Wayne State alumnus Dr. Craig Spencer returned to the School of Medicine to discuss the challenges and controversies of West Africa’s Ebola epidemic on Feb. 17.
In September and October 2014, Spencer, an associate professor of clinical medicine at Columbia University Medical Center, volunteered with Doctors Without Borders and spent six weeks treating Ebola patients in Gueckedou, Guinea. He returned to New York City on Oct. 17, and gained worldwide media attention after he tested positive for Ebola on Oct. 23. Twenty days later he was released from New York City’s Bellevue Hospital after he recovered from the virus.
In his presentation, Spencer took on some of the international and domestic issues related to Ebola. “There is a lot of misinformation that is being spread, which I think has caused problems with stigma and fear,” Spencer said.
He argued that some of the best U.S. academic medical centers and public health schools have made it nearly impossible for U.S. doctors and medical students to volunteer in West Africa to treat Ebola patients. Spencer said these institutions claim that people like himself—“a post-doctoral fellow of international emergency medicine” who completed a residency in medical school—“aren’t mature enough or don’t have enough training.”
“A lot of medical centers say ‘it’s not in our job title, it’s not in our description, it’s not what we do,’” Spencer said. WSU geography student Marion Quemener said she did not understand why academic medical centers made these excuses. “The aim of doctors or new students is to cure people,” Quemener said. “If you look at their description, it says that they’re there to help people who are sick, people who need healing, regardless of race, regardless of ability to pay, regardless of all these issues,” Spencer said.
In West Africa, however, locals without any formal medical education—certainly without medical training—are being taught to treat Ebola patients at Doctors Without Borders clinics. “You’re taking people without a high school education, you’re teaching them through weeks of repetitive training how to put on and take off personal protective equipment and about very basic virus ecology,” Spencer said. He was assigned 30 to 40 Ebola patients a day at the Guinea treatment center, which took in up to 100 patients a day. “We had five doctors when I started, and we had to send two home because they were falling asleep in the middle of rounds,” Spencer continued, “they were working 14 hours a day for six months.”
Spencer questioned the U.S.’s focus on its domestic Ebola response, rather than its international response. “More money has been spent on building bio-containment and isolation facilities at hospitals in New York and all throughout the country than has likely been spent on the treatment of all the patients in West Africa at Doctors Without Borders facilities combined,” Spencer said. Quemener agreed with Spencer’s argument. “All of these facilities at U.S. hospitals are totally useless,” she said. “The U.S. should put this money in West Africa, where the real problem is.” Doctors Without Borders’ 2014 operating budget to treat Ebola in West Africa was somewhere in the $50 to $60 million range. “I’ve heard that all Michigan hospitals have isolation facilities,” Quemener said. “It’s ridiculous.”
Spencer also disagreed with New York and New Jersey governors who supported heightened standards to quarantine all U.S. health care workers returning from West Africa in 2014. “They knew that public health experts would disagree with their decision, but decided they wanted broad, tough policy that would calm people’s fears,” he said.
Matthew Seeger, dean of WSU’s College of Fine, Performing and Communication Arts and co-author of the Center for Disease Control and Prevention’s manual titled “Crisis and Emergency Risk Communication,” agrees Ebola became a very political disease. “All disease and all crises have politics associated with them. It’s always part of the conversation,” Seeger said. “But in this case, we had some politicians who were actively promoting fear of Ebola. And that’s a relatively unique circumstance.”
Seeger explained the difficulties public health professionals face when making policies in the midst of an outbreak. “There are significant challenges involved in helping the public understand risks and how those risks can be effectively managed,” he said. “Part of the problem is that there is a lot of uncertainty with risks.”
Spencer concluded his presentation with remarks about his initial reluctance to volunteer in West Africa and why he overcame them. “People say ‘oh, you’re so brave, you’re so courageous, people like you are heroes,’ and I don’t necessarily think that’s true,” Spencer said. “I just think we have a different set point for what we’re willing to do and what we think is irresponsible not to do.”
|Andrew Awabdeh (left), Nathan Gyani (center) and Hannah Varughese (right) perform in front of|
Yousef B. Ghafari Hall on April 3. The Detroit CRU organization hosted the performance.