Department of Social Medicine and Health Service Management, Army Medical University (Third Military Medical University), Chongqing, China.
Bureau of Medical Affairs Administration, First affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China.
Infect Dis Poverty. 2018 Aug 16;7(1):92. doi: 10.1186/s40249-018-0468-6.
Health care workers are at the frontline in the fight against infectious disease, and as a result are at a high risk of infection. During the 2014-2015 Ebola outbreak in West Africa, many health care workers contracted Ebola, some fatally. However, no members of the Chinese Anti-Ebola medical team, deployed to provide vital medical care in Liberia were infected. This study aims to understand how this zero infection rate was achieved.
Data was collected through 15 in-depth interviews with participants from the People's Liberation Army of China medical team which operated the Chinese Ebola Treatment Center from October 2014 to January 2015 in Liberia. Data were analysed using systematic framework analysis.
This study found numerous bio-psycho-socio-behavioural risk factors that directly or indirectly threatened the health of the medical team working in the Chinese Ebola Treatment Center. These factors included social and emotional stress caused by: (1) the disruption of family and social networks; (2) adapting to a different culture; (3) and anxiety over social and political unrest in Liberia. Exposure to Ebola from patients and local co-workers, and the incorrect use of personal protective equipment due to fatigue was another major risk factor. Other risk factors identified were: (1) shortage of supplies; (2) lack of trained health personnel; (3) exposure to contaminated food and water; (4) and long working hours. Comprehensive efforts were taken throughout the mission to mitigate these factors. Every measure was taken to prevent the medical team's exposure to the Ebola virus, and to provide the medical team with safe, comfortable working and living environments. There were many challenges in maintaining the health safety of the team, such as the limited capability of the emergency command system (the standardized approach to the command, control, and coordination of an emergency response), and the lack of comprehensive international protocols for dealing with emerging infectious disease pandemics.
The comprehensive and multidisciplinary measures employed to protect the health of the medical team proved successful even in Liberia's resource-limited setting. The global health community can learn valuable lessons from this experience which could improve the safety of health care workers in future emergencies. These lessons include: establishing capable command systems; implementing effective coordination mechanisms; providing adequate equipment; providing training for medical teams; investing in the development of global health professionals; and improving research on ways to protect health care workers.
医护人员是抗击传染病的前线战士，因此他们面临着高度感染的风险。在 2014-2015 年西非埃博拉疫情期间，许多医护人员感染了埃博拉病毒，其中一些不幸死亡。然而，被部署到利比里亚提供重要医疗服务的中国抗击埃博拉医疗队成员无一例感染。本研究旨在了解如何实现这一零感染率。
本研究通过对 2014 年 10 月至 2015 年 1 月期间在利比里亚运营中国埃博拉治疗中心的中国人民解放军医疗队的 15 名参与者进行 15 次深入访谈收集数据。使用系统框架分析对数据进行分析。
本研究发现了许多直接或间接威胁在利比里亚的中国埃博拉治疗中心工作的医疗团队健康的生物心理社会行为风险因素。这些因素包括：（1）家庭和社会网络的中断导致的社会和情感压力；（2）适应不同文化；（3）对利比里亚社会和政治动荡的焦虑。与患者和当地同事接触埃博拉病毒以及因疲劳而错误使用个人防护设备是另一个主要风险因素。其他风险因素包括：（1）物资短缺；（2）缺乏训练有素的卫生人员；（3）接触受污染的食物和水；（4）工作时间长。在整个任务中都采取了全面的努力来减轻这些因素。采取了一切措施来防止医疗团队接触埃博拉病毒，并为医疗团队提供安全、舒适的工作和生活环境。在维护团队的健康安全方面存在许多挑战，例如应急指挥系统（指挥、控制和协调应急响应的标准化方法）的能力有限，以及缺乏处理新发传染病大流行的全面国际协议。
即使在利比里亚资源有限的情况下，保护医疗队健康的全面和多学科措施也取得了成功。全球卫生界可以从这一经验中吸取宝贵的经验教训，以提高未来紧急情况下医护人员的安全性。这些经验教训包括：建立有能力的指挥系统；实施有效的协调机制；提供充足的设备；为医疗团队提供培训；投资于全球卫生专业人员的发展；并改善保护医护人员的方法研究。
