2014-11 From the President: What epidemics tell about caregivers

What epidemics tell us about caregivers

Most of us, in an aging population, have faced, are facing, or will face the reality of caregiving. After raising children, we became caregivers of parents, spouses, and other family members. We now are, or soon will be, in need of caregiving for ourselves.

Of particular concern, as I write this, are the caregivers involved in the growing threat of Ebola that is sweeping West African countries of Liberia, Sierra Leone, and Guinea. What we may have thought was far away in another continent has already come to our shores. We have just witnessed the death of a Liberian who flw into Dallas. As many as 40 people in Texas Health Presbyterian Hospital, as well as his family members, were exposed to him, and we read of the infection of a Dallas health worker who cared for him.

Described by some as the next AIDS epidemic, Ebola was fist discovered in 1976 in remote areas of Africa. Deadly as it was, it ran its course, and the very isolation of rural areas helped to end its threat. But now Ebola is in African urban areas, and it travels from house to house and city to city—and from there, continent to continent. In September, the Centers for Disease Control (CDC) estimated that, unless much more is done much more quickly, the toll of the disease in West Africa could strike as many as 1.4 million by January.

At particular risk are the family members of the infected, who are the fist line of caregivers. They, in turn, are infected, and many of them die from the disease. Next are the local health workers who are exposed to the sick as they treat them, but often without adequate training and equipment. According to the October 13 issue of Time magazine: “The disease has taken the lives of 92 local health workers and has caused others to abandon their posts out of fear.”

African treatment centers are overwhelmed. The New York Times for October 11 carries a headline, “Officials Admit a ‘Defeat’ by Ebola in Sierra Leone—Tell Families To Care For Victims at Home because Clinics Cannot Keep Up.” Dr. Peter Kilmarx, the leader of the federal Centers for Disease Control and Prevention team in Sierra Leone agreed that “the risks of dying from the disease and passing it to loved ones at home were serious under the new policy. ‘You push some Tylenol to them, and back away,’” Dr. Kilmarx said, describing [the policy’s] obvious limits.

As Ebola is spreading exponentially, calls for international help have gone out for workers, equipment, and medicines. The U.s. is sending 3,000 troops to build 17 100-bed treatment centers. Doctors without Borders has been eagerly searching for help and has opened treatment centers in Liberia, Guinea, and Sierra Leone but, as yet, the response has not kept close to the need.

Uho are these caregivers? Susan Donaldson James, in an NBC report, characterized them as religious, selflss, and heroic. Her report features Dr. Kent Brantly and Ms. Nancy Writebol, Christian missionaries and the fist Americans to contract Ebola. James quotes Dr. William Schaffner, an infectious disease specialist at Vanderbilt Medical Center, who says of Brantly and Writebol:

“Their mission is deep and strong. It is humbling: many medical volunteers who put their lives in danger to help others go overseas because of a deep religious commitment and wish to express their faith.”

Of course, not all of today’s volunteers are motivated by religious faith. Dr. Schaffner describes them: “They have a sense of service. Kind of like grown-up boy scouts.”

James also quotes Dr. Arthur Caplan, director of Medical Ethics at NYU’s Langone Medical Center (and formerly at U of M Medical School), who says of caregivers: “You see people who want to help those who are desperately in need and the challenges are fiable. And there are those with a social justice calling. Whatever their motivation, they really do care.”

Though Caplan’s words are referring to Ebola workers, these motivations are present to some extent in every caregiver—from parents who care for their children, to children who take responsibility for failing parents, to nurses and doctors, priests, and laypeople. They bless us, and we thank them.

— Hal Miller, UMRA President miller@umn.edu