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Mali sub-Saharan Country Plagued by Ebola Virus, Fruit Bats and Ebola in the Wilds. Chris Morgan Southern New Hampshire University IHP 501: Global Health and Diversity Dr. Carolina Baldwin August,13,2023
Conventional (modern, Western medicine-based) Intervention Vision The use of a new vaccine called rVSVΔG-ZEBOV-GP (ERVEBO) Ebola vaccine (Malenfant, et al., 2022,p. 290) has been introduced and approved by the FDA in 2019. With vaccinating the population that is most at rick of being exposed to EBV. The southern portion of Mali where the rural population is located is the highest risk factor. Many people living in the rural southern portion will be exposed to fruit bats that could be carrying the Ebola Virus. This population needs to be vaccinated against EBV to prevent the spread of the virus. The use of ERVEBO to prevent the spread of EBV in the rural population in Mali is the main purpose of this trip. Between the years of 2012 to 2015 there was a higher spike in the confirmed cases of EBV in the SSA, more confirmed cases have been found during those years then any other country (Akintunde et al., 2021). The larger spike in confirmed cases means that there is a spread of EBV in the area that needs to be quarantined to avoid more spread and contamination. With the ERVEBO “vaccine regimen was shown to be safe and generated both humoral and cellular responses against Ebola virus glycoprotein in most participants (Fausther-Bovendo, Kobinger, 2021, p. 440). There is no need to be afraid if there is going to be health issues with the vaccine. Introducing ERVEBO vaccine into the general population without major side effects is the goal. In trying to introduce the vaccine into the population the goal is to slow the spread of EBV into the rest of the country. Implementation
To have the current standard of care that is needed the team must consist of Nurses, Providers and Interpreter’s. While each team member has a role to play in this trip there must be guidelines that are set. Each team member has to have years of experience. Must be able to work in conditions that are not current in medical standards. While the nurses will be doing more than just administering the vaccines out to patients the nurse’s role is important as they are the first healthcare workers that a patient will see and the last that the patient will interact with. “Nurses are responsible to protect the physical and psychological health of victims/survivors of disasters at each phase of disasters” (Loke, et al., 2021, para. 5). Nurses are the critical players for this trip as many nurses will be needed to support patients and give care to those who do not need serious medical attention. There will be a need to have providers that can treat patients that are infected with EBV. The amount of providers that is needing would be greater than normal, the reason for this would be “at the start of the EVD outbreak, Sierra Leone had only one infectious disease specialist who was trained to manage haemorrhagic fevers, including EVD” (James, et al., 2020, p. 1381). This means that there was not enough providers to treat the EBV outbreak when it started. Many providers could not keep the population healthy and safe from EBV as the outbreak started so fast. Providers will need to be aware of what is going on and to ensure that the people are safe. There will be a need to have interpreters as the language barrier between those that speak English and French will be prominent. Along with radiologist’s that will be needed to be able to read the X rays that are taken for patients to see if EBV is present. Medical assistants will be needed to assist nurses and providers with patients in offices and in tents that will be set up for
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extra space. Phlebotomists will be needed for the many lab drawings that will be needed for blood testing. “The design of an efficient humanitarian relief supply chain (HRSC) for disaster management depends on the integration of pre- and post-disaster decisions, which reduces the suffering of the victims and saves lives” (Modarresi, Maleki, 2023, p. 15). There must be clear resources that will be used for this trip. Drinking water is the most important as this is needed for everyone, soap and hand sanitizer to kill germs and bacteria. Working with the local hospitals to utilize MRI, X ray and CT scanners will help eliminate the need to have these in the field. While working closely with the hospitals in Mali the teams can use all resources that the hospital has to ensure that all patients are given the proper care. Cost The overall portion of the trips budget will be spent on all medical staff using the standard rate for foreign aid trips as the base line. The budget of $24,000.00 for having Four providers on the team for a month is the highest of all the budgets. Many providers need to have longer hours and better sleeping accommodation as they will be working long hours. There will be two providers at all times working to help prevent the spread of EBV. The budget plan of $18,000.00 for Six nurses that will be there for the month. $16,000.00 for eight medical assistants that will be there for the month. The medical staff will be encountering the patients in the hospital setting the most, the goal is that the nurses and medical assistants are not out in the field treating patients as the providers will be. Making these two groups more
valuable to the hospital for treatment of patients that are confirmed. The last part of the budget is $3,000.00 for supplies that will not be donated to the trip. Complementary or Integrative Health (CIH) Intervention “Chiropractic care, acupuncture, and therapeutic massage are the most common practitioner-delivered CIH therapies offered by health care systems and reimbursed by insurers” (Zeliadt, et al., 2020, p. 101). Well there is no Yoga treatment that is reimbursed by insurance companies there are many yoga therapies that are offered for pain. Yoga has been known to increase the patient’s blood flow which helps with healing. Vision “Yoga therapy, which focuses on the mind-body connection, shows promise as an innovative complementary treatment that may provide relief for psychological and physical symptom” (Chan, Burker, 2021, p. 267). The main reason for yoga as therapy is the patient can increase physical activity and decrease pain levels that are associated with EBV. Many patients that use Yoga therapy as treatment have seen a 35% decrease in pain and have increased flexibility (Chan, Burker, 2021, p. 271). Implementation “It is important that health care providers and yoga instructors (YI) understand the benefits and risks of yoga to reduce the risk of injury or adverse events related to yoga practice” (Lein, et al., 2020, para 2). The YI must be trained and work closely with the providers to ensure that the patient has the correct treatment that is needed. With the patients needs being first both
the provider and the YI must be on the same level of care. Patients need to have a care plan that yoga will take over to help with he pain that the patient is feeling. The main supplies that will be needed would be the yoga instructor that is certified and has been working with the provider. Yoga mats and blocks would the main tools that are required but if the YI has other tools that are needed only by the providers instructions. Overall cost of the YI would be about $6,000.00 per two weeks for a course of Twenty patients. The other items will be provided by the instructor in the course that will be in the studio.
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References Akintunde, T. Y., Musa, T. H., Musa, H. H., Chen, S., Ibrahim, E., Muhideen, S., & Kawuki, J. (2021). Mapping the global research output on Ebola vaccine from research indexed in web of science and scopus: a comprehensive bibliometric analysis. Human Vaccines & Immunotherapeutics, 17 (11), 4246–4258. https://doi.org/10.1080/21645515.2021.1948785 Chan, D. V., & Burker, E. J. (2021). Yoga therapy as an innovative treatment for complex trauma. Journal of applied rehabilitation counseling, 52 (4), 266–281. https://doi-org.ezproxy.snhu.edu/10.1891/JARC-D-20-00019 Fausther-Bovendo, H., & Kobinger, G. (2021). Vaccine innovation spurred by the long wait for an Ebola virus vaccine. Lancet Infectious Diseases , 21 (4), 440–441. https://doi-org.ezproxy.snhu.edu/10.1016/S1473-3099(20)30515-6 James, P. B., Wardle, J., Steel, A., Adams, J., Bah, A. J., & Sevalie, S. (2020). Providing healthcare to Ebola survivors: A qualitative exploratory investigation of healthcare providers’ views and experiences in Sierra Leone. Global Public Health, 15 (9), 1380– 1395. https://doi-org.ezproxy.snhu.edu/10.1080/17441692.2020.1762105 Lein, D. H., Singh, H., & Kim, S. (2020). Are screening by yoga instructors and their practice patterns important to prevent injuries in yoga clients? Complementary therapies in clinical practice, 40 ,N.PAG. https://doi-org.ezproxy.snhu.edu/10.1016/j.ctcp.2020.101196 Loke, A. Y., Guo, C., & Molassiotis, A. (2021). Development of disaster nursing education and training programs in the past 20 years (2000–2019): A systematic review. Nurse
education today, 99 ,.PAG. https://doi-org.ezproxy.snhu.edu/10.1016/j.nedt.2021.104809 Malenfant, J. H., Joyce, A., Choi, M. J., Cossaboom, C. M., l, A. N., Harcourt, B. H., Atmar, R. L., Villanueva,J. M., Bell, B. P., Hahn, C., Loehr, J., Davey, R. T., Sprecher, A., Kraft, C. S., Shoemaker, T., Montgomery, J. M., Helfand, R., Damon, I. K., Frey, S. E., & Chen, W. H. (2022). Use of Ebola vaccine: expansion of recommendations of the advisory committee on immunization practices to include two additional populations United States, 2021. MMWR: Morbidity & Mortality Weekly Report, 71 (8), 290 292. https://doi-org.ezproxy.snhu.edu/10.15585/mmwr.mm7108a2 Modarresi, S. A., & Maleki, M. R. (2023). Integrating pre and post-disaster activities for designing an equitable humanitarian relief supply chain. Computers & Industrial Engineering, 181, 109342. https://doi-org.ezproxy.snhu.edu/10.1016/j.cie.2023.109342 Zeliadt, S. B., Coggeshall, S., Gelman, H., Shin, M. H., Elwy, A. R., Bokhour, B. G., & Taylor, S. L. (2020). Assessing the relative effectiveness of combining self-care with practitioner delivered complementary and integrative health therapies to improve pain in a pragmatic trial. Pain Medicine , Suppl.2, 21, S100-S109. https://doi.org/10.1093/pm/pnaa349