Occupational health for humanitarian aid workers in an Ebola outbreak

The recent Ebola outbreak has caused worldwide consternation due to the spread of the disease and the high fatality rate, especially within the health care profession. Unfortunately this exacerbated the already limited health care infrastructure within Guinea, Liberia and Sierra Leone. Recruitment and the ability to respond by humanitarian aid organisations were impaired due to lack of willing delegates, facilities and equipment. This investigative qualitative study of International Federation of the Red Cross and Red Crescent staff was conducted in three West African countries to assess the current staff health situation and make recommendations for improvement to issues and needs that may impact staff capacity to deliver services during deployment. A field visit was conducted in September 2014 during which a diary of interviews, notes and logged events was taken. The information will be used to inform a modified Delphi study for the development of minimum standards for occupational health for humanitarian aid workers. A total of 24 delegates were interviewed in Conakry (Guinea), Freetown and Kenema (Sierra Leone) and Monrovia (Liberia).

The issues raised during the interviews covered pre-deployment, deployment, post-deployment and various issues related to work and life as a delegate in an Ebola operation. Pre-deployment issues raised were: addressing the concerns expressed by family, friends and employer, the importance of medical clearance and receiving health briefing prior to deployment and appropriate special training. Deployment raised different issues regarding ability to maintain personal health, location and acceptability of accommodation, new ways of living and working, including development of standard operating procedures to ensure quality of care and safety, security and travel restrictions and communication with family, friends and colleagues. Post-deployment concerns included media-related issues impacting on family, alienation instead of admiration, quarantine and ability to go home, and coming to terms with their experiences. The Ebola outbreak posed a huge challenge to the deploying humanitarian organisations in terms of recruiting, preparing, deploying, post-deployment and supporting their delegates through this process. The lessons learnt from this study and recommendations made to improve the future health and safety of humanitarian aid workers will inform the development of minimum standards for occupational health for these professions.