratory syndrome coronavirus (MERS-CoV).
'The briefing gave us a knowledge refreshment on the diseases,' said Sukara.
The development comes at a time when at least 170,000 Indonesians are flying to Saudi Arabia for a one-month haj pilgrimage. That their return will pose concerns over the possibility they are carrying such viruses.
Earlier this month, the World Health Organization (WHO) declared the outbreak 'a public health emergency of international concern' and recommended all states to take preventive measures, including educating the public about the outbreak, to minimize risks.
The WHO also requires local authorities to intensify surveillance at airports and prepare supporting facilities to detect, investigate and manage Ebola cases.
The director of the Surabaya-based Dr. Soetomo Hospital, Dodo Anondo, said East Java's biggest hospital had a sufficient number of trained medical staff to manage its four bird flu isolation rooms that would be used to treat Ebola patients.
'We have around 20 staff ready to treat patients with highly infectious diseases like Ebola. However, according to our recent experience in handling suspected MERS-CoV patients, 10 personnel was more than enough,' he said.
Among Ebola's symptoms are a sudden fever, intense weakness, muscle pain, headaches and a sore throat.
This is followed by vomiting, diarrhea, the appearance of a rash, impaired kidney and liver functions and, in some cases, both internal and external bleeding.
The disease is highly infectious and can be transmitted through physical contact with body fluids such as blood, saliva, urine, sweat and semen, among others.
To avoid virus transmission, people approaching Ebola patients should at the very least wear gloves, fluid resistant gowns, eye protection and face masks.
Since there is no available cure for Ebola infections, patients require intensive care, like oral rehydration with solutions containing electrolytes or intravenous fluids.
While the facilities to treat Ebola patients are deemed sufficient, the most daunting task health authorities must face is likely to be on the preventive side.
Thermo scan facilities at Soekarno-Hatta International Airport, for example, are not regularly in use for scanning incoming travelers.
University of Indonesia (UI) public health professor Umar Fahmi Achmadi, who served as the Health Ministry's disease control and environmental health director general during the outbreak of severe acute respiratory syndrome (SARS) and bird flu between 1997 and 2005, suggested that the authorities put in place strict prevention procedures.
'Several years ago, for example, there was a foreigner suspected of having bird flu. He refused to be treated at a hospital and instead asked to stay at his boarding house. It turned out that he left the country on the following day's earliest flight,' he said.
Traveler awareness about Ebola symptoms could also be lacking.
'The biggest problem arises when a person carrying the virus shows no symptoms upon entering the country,' said Health Ministry disease control and environmental health acting chief Agus Purwadianto.
'We strongly encourage those suffering from high fever for a quite long period after traveling overseas to immediately visit a hospital and inform physicians of their travel and contact history in detail. This information will be valuable in helping doctors decide follow-up procedures.'
On Monday, the Health Ministry declared that Indonesia remained free of Ebola after the examination of a 32-year-old Ghanian citizen suspected of having a viral disease drew a negative.
Another problem on the prevention side is the absence of community awareness.
Residents in Tanah Abang, Central Jakarta, for example, have not been reached with any campaigns from the local health authorities, despite having the country's largest concentration of Africans.
Health Minister Nafsiah Mboi said on Aug. 13 that the government had alerted its embassies in Saudi Arabia and Africa to be cautious when issuing visas.
Campaigns on best practice when handling suspected Ebola patients may also be lacking.
For example, many health workers in the region and the general public are unaware that they should refrain from touching the suspected patient without using medical gloves, and that they should transport the patient only in a specialized ambulance.
'Such campaigns seem to be lacking. Our past experience shows that some MERS-CoV suspects were transferred to our hospital in regular ambulances instead of a specially-designed ones,' said Dodo Anondo. 'This will increase the possibility of virus transmission from the patient to the driver and accompanying nurses,' he said.
