For a Sierra Leonean colleague who developed Ebola within days of the American, the course of care has been markedly different. The health officer, identified by his caregivers only by his first name, Usman, was first sent to a local treatment unit where roughly 50 percent of all Ebola patients die. He was told there was “no room” at the specialized British unit.
Public health officials said 11 of the American’s colleagues who might have had exposure to the virus, but had not tested positive for Ebola, were taken to that British unit before being transported to the United States, where the majority of the few patients treated for Ebola have survived. The last three of them arrived Monday for monitoring in proximity to medical centers prepared to care for Ebola patients, with the costs of private transportation borne by the charity they worked for, Partners in Health.
Before falling ill, both the American and Usman, an employee of the Sierra Leone government, worked at an Ebola treatment unit supported by Partners in Health. The group has distinguished itself by promoting the principle articulated by its co-founder Dr. Paul Farmer that people in poor countries deserve the same high standard of medical care as those in wealthy nations.
The paths taken by the Americans and their Sierra Leonean colleague have raised questions about whether the charity has been acting in concert with its stated values.
“This person’s life is less than the American’s?” asked Dr. Kwan Kew Lai, a doctor who helped care for the ailing health officer at an International Medical Corps treatment unit in the Port Loko district of Sierra Leone. Dr. Lai said there was little to offer him other than encouragement, intravenous fluids and morphine.
“There’s a dilemma that Partners in Health is facing, or all of us need to look at,” she said. “I don’t think it’s right.”
Usman was transferred to the British treatment center two days later, on Sunday night, Dr. Lai said.
Leaders of Partners in Health declined to address whether they had made a request for Usman to be taken to the United States or a Western medical facility. When asked whether the organization had advocated a higher standard of care for Usman, Partners in Health provided only a brief statement through its media relations manager, Jeff Marvin: “The bottom line is that we’re advocating for, and committed to, raising the standard of care for all people in Sierra Leone.”
There are precedents for bringing foreign citizens to the United States for emergency treatment, for instance after the earthquake in Haiti, and through a little-known exception to immigration protocols known as humanitarian parole.
When Partners in Health entered the Ebola campaign last fall, it pledged to provide its patients with better care than what was being offered by other aid groups.
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Dr. Peter George, the medical superintendent in Port Loko, said he was told by Partners in Health that they had called the British treatment unit, known as Kerry Town, and were told there were no beds available for Usman. At the same time, the Partners in Health site was being shut down.Usman was taken by ambulance to the unit run by International Medical Corps, an American charity. His arrival was treated with disbelief.
“We said, How come he didn’t go to Kerry Town, since he’s a health care worker?” said Dr. Lai, a volunteer with International Medical Corps.
In an unrelated episode, a British health worker was also diagnosed with Ebola and treated at Kerry Town before being flown back to Britain with several colleagues late last week.
The British military declined to answer questions about the Kerry Town center, offering only a statement saying that the facility was intended both for international and some Sierra Leonean health care workers. The statement also said, “The provision of this care should provide reassurance to health care workers in Sierra Leone.”
Dr. George, who is monitoring himself for symptoms because he treated Usman for a pre-existing ulcer when he initially became sick with Ebola, said he would welcome the chance to undergo monitoring in the United States, “if that were an option given to me.”
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