Ebola health care worker dies after childbirth in Liberia
Salome Karwah survived Ebola after it killed both her parents and seven other relatives, then returned to her clinic to help countless others as she had become immune to the deadly virus. Her face graced the cover of Time magazine when it recognized the brave health care workers battling Ebola in 2014.
But in a heartbreaking reminder of just how strong fear remains in Liberia, her husband says the nurses on duty were too afraid to touch Karwah when she experienced complications after childbirth last month.
“I personally went into the emergency ward to bring a wheelchair to take my wife into the operation room,” James Harris, a psychosocial counsellor, told The Associated Press.
Karwah died two weeks ago at age 31, several days after her fourth child was delivered by cesarian section. It was a tragic end for a woman who had fought tirelessly against the stigma of Ebola.
“Salome’s own experience of Ebola gave her incredible empathy for the patients that she worked so hard to care for,” said a statement from Doctors Without Borders, known by its French acronym MSF. “Our many staff who remember working with her speak of her strength and compassion, but also of her smile.
“She made a huge contribution to MSF’s work at the height of the outbreak in Monrovia.”
The outbreak in West Africa was the deadliest ever of the virus, with about 11,300 people killed. Ebola is spread through bodily contact with the fluids of someone sick enough to show symptoms.
While the World Health Organization declared an end to the outbreak in June 2016, some Liberians still wrongly fear that survivors can transmit the virus.
Tolbert Nyenswah, the man who led Liberia’s Ebola fight and now heads the country’s newly established National Public Health Institute, said he could not confirm reports that health workers were frightened to treat Karwah because of her Ebola survivor status as she suffered seizures.
He said the death was being fully investigated to know “what really went wrong.”
“Normally if a cesarian section is conducted, the person is supposed to stay in the hospital for seven days and monitored to see whether there are complications,” Tolbert said. “But to my understanding, that protocol was breached; she spent less than that in the hospital and was discharged, and when she was facing complications her husband took her back to the hospital to seek further care.”
The hospital has not commented. Liberia’s chief medical officer, Dr. Francis Kateh, told the AP he understood the husband’s feelings. But he then echoed the mistaken belief that survivors can transmit the virus, saying that “the hospital knew she had Ebola and they operated on her, which put them at more risk.”
Her husband told the AP that it was the hospital that decided to discharge her prematurely even though “her blood pressure was high each time it was taken” after the C-section and he wanted her to stay a bit longer.
James Harris said he blames the hospital for his wife’s death “because they had her waiting in a vehicle for three hours” before she was attended to. He said what really hurt was “a nurse on duty, instead of attending to the emergency, was standing by the front counter busy on Facebook.”
Liberia already had one of the world’s highest rates of maternal mortality before the Ebola outbreak. Before the epidemic began in 2014, a woman had a one-in-10 chance of dying in childbirth, compared to 1 in 8,000 on average in developed countries, according to government statistics.
The situation has been so grim that one pilot program after the Ebola crisis trained midwives how to perform cesarians, according to the U.N. humanitarian agency.
More than 4,800 people died of Ebola in Liberia during the epidemic, with more than 10,000 cases across the country. Among them, 184 health workers were killed.
With no treatment for Ebola approved by the U.S. Food and Drug Administration, it was through the supportive care of people like Karwah that many survived.
“If a patient doesn’t want to eat, I encourage them to eat. If they are weak and are unable to bathe on their own, I help to bathe them,” she said in a 2014 interview, according to MSF. “I help them with all my might because I understand the experience — I’ve been through the very same thing.”