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Ebola epidemic in Africa: Cuban medical experience in this international health emergency (VIII)
Epidemia de ébola en África: experiencia médica cubana en esta emergencia sanitaria internacional (VIII)
Rafael Rufino Corona Pérez
Universidad de Ciencias Médicas de Villa Clara. Cuba.
ABSTRACT
The mission of the medical brigade belonging to the "Henry Reeve "International Contingent Specialized in Situations of Disasters and Serious Epidemics, which worked in Sierra Leone, ended on April 1, 2015, with its objectives fulfilled. 1589 patients were treated and 619 confirmed with Ebola (38.9 %), the death rate was reduced from 92 % to 43.3 % and 351 lives were saved from November 5, 2014 to March 10, 2015. they worked 377 days in all, with 6024 hours of stay in the Ebola Treatment Center and 2217 hours wearing the personal protection equipment. Its members received national and international recognition and numerous distinctions that endorsed the performance of such a successful mission.
MeSH: hemorrhagic fever, ebola, disaster sanitation, disaster emergencias, international assistance in disaster, education, medical.
RESUMEN
La misión de la brigada médica perteneciente al Contingente Internacional Especializado en Situaciones de Desastres y Graves Epidemias "Henry Reeve", que laboró en Sierra Leona, terminó el 1ro de abril de 2015, con sus objetivos cumplidos. Fueron atendidos 1589 pacientes y confirmados 619 con el ébola (38,9 %), se disminuyó el índice de mortalidad de 92 % a 43,3 % y se salvaron 351 vidas entre el 5 de noviembre de 2014 y el 10 de marzo de 2015. En total se trabajaron 377 días, con 6024 horas de estancia en el Centro de Tratamiento del Ébola y 2217 horas vistiendo el equipo de protección individual. Sus integrantes recibieron reconocimientos nacionales e internacionales y numerosas distinciones que avalaron el desempeño de tan exitosa encomienda.
DeSC: enfermedad por el virus de ébola, saneamiento en desastres, emergencias en desastres, asistencia internacional en desastres, educación médica.
Editorial Note
From volume 9, No. 2 on, EDUMECENTRO journal published a group of articles under the title: Epidemic of Ebola in Africa: Cuban medical experience in this international health emergency, authored by Dr. Rafael Rufino Corona Perez, member of the "Henry Reeve" International Specialized Contingent in Disaster Situations and Severe Epidemics and professor of Villa Clara University of Medical Sciences, who wrote his experiences as vivid testimony of what happened in those months, where the intellect, perseverance, courage and struggle for life prevailed facing the health disaster and were proclaimed victorious. In these research papers was respected the writing in first person by the psychological implication of the facts that were narrated in the personality of the mentioned doctor. This is the last of the eight research papers that were agreed on these historical events.
Nota editorial
A partir del volumen 9, No. 2 de 2017, la revista EDUMECENTRO publicó un grupo de artículos bajo el título: Epidemia de ébola en África: experiencia médica cubana en esta emergencia sanitaria internacional, cuyo autor principal es el Dr. Rafael Rufino Corona Pérez, integrante del Contingente Internacional Especializado en Situaciones de Desastres y Graves Epidemias "Henry Reeve" y profesor de la Universidad de Ciencias Médicas de Villa Clara, quien redactó sus experiencias como testimonios vívidos de lo acontecido en esos meses, donde el intelecto, la perseverancia, la valentía y la lucha por la vida se impusieron ante el desastre sanitario y se proclamaron victoriosos. En estas comunicaciones se respetó la redacción en primera persona por la implicación psicológica de los hechos que se narraron en la personalidad del mencionado doctor. Esta es la última de las ocho previstas sobre estas históricas vivencias.
Mission accomplished
The Henry Reeve brigade to face Ebola in Sierra Leone was integrated by 165 collaborators: 101 nurses, 62 doctors, an economist and a logistics. The management was integrated by the boss, the second boss, 2 logistics and an economic one.
The cohesion achieved allowed for objective analysis in the board of directors meetings, which facilitated the taking of timely decisions for the best performance. All the necessary information and communications were available, both with the dispersed and crowded brigade in Sierra Leone, and with the management center in Cuba.
The permanent search for information, the political evaluation, the systematic ideological work, the incorporation of the Charge d'Affaires together with the decisive management of the heads of hotels and the high moral of the collaborators, allowed to reach the excellent achievements: 1589 patients were attended and 619 confirmed with Ebola (38.9 %), the death rate was reduced from 92 % to 43.3 % and 351 lives were saved, from November 5, 2014 to March 10, 2015. they worked 377 days in all, with 6024 hours of stay in the Ebola Treatment Center (ETC) and 2217 hours wearing the personal protection equipment.
The brigade left Sierra Leone when adequate control of the disease was achieved and professionals from different countries, especially Africans, were recruited, stimulated by the Cuban experience, as they referred; new ETCs were created by the international institutions participating in the Ebola confrontation. At the beginning, the capacity to diagnose it was minimal, but it was increased until reaching the network of 12 specialized laboratories. The most active were those of Bo, Port Loko and Makeni.
The brigade left Sierra Leone in two parts. The first group was formed by 98 collaborators who served in Port Loko and Kerry Town; they departed on March 20, 2015, after completing 12 days quarantine; and on April 1, the rest. Each group was recognized and dismissed by the highest representations of the UN, WHO and the Cuban Health Ministry (CHM) in solemn acts held in the places of residence.
In the report No.189 to the management position of the (CHM) on Monday, March 30, the farewell ceremony of the last 64 employees at the Hotel Mariam was summarized. The meeting was chaired by the Cuban Ambassador, Jorge Lefebre, Deputy Minister of Health and Health Sierra Leone, Yadeu Siwi and Dr. Anshu Banerjee, representative of WHO. We were accompanied by many WHO staff, Susanne Kristensen, coordinator of the European voluntary operational organization International Humanitarian Partnership (IHP) who played a key role in transportation, car rental, WHO document preparation, course coordination, care and the assembly of the protection aids for the isolation of Ebola suspects.1 Andy Mason, representative of the British foundation Save the Children International, the director of the Italian humanitarian organization Emergency, and other representatives also accompanied us.
The national anthems of Sierra Leone and Cuba started the event: a collage of photos about the collaboration was presented and certificates issued by WHO and Health Ministry were delivered; Dr. Banerjee stressed that Cuba was the first country to respond to WHO's call with a large number of collaborators, and thanked for the work done; In the same way, the representative of the Health Ministry praised this work and insisted on the response of Cuba as a faithful friend of the people of Sierra Leone; Ambassador Lefebre concluded by thanking the Government of Sierra Leone and the WHO for the opportunity to work in that brother country in the fight against Ebola and expressed that the medical collaboration would continue unchanged.
The arrival to Cuba was through Varadero and the 21 day quarantine, we met it in Jagüey Grande with a careful attention of the (CHM). Figure 1 shows the joy of the collaborators for the duty fulfilled and the presence of the (CHM). Minister.
The visit of Minister Roberto Morales Ojeda was encouraging, experiences and opinions were shared in an atmosphere of true revolutionary conviction, in which there was no lack of commitment to face future missions regardless the risks.
In each province and work centers of the brigade members acts were held to receive and recognize them, as shown in figures 2 and 3. In Villa Clara, its newspaper Vanguardia published an article on April 22 about their arrival, which may be read at: http://www.vanguardia.cu/villa-clara/3585-other-grupo-de-villaclarenos-que-enfrentaron-el-ebola-ya-esta-en-casa; They were stimulated with the Seal "From the daily combat to secure victory" in the Comandante Ernesto Che Guevara Sculptural Complex where, according to Dr. Corona Pérez, they took to the Heroic Guerrilla the happy fulfillment of the task and the commitment to continue until victory forever. In the Provincial Party Committee were received by its first secretary, government and health officials, family, friends, and a representation of the people.
One of the greatest recognitions was expressed by comrade Fidel Castro Ruz on October 4, 2014, according to the Granma newspaper:
"(...) The sending of the first medical brigade to Sierra Leone, indicated as one of the points of greatest presence of the cruel Ebola epidemic, is an example of which a country can be proud of, because it is not possible to reach at this moment a seat of greater honor and glory, if no one had the slightest doubt that hundreds of thousands of combatants who went to Angola and other countries in Africa or America, gave humanity an example that can never be erased from human history; no doubts that the heroic action of the army of white coats will occupy a very high place of honor in that history"
The American weekly issue Time Magazine declared on Wednesday, December 10, 2014, "Person of the Year" the fighters against the Ebola epidemic, with epicenter in West African countries (Guinea, Liberia and Sierra Leone).
The annual conference of Norwegian trade unionists, meeting in Trondheim, unanimously approved the nomination of the International Peace Prize for the Henry Reeve Physicians Specialists in Disaster Situations and Serious Epidemics as candidates for the 2015 Peace Prize as published by the Internet Press Agency@granma.cu on February 3, 2015.
On July 9, 2015, 248 brigadistas were decorated with the "Carlos J. Finlay" Order of Scientific Merit granted by the Council of State of the Republic of Cuba. They were received postmortem by the four deceased: two in Africa and two in Cuba.
The letter from President Raúl Castro read at the award ceremony was also a high recognition:
"(...) After having fulfilled the honorable mission that took them to West Africa six months ago, even at the risk of their own lives, to fight the outbreak of Ebola that was hitting that continent, they returned to the Homeland that received them with the greatest pride".
This brigade was decorated with the Medal for the 60th Anniversary of the Revolutionary Armed Forces of the Republic of Cuba, in January 2017.
The "Henry Reeve" International Contingent of Physicians Specialized in the Disaster Response and Serious Epidemics and in particular the brigade that faced Ebola was recognized with the World Health Prize in Memory of Dr. Lee Jong-Wook, unanimously granted by the 140th Meeting of the WHO Executive Board, in May 2017.
The mission was fulfilled surpassing expectations, because as soldiers of a heroic people we assume the responsibility of the Homeland, and although many consider us heroes, we say that because they are sons of the Cuban people who do deserve that condition historically, because their roots grow with the values forged in the struggle and in the foundational values, such as dignity, humanism, intransigence and intolerance before all kinds of foreign domination and revolutionary internationalism. Enough reasons and it is clear that the world can count on the revolutionary Cuba of Martí, Fidel, Che, Raúl, the Cuban Five Heroes and others who anonymously sacrifice themselves and offer everything for a better world.
The decisive participation of Cuban professionals in the world campaign against Ebola means a revolutionary contribution to universal history, the history of Cuba, and in particular, in the history of Cuban medicine. The lived experiences deserve to be included in the study programs of the medical sciences and in other related disciplines and to continue the scientific researches that cover the wide spectrum of their emergence and development continues to be a serious problem of global health.
Declaration of interests
The author declares no conflict of interest
BIBLIOGRAPHIC REFERENCE
1. Corona Pérez RR. Epidemia de ébola en África: experiencia médica cubana en esta emergencia sanitaria internacional (III). EDUMECENTRO [Internet]. 2017 [citado 20 Jun 2017];9(4):[aprox. 6 p.]. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S2077-28742017000200016&lng=es
Submitted: November 22 2018.
Accepted: December 4 2018.
Rafael Rufino Corona Pérez. Villa Clara University of Medical Sciences de. Cuba. E-mail: rafaelcorona@infomed.sld.cu
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