Indiana medical experts say it's unlikely the United States will experience an Ebola epidemic, despite three cases confirmed in the country over the past month.
But that doesn't mean Americans shouldn't be concerned.
Two Indiana University doctors were in Liberia earlier this year as the outbreak started. They saw firsthand how deadly the disease can be.
Absence Of Resources Fuels Epidemic
Adama Dabo doesn't have much spare time.
The Indiana University student is constantly studying for her public health administration and African studies degrees.
She came to Indiana about four years ago, inspired by her family.
"My mom and my older brother work at a hospital," Dabo said.
They're doctors in her native country of Guinea, where the Centers for Disease Control and Prevention says more than 1,000 cases of Ebola have been reported. The medical professionals tasked with treating the disease run a high risk of contracting it themselves.
"They are a little bit worried about the risk of contamination because some of their colleagues got the disease," Dabo said. "Some died and others survived. Where they are working right now, that environment is a little bit risky."
Their line of work is especially risky in West Africa.
Indiana University hosted a forum focusing on the outbreak in Liberia earlier this week, where the CDC reports more than 4,000 cases of Ebola.
Since the Second Liberian Civil War ended in 2003, there's been a severe shortage of medical professionals and supplies. The situation's only become worse since the Ebola outbreak started earlier this year.
"The health system collapsed because healthcare workers didn't have any protective equipment," said Charles Reafsnyder, retired associate vice president for IU's International Affairs program. "In the very beginning, a fair number of them contracted and died from Ebola. And, the rest of the health workers there got the message, 'gee we don't have anything to protect us from getting Ebola, I'm not going into work.'"
Reafsnyder said Liberia has far fewer doctors per capita than the World Health Organization recommends.
He died shortly after we realized he probably did have Ebola.
-Dr. Josh Mugele
The co-directors of IU's Disaster Medicine Fellowship saw firsthand what impact that shortage is having on the treatment of patients. They were in Liberia in May, helping the staff at JFK Hospital identify their vulnerabilities and determine how to respond in the event of a crisis.
While they were there, the first case of Ebola came into the hospital.
"This patient ended up being in the hospital for six hours and, subsequently, he died shortly after we realized he probably did have Ebola and tried to move him to isolation," said Dr. Josh Mugele. "Subsequently, three of the doctors who handled that patient ended up contracting Ebola from that patient and only one of those doctors survived."
Mugele and the rest of the team tried to restrict access to the hospital and track down all of the people the infected man came into contact with during his six hours at the hospital.
But that proved to be difficult.
"We had a couple of janitors who were helping move the body and we couldn't even get their names," Mugele said. "So, we could not effectively trace who those people were, whether they ended up becoming symptomatic and needed to get treatment later on down the road."
Ebola's Crippling Impact On West Africa
The quickly-spreading disease is already causing massive social consequences in countries throughout West Africa.
Access to food is becoming a challenge in Liberia, where Priest says large quarantines are in place.
"In one case, an entire neighborhood was quarantined," he said. "That had severe and immediate ramifications for the ability to eat."
Not being able to eat has a direct impact on the body's ability to fight infection. Priest said the United Nations and the Liberian government launched an assessment to officially categorize the food stability situation in the country.
The Ebola outbreak is also halting some of Liberia's most meaningful traditions.
Funerals are one of the most important events in Liberian culture. As part of the ceremony, women wash the body of the deceased. Medical professionals believe that practice contributed to the outbreak of the disease, so it's now prohibited.
"Now we have a situation where what is a multi-sensory, multi-channel event can't take place," said Ruth Stone, IU's Laura Bolton professor of folklore and ethnomusicology. "The very thing where people gather, significant people come together and join together is being prohibited."
What The Outbreak Means For The United States
Hospitals in the U.S. are now working to make sure they're adequately prepared to treat Ebola.
In some cases, that means training staff on proper protocols and reviewing quarantine procedures.
Three cases of the disease have been confirmed in the country. A man traveling from West Africa to Dallas died at Texas Presbyterian Hospital earlier this month, but not before infecting two hospital workers who were treating him.
While the incident is cause for concern, Assistant Dean for Operations and Community Partnerships at the Indiana University School of Nursing Chad Priest said there's no reason to panic.
"We will not have a large outbreak of Ebola in the United States," he said. "But, we will have a large outbreak of something, we will have another serious epidemic in the United States."
Mugele said there are other, more pertinent threats people should be worried about.
"We need to be concerned about Influenza that happens every year, we need to be concerned about Measles that's making a comeback, we need to be concerned about Enterovirus, which is affecting our kids in the Midwest. So, I think there's other things that will probably have a bigger impact in the U.S. But, it's certainly understandable that people are afraid of Ebola."
Our ability to stop Ebola in the United States is directly related to our ability to stop Ebola in Africa."
-Chad Priest, RN
While Ebola may not pose a large threat to the United States, Mugele and Priest said countries have a responsibility to step in and help stop the outbreak in Africa.
"Our ability to stop Ebola in the United States is directly related to our ability to stop Ebola in Africa," Priest said. "And, that's going to be the same for the next pandemic Influenza, where ever it emerges. We're just going to have to get more comfortable as a nation going overseas and viewing that help to those place as more than just a charity, but really part of our survival."
