Dr Holly Gettings / Consultant, Emergency Medicine
In a follow-up to our Ebola Q&A, Dr Holly Gettings gives us the lowdown on the UK volunteer response and how to get involved. Holly is an Emergency Medicine Consultant at Guy’s and St.Thomas’, London, and has previously deployed with UK-Med in the UK medical team to the Philippines following Typhoon Haiyan. She is now an acting advisor to UK-Med for the selection of medics for the UK Ebola Response Team, and has been busy helping with shortlisting and interviews.
Background
On September 19th the Chief Medical Officer of the Department of Health, together with the Medical Director of NHS England, co-signed a letter in support of NHS staff deploying to Sierra Leone as part of the UK Ebola response. The Department for International Development have been working with the military to build a new facility in Kerry Town to provide beds to initially treat health care workers, and subsequently the local population affected by Ebola. UK-Med is the charity charged with coordinating the recruitment of NHS staff wishing to volunteer, and are working closely with Save the Children to select teams that can be deployed over the next 6 months. It is forming the UK International Emergency Medical Register (UKIEMR), a database of healthcare professionals willing to be involved in volunteering in sudden-onset disasters. Doctors currently employed by the NHS with at least 3 years experience post-graduation and acute care skills are encouraged to apply. Deployments are anticipated to last for 8 weeks (consisting of 4 weeks working in an Ebola treatment centre).
What if I don’t work for the NHS?
If, however, you are not currently employed by the NHS, but would still like to be involved, there are a number of humanitarian organisations sending teams to affected countries. Doctors of the World, Save the Children, Medecins Sans Frontieres, GOAL and the International Medical Corps are the main agencies in-country currently coordinating staff recruitment. See their websites or check out the links at the bottom of this article for information on person specifications, detail of what would be expected of you, length of deployments and recruitment processes. Whichever agency you decide to work with, healthcare workers interested in deploying should be satisfied that they will receive adequate training, well-being support and will be provided with suitable equipment following internationally accepted infection control procedures.
What happens when you return home?
Following recent events in America there is some concern about the precautions needed with returning healthcare workers. Public Health England issued advice on 24th September regarding workers returning to the UK: those who have had direct contact with patients infected with Ebola but with no known breaches in PPE (personal protective equipment) are able to return to their home with ordinary family and social contact. They can also return to work, with some restrictions on clinical duties. They will be asked to check their temperature twice a day for 21 days and contact Public Health if they develop a fever. Workers who think they have been exposed to Ebola with a breach in PPE or direct contact with bodily fluids will be under tighter restrictions. Clearly the situation is constantly evolving and advice may change but up to date information can be found on the Public Health England website.
What happens if a UK healthcare worker is infected?
If a UK humanitarian worker was to become infected “in the field”, their care would initially be coordinated by the humanitarian organisation they were working for. In Sierra Leone it is likely they would be cared for by NHS staff in the new treatment centre for health care workers in Kerry Town. This facility consists of 12 beds and is clinically led by Infectious Disease specialists from the UK. Decisions regarding repatriation to the UK would be made on a case by case basis. So far there has only been one UK healthcare worker infected who was evacuated back to the UK by the military, the day after testing positive. There may be potential for the use of vaccines and novel treatments in British healthcare workers but the development and supply of these drugs are still at an early stage (see our previous article on Ebola).
Any Ebola positive patients in the UK would be taken to the High Level Isolation Unit at the Royal Free Hospital in London. There is a contingency plan for secondary units in Liverpool, Sheffield and Newcastle to receive patients if there was a larger outbreak. Every trust in the UK now has a plan for the possibility of a patient arriving in A&E with suspected Ebola. Frontline NHS staff should be trained to put protective equipment on (and more importantly take it off) without contaminating themselves. Blood samples would be taken and sent to the laboratory in Porton Down, with results taking 8-12 hours to return. If Ebola was diagnosed then the patient would be transferred to Royal Free if not already there.
Interested in learning more or becoming involved?
If you are looking to volunteer, please ensure that you do so through formal, well-established means. Think it through and read up on what will be expected, in order to avoid becoming a hindrance rather than a help. Increasing awareness and fundraising are other incredibly important ways in which to get involved.
Dr Stacey Mearns is a UK doctor working in harrowing conditions in Sierra Leone. To get an insight into the day-to-day work involved in caring for those with or at-risk of Ebola, view her first, second and third video diary installments that she has filmed for the BBC.
The World Health Organisation has up-to-date information on the situation in-country, including situation reports updated every few days. Their current document Ebola virus disease: information for humanitarian aid workers is an excellent initial source of information for people considering volunteering.
Each country will have their own avenues for volunteer potential. Here are some useful links for those both in and outside the UK:
- For NHS staff, UK-Med is coordinating & recruiting staff via the UK-MED register.
- Doctors of the World UK have just received large grant from UK government to set up an Ebola treatment centre in Sierra Leone and are actively recruiting medical and non-medical staff.
- The London School of Hygiene and Tropical Medicine has been heavily involved in the UK response.
- Medecins Sans Frontieres has been heavily involved in volunteer placements, and have an excellent safety record in the field.
- The King’s Sierra Leone Partnership has a comprehensive site, with plenty of information in general, and details on who to contact if you are able to volunteer.
- A non-exhaustive list of other charities who need either direct help or are looking for help with fundraising include Save the Children, GOAL, Disasters Emergency Committee and International Medical Corps.
