Haemorrhagic Fevers – Getting ready: viewpoints from Kenyan Public Health Practioners

Abstract

Background: The current wave of Hemorrhagic fevers currently being witnessed require increased bio-risk assessment exercises and vigilance at all levels of the healthcare continuum. This article review will outline key subjects from an agenda-setting, multi-disciplinary panel convened to examine implications for health systems in Kenya. Discussion: Researchers' personal stories and media debates to define fundamental issues and opportunities for preparedness focused on three inter-linked subjects. First, the risks of the fear response itself were underlined as a danger to the reliability and stability of quality care. Second, healthcare workers' reservations were complicated by a demonstrable lack of societal and personal protections for infection prevention and control in communities and healthcare facilities, as evidenced by an ongoing cholera epidemic affecting over 5,000 patients across Kenya in 2015 alone. Third, a lack of clear messaging and course from leadership have limited organization and strengthened a level of suspicion in the government's ability and obligation to mobilize an adequate response. Initial recommendations include urgent investment in the needed supplies and infrastructure for basic, routine infection control in communities and healthcare facilities, provision of assurances with securities for frontline healthcare workers, establishment of a multi-sector, "all-hazards" outbreak surveillance system, and engaging directly with key community groups to co-produce contextually relevant educational messages that will help decrease stigma, fear, and the demoralizing perception that the diseases defy remedy or control. Summary: The occurrence of hemorrhagic fevers especially the Ebola outbreak in West Africa provides an unprecedented opportunity for other countries like Kenya to make progress on tackling long-standing health systems weaknesses. These discussions emphasized the urgent need to strengthen capacity for infection control, occupational health and safety, and leadership coordination. Substantial commitment is needed to raise standards of hygiene in communities and health facilities, build mechanisms for co-operation across sectors, and engage community stakeholders in creating the needed solutions. It would be both distressing and irresponsible to waste the opportunity.