Pregnant in the Time of Ebola: Women and Their Children in the 2013-2015 West African Epidemic

ISBN-13: 9783319976365 / Angielski / Twarda / 2019 / 487 str.

Schwartz, David A.

Opis

For the first time, this book incorporates the experiences and opinions of a team of internationally respected experts from different fields to address a public health problem of global magnitude -- the West African Ebola virus epidemic. In particular, the book addresses the effects of the epidemic on the most vulnerable elements of society -- women and children -- whose health and even survival were significantly affected by the outbreak, whether they were infected with Ebola virus or not. The authors are from some of the leading global health agencies that were involved in the Ebola relief effort -- UNICEF, Partners in Health, Médecins Sans Frontières, International Rescue Committee, UNFPA, The Carter Center, and others as well as from multiple universities. The biomedical aspects of the recent Ebola virus epidemic, occurring predominantly in the West African nations of Guinea, Sierra Leone, and Liberia, have received unprecedented worldwide attention, but little systematic analysis. Even before the epidemic, these three countries had some of the highest maternal mortality rates in the world, and had severe shortages of medical personnel and equipment. There were also significant sociocultural and behavioral factors that played important roles in fostering the dissemination of the virus among the individuals in these societies, as well as interrupting the medical care of non-infected individuals. In outbreaks of infectious diseases, sex, gender, and age play important roles in vulnerability to infection, caregiving roles, patient roles, access to healthcare resources, and perceptions and realities of risk. During the Ebola virus outbreak, however, the impact of sex, gender, and age was insufficiently studied and frequently misrepresented. This volume is the first to address these issues, and provide research, policy insights, and observations that can be of use to biomedical, health policy, social science, and public health students and experts in future epidemic events. Women and children, and especially pregnant women, are generally the most defenseless persons in the event of an infectious disease catastrophe such as the present Ebola virus outbreak. Women, children, and pregnant women were further affected by the inability of international NGOs to initially provide effective clinical care to pregnant women with Ebola, the rapid increase in "Ebola orphans," and the complex role that traditional healers (like midwives) played in both expanding and containing the epidemic. Pregnant women were notoriously excluded from access to clinics, hospitals, and Ebola Treatment Units. Mortality among pregnant women was close to 100% until late in the outbreak. Family structure was disrupted by the death of elder, adult, and child relatives. The current West African epidemic probably began with an infant's death in rural Guinea in December 2013, spread rapidly across porous national borders to the adjacent nations of Sierra Leone and Liberia and, as of March 31, 2016, has accounted for 28,646 confirmed, probable, and suspected infections, and resulted in 11,323 deaths. These figures are undoubtedly conservative, with the World Health Organization believing that many more infections and deaths have been undocumented. Contributing to the spread and severity of the epidemic were widespread deficiencies in infrastructure resulting from years of civil wars, political disruption, and mistrust of government representatives, extreme poverty, dysfunctional healthcare systems and shortages of local medical personnel, and some local customs that increased risk of transmission of the virus. The West African Ebola outbreak was highlighted by several "firsts" -- it was the first Ebola virus incident to reach epidemic proportions, the first to extend into densely-populated cities where additional transmission occurred, the first in which significant numbers of anthro

Recenzje

"It is an important, worthy project, and the volume is the most comprehensive work on "lessons learned" from the West Africa epidemic. It will be an invaluable resource for policy makers and practitioners faced with future health emergencies of international concern." (Catherine Bolten, African Studies Review, Vol. 63 (3), 2020)
"This is a comprehensive and detailed source book for anyone in the medical, public health, anthropology, and political fields who wish to learn about and from the Ebola epidemic of 2013-15. ... It is a rich resource from which to build in order to prevent, provide rapid intervention, and ameliorate the consequences of future Ebola outbreaks." (Joan Ann MacEachen, Doody's Book Reviews, November 8, 2019)

Spis treści

1) Sharon Abramowitz, PhD, Independent Consultant. Pending Research Affiliate with Rutgers, The State University of New Jersey                                                                                 "Ebola's Assault on Women, Children, and Family Reproduction: An Introduction to the Issues"

2) David A. Schwartz, MD,MS Hyg, FCAP, Clinical Professor, Medical College of Georgia, Augusta University, Augusta, Georgia                                                                        

"The West African Ebola Epidemic: Overview and Timeline"

3) Julienne Ngoundoung Anoko, PhD, MS, Universite Sorbonne, Paris, France, and Doug Henry, PhD, Associate Professor, Department of Anthropology, University of North Texas, Denton, Texas

"Finding Flexibility Within Tradition in Guinea: Diffusing Community Crisis Through Ebola-focused Ethnography"

4) Adrienne Strong, MA, PhD Candidate, Departments of Anthropology, Washington University of St. Louis and University of Amsterdam, Netherlands, and David A. Schwartz, MD, MS Hyg, FCAP, Clinical Professor, Medical College of Georgia, University of Augusta, Augusta, Georgia

"Effects of the Ebola Epidemic on Health Care of Pregnant Women: Stigmatization With and Without Infection"

5) Gillian Burkhardt, MD and Elin Erland, MD. Médecins Sans Frontières, Operational Centre, Barcelona, Spain

"Ebola's Unintended Consequences: The Challenges of Managing Pregnant Ebola-suspected Women in Ebola Contexts" 

6) Benjamin Black, MBBS, MSc, MRCOG and Ruth Kauffman, BSN, RN. Médecins Sans Frontières Operational Centre, Barcelona, Spain

"Clinical Care for Pregnant Women in an Ebola Treatment Center"

7) Guirlene Frederic, UNICEF, Chief, Child Protection, Conakry, Guinea 

"The Care of Children and Orphans Affected by Ebola During the Response to the Disease in Guinea"

8) Jonah Lipton, PhD Candidate in Anthropology, London School of Economics, London, Great Britain

"Taking 'Life Off Hold' During a Time of Crisis in Freetown, Sierra Leone"

9) Paul Farmer, PhD, MD, Joia Mukherjee, MD, MPH, Regan Marsh, MD, MPH, and Kerry Deirberg, MD. Harvard Medical School, Brigham and Women’s Hospital, and Partners In Health, Boston, Massachusetts

"Public Health Aspects of the Ebola Epidemic in Women and Children"

10) Veronica Fynn Bruey, LLM, BSc, MPH, LLB and PhD Candidate, Visiting Scholar, School of Law, University of Washington, Seattle 

"Maternal and Reproductive Rights: Ebola and the Law in Liberia"

11) Ramatou Ouedraogo, PhD, Laboratoire les Afriques dans le Monde (LAM), Bordeaux, France, and Veronica Gomez-Temesio, PhD, Ecole Normale Supérieure de Lyon, France & Graduate Institute of Geneva, Switzerland

"Between Safety, Fear, and Obligation of Care: Being Pregnant in a Guinean Ebola Treatment Unit"

12) Theresa Elizabeth Jones, PhD, Clinical Psychologist, International Rescue Committee, Monrovia, Liberia 

"Risk Without Recognition: The Experiences of Traditional Midwives and Birth Attendants Who Filled the Gap in the Time of Ebola"

13) Dr Edwige Adekambi Domingo, UNFPA, Conakry, Guinea 

"Ebola and Pregnancy in Guinea"

14) Sarah Paige, PhD, MPH, Co-Founder, Ebola Survivor Corps, Medical Geographer, University of Wisconsin-Madison Global Health Institute, Madison, Wisconsin, Andrew Bennett, University of Wisconsin-Madison and Ebola Survivor Corps, Nell Bond, PhD, Tulane University, New Orleans, Louisiana, and Lina Moses, Director, Community and Ecology Based Research, Tulane University Lassa Fever Program, Tulane University, New Orleans, Louisiana

"The 2013-2015 Ebola Outbreak and Child Development: Measuring the Impact Among Child Survivors and Peers, and Identifying Opportunities for Care"

15) Janice Cooper, PhD, MPA, Country Representative, Liberia Mental Health Initiative and Project Lead, Mental Health Program, The Carter Center in Monrovia, Liberia 

"Perspectives From Ebola Survivors in Liberia"

16) Ken Limwame, MPH (SBCC) and Karyartay Karyar, UNICEF, Monrovia, Liberia

"Retrospective Community Perceptions of Being Pregnant During the Ebola Outbreak in Urban Liberia"

17) Indi Trehan, MD, MPH, DTM&H, Assistant Professor of Pediatrics, Washington University in St. Louis, St. Louis, Missouri and Charles W. Callahan, DO, Partners in Health, Boston, Massachusetts

"Comprehensive Clinical Care for Children With Ebola"

18) Emily Bayne, MBBS, Cert ClinEd, DTM&H, National Health Service, Great Britain

"Providing Care for Women and Children During the Ebola Epidemic: A Volunteer Physician's Experiences"

19) Rebecca Henderson, MD/PhD Candidate, University of Florida Department of Anthropology and School of Medicine and Sharon Abramowitz, PhD, Independent Consultant. Pending Research Affiliate with Rutgers, The State University of New Jersey                                                                  

"Who Delivers? Birthing Roles in Sierra Leone"

20) Monica Ontango, PhD, RN, MPH, MS, Clinical Assistant Professor of Global Health, BU Center for Global Health & Development, Boston University School of Public Health, and Kirsten Resnick, MS, Medical Anthropologist, Boston Medical Center, Boston, MA

"Gender-based Violence and Teenage Pregnancy: Neglected Consequences of the 2013 Ebola Outbreak"

21) Dominique de Juriew, PhD, Child Protection Consultant, UNICEF and UNHCR, Montreal, Canada

"Health Workers, Children, and Families: Communication Challenges in the Ebola Context"

22) Moussa Koulibaly, MD, Professor and Director, Ignace Deen Hospital; Telly Sy, MD, Chief, Department of Obstetrics and Gynecology, Ignace Deen Hospital; and Diallo Yaya, MD, Deputy Chief, Department of Obstetrics and Gynecology, Ignace Deen Hospital and University of Conakry, Conakry, Guinea

"Medical Care of Women and Pregnancy in Conakry at the Ignace Deen Hospital During the Ebola Epidemic"

23) Chrissy Godwin, MSPH, Doctoral Candidate, Department of Maternal and Child Health, Gillings School of Public Health, University of North Carolina, Chapel Hill, North Carolina

"Understanding Sexual Behavior and Fertility Changes in Female Survivors of Ebola"

O autorze

David A. Schwartz, MD, MS Hyg, FCAP, has an educational background in Anthropology, Medicine, Public Health, Emerging Infections, Women's Health and Epidemiology. He sub-specializes in Obstetrical, Fetal, and Perinatal Pathology as well as Emerging Infections, and has a professional interest in reproductive health, and maternal and infant disease and death in both resource-rich and resource-poor countries. Dr. Schwartz has organized and directed large national and international investigations of health of women and children, obstetrical disease, perinatal pathology, and epidemiology for many government agencies including the CDC, NIH, and USAID, and has consulted and taught in these specialties in resource-poor nations. He has been a recipient of many grants, and was a Pediatric AIDS Foundation Scholar. He edited a newly-published book regarding anthropological and public health aspects of maternal morbidity and mortality in developing nations that was published in October, 2015 (Maternal Mortality: Risk Factors, Anthropological Perspectives, Prevalence in Developing Countries and Preventive Strategies for Pregnancy-Related Deaths), and was previously a co-editor of an award-winning 2-volume medical textbook on infectious diseases with Appleton-Lange Publishers (Pathology of Infectious Diseases. Volumes I and II). He is the editor of a 36-chapter text currently in progress for Springer, Maternal Health, Pregnancy-Related Morbidity and Death Among Indigenous Women of Mexico & Central America: An Anthropological, Epidemiological and Biomedical Approach. He has authored more than 120 peer-reviewed articles as well as 47 chapters in his specialty areas in the medical literature. Dr. Schwartz is an experienced editor, currently serving on the Editorial Boards of three major international journals, and is associate editor for one of them. He has previously taught at several universities, and is currently a clinical professor at the Medical College of Georgia. Dr. Schwartz has long experience at understanding and integrating the anthropological, biomedical, epidemiological, and public health aspects of emerging infectious diseases as they affect society, especially women and children. Both Drs. Schwartz and Abramowitz have recently been active in addressing aspects of the current global Zika virus situation.

Julienne N. Anoko, PhD, MS, is a social anthropologist (PhD) from the Sorbonne University in Paris, France. She completed her academic preparation (MS) in the areas of epidemiology and public health, and gender and health. For more than 15 years, she has been supporting several institutions (public administrations, NGOs, international development, and United Nations organizations) in addressing social norms and gender issues both during emergency outbreaks and into development programs for better efficiency and accountability. Between 2005 and 2014, Dr. Anoko supported the World Health Organization and UNICEF during the Ebola and Marburg outbreaks, as well as the H1N1 influenza pandemic in both developed and developing countries in Africa, America, and Europe. In 2015, she joined the United Nations Mission for Ebola Emergency Response (UNMEER) in Guinea to coordinate, support, and leverage the Social Mobilization and Community Engagement pillar in order to implement interventions compatible with local contexts to gain community trust and participation into the overall response. Between 2015 and 2016, she was appointed as in-house social anthropologist of UNICEF in the Guinea-country Office to support the mainstreaming of social norms into both the Ebola emergency response and development programs. Dr. Anoko has published books and papers and contributed in developing several guidelines for United Nations agencies dealing with her areas of expertise. She had been featured in articles from NPR, National Geographic, The Washington Post, WHO, and others. She is recipient of the "Research and Innovation 2015 Award" for her engagement in the field during the West African Ebola epidemic from the French Red Cross Humanitarian Fund.

Sharon Abramowitz, PhD, is an independent consultant and former assistant professor of Anthropology and African Studies at the University of Florida in Gainsville. She is currently pending as a research affiliate with Rutgers, The State University of New Jersey. As a medical anthropologist, Dr. Abramowitz has conducted research on community-based response to epidemics and pandemic events, Ebola, humanitarian intervention, mental health, gender-based violence, health sector transitions, and post-conflict reconstruction in West Africa since 2000. She is the author of Searching for Normal in the Wake of the Liberian War (University of Pennsylvania Press 2014), co-editor of Medical Humanitarianism: Ethnographies of Practice (University of Pennsylvania Press 2015), and has authored many peer-reviewed articles in leading scientific journals. Presently, Dr. Abramowitz plays a leading role in social science's response to the West African Ebola epidemic, and is the principal investigator for the Ebola 100 Project, which is establishing a "history of the present" of humanitarian experiences during the Ebola outbreak. She also is conducting research on community-based responses to epidemic and pandemic events.

Blurb

This comprehensive account of the deadliest Ebola outbreak in history examines its devastating effects on West Africa’s most vulnerable populations: pregnant women and children. Noted experts across disciplines assess health care systems’ responses to the epidemic in Liberia, Guinea, and Sierra Leone, emphasizing key areas such as pregnancy, prenatal services, childbirth, neonatal care, and survivor health among pregnant and non-pregnant women. The 30 chapters hone in on gender-based social issues exacerbated during the outbreak, from violence against women and girls to barriers to female education. At the same time, chapters pinpoint numerous areas for service delivery and policy improvements for more coordinated, effective, and humane actions during future pandemics. 

A sampling of the topics: 

• Ebola virus disease: perinatal transmission and epidemiology
  
• Comprehensive clinical care for children with Ebola virus disease
  
• Maternal and reproductive rights: Ebola and the law in Liberia
• Ebola-related complications for maternal, newborn, and child health service delivery and utilization in Guinea
• The Ebola epidemic halted female genital cutting in Sierra Leone—temporarily 
• Maternity care for Ebola at Médecins Sans Frontières centers
• Stigmatization of pregnant women with and without Ebola
• Exclusion of women and infants from Ebola treatment trials
• Role of midwives during the Ebola epidemic

Pregnant in the Time of Ebola is a powerful resource for public health specialists, anthropologists, social scientists, physicians, epidemiologists, nurses, midwives, and governmental and non-governmental agency staff studying the effects of the epidemic on women and children as a result of the most widespread Ebola outbreak to date.