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Vol. 79/No. 7      March 2, 2015

(feature article)
Cuba pledges fight to the end
against Ebola in West Africa

“First of all, we volunteer. Each person has to make that decision,” said Félix Báez, recalling how he became one of the 256 Cuban medical personnel helping to fight Ebola in Sierra Leone, Guinea and Liberia, and the first and only one to become infected with the virus himself. He was interviewed by MEDICC Review in their January issue. “When I read about Ebola, I decided to sign up because it seemed help was needed right away,” he said. The World Health Organization, which sponsors Cuban doctors fighting Ebola, sent Báez to Geneva University Hospital in Switzerland for treatment. “I was totally isolated, wrapped up in what looked like a space suit covered with cellophane,” Báez said. He was met in Geneva by Jorge Pérez, director of Cuba’s Pedro Kourí Tropical Medicine Institute, which organizes training the Cuban volunteers.

“They treated Félix with enormous affection,” Pérez told MEDICC Review. “Once he was on the mend, his sense of humor — that Cuban sense of humor — also came back. … He told me ‘I’m going to be okay, and I’m going back to Sierra Leone,’” Pérez said. “Those were his first words to me.”

MEDICC Review is published by Medical Education Cooperation with Cuba, which works to develop coordination between health workers in Cuba, the U.S. and elsewhere in the world.

“Although we’ve gone over and over it, we still don’t know how I was infected,” Báez said, noting they carefully follow rigorous protocols to prevent getting sick. “But of course, we didn’t live in a bubble; we lived in a hotel, we ate food there, mingled to some extent with others outside the hospital setting.”

“They have to find a vein [to put in IV fluids], examine patients, touch patients, help them to the bathroom,” Pérez added.

The largest contingent of Cuban health workers, 165, are posted at four clinics spread throughout Sierra Leone.

“The first cases I saw were critical, people who had sought treatment very late. My first three patients died,” Báez said. “Then there was a little four-year-old girl, who came in with no pulse, very sick with malaria. We were able to save her. And then a brother and a sister, Cecilia and Daniel, in their 30s. Both had Ebola.”

“Once I got sick, I was in the room across from them, and we’d shout to each other across the hall,” he said. “Thankfully, both of them recovered, too.”

“Without proper conditions, fatalities run from 50 percent to 90 percent. We’ve now reduced them to about 20 percent where the Cubans are working in teams with others,” Pérez said.

“Ebola brings into terrible relief the difference between robust health systems and ones that are struggling without resources,” he said. “We see only incipient health systems throughout Africa, with the exception of South Africa.”

“The problem of Ebola will only be resolved in communities themselves,” Pérez said, noting it is a social not just a medical question. It requires “education, local health workers in direct contact with people who live there. So they can recognize the symptoms, know what to do early, learn how to bury their dead in a safer way.”

Pérez’s institute is sharing Cuba’s experience in fighting Ebola with other Latin American countries. All Cuban health workers are quarantined for Ebola’s 21-day incubation period when they return. Cuba doesn’t yet have a WHO-certified laboratory for confirming Ebola cases and because of the U.S. embargo has access to only one certified lab, in Winnipeg, Manitoba. “Soon, we hope our lab will also have the requisite conditions for certification,” Pérez said.

The number of new cases across Liberia, Sierra Leone and Guinea has fallen from a peak of more than 1,000 per week in October to less than 125 per week by late January. But new cases have increased for the last two weeks, reaching 144 in the week ending Feb. 8.

Speaking of his case, “I think it helped make more people aware that Cubans and others were risking their own lives to save African lives,” Báez said.

“I said to myself: human life began in Africa. Will it end there, because people are abandoned?” Báez said. “I decided to go back because people need us, our whole team.”

“And besides,” he said, “my dad always told me never to be a quitter.”

The Cuban government and leaders of the volunteer brigades have pledged they will remain in West Africa until the epidemic is wiped out.

This is in sharp contrast to the U.S. government, the richest in the world, which sent 3,000 soldiers to build 17 Ebola treatment units in Liberia, but completed just 10. By the time the first clinic opened in November new cases in Liberia had already declined and U.S.-built facilities stand nearly empty. Several haven’t seen a single Ebola patient.

“If they had been built when we needed them, it wouldn’t have been too much,” Moses Massaquoi, who heads Liberia’s Ebola case management, told Stars and Stripes. “But they were too late.”

Half of the U.S. troops have already been pulled out and most of the rest will leave by March, reported USA Today.

Two Cuban volunteers contracted malaria and died. Jorge Juan Guerra Rodríguez died Oct. 26 in Guinea, and Reinaldo Villafranca died Jan. 18 in Sierra Leone.

“Today, Jan. 19, 2015, we discharged eight patients who had been infected with Ebola,” reported Cuban volunteers in Guinea after Villafranca died. That is “the best homage we can pay to a brother fallen while carrying out his duty.”
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