Analyze

This film focuses on the environmental and social problem of having large gas (lethal) plants near cities or other populated areas where people can be harmed. Environmentally these gasses are no good because they are emitted into the air and are very soluble in the water which leads to ocean acidification. Ocean acidification makes it so that the ocean has a lower pH level, this can harm marine wildlife. Socially, the gas is toxic to people and as seen in the Bhopal tragedy, it can kill people or severely alter their lives. This could be seen through the immediate deaths of civilians, deformities of children born after the incident, and the families affected even years after hoping for justice.

From watching the video, I feel affected emotionally because it was definitely hard to watch so many people die, especially the innocent children. It is a hard pill to swallow to watch the lives of so many people taken away from them so unexpectedly in their own homes. I feel affected by seeing the photo of the unknown child because it was hauntingly touching as it was for so many people that advocated for justice after this tragedy. It was also really daunting seeing so many people being buried and burned in mass because they were not granted the ability to be respectfully honored for their death which I think is something very valuable. Intellectually I think that this film made me think about how this tragedy could have been possibly prevented if the plant had been maintained and checked up on regularly or if the plant wasn’t so close to a whole city in the first place. And I also feel gratitude to those who are still advocating for justice for the victims and trying to get people with government power to make that change.

This study examined the risk of acquiring Ebola Virus Disease (EVD) by healthcare workers in the setting of general hospitals and isolation units. By looking retrospectively at the Ebola Outbreak in Sierra Leone, the relative levels of risk to healthcare workers were computed and compared. The reasoning for these levels was also examined through interviews of surviving workers and the families/associates/colleagues of the deceased workers. The interviews reviewed common actions (and lack there of) for affected workers. This revealed certain themes that should be visited when reveising/creating hospital infection prevention and control policies.

In the case of this study, the vulnerable population examined was healthcare workers in Sierra Leone during the outbreak. These workers were found to be at a significant level of risk for transmission for a number of reasons. These include proximity to the virus (due to the occupation), lack of training in the area of infection control, and cultural factors (such as prevalence of self-medication and home management of illness). Nurses as a whole were most affected, with over half of the infected members. 

The data acquired in this study can be used not only for improvement in policies and training for healthcare workers, but also to examine the risk factors for the disease. One example is the age and gender disparities in those nfected. These could be explained by the typical age and gender of healthcare workers, but could also show a trend in risk when coupled with patient data. The data on the districts and their infection rates can be used to help pinpoint the origin of infection. 

The study was published in BMC Infectious Diseases, a peer-reviewed journal on the prevention, diagnoisis, and management of infectious disease. The journal seems to be genrally well respected.

This was a retrospective study. While not the most accurate and well supported way to conduct a study, due to the effects of recall bias, it was really the only way to gain the data that was presented in the report. There isn't really anything new about the style of research. 

At least one further study has been conducted using this data. A more focussed paper on the Kenema District in Sierra Leone was written, addressing the staggering number of cases with infected healthcare workers. The paper is titled "Facors Underlying Ebola Virus Infection Among healthcare Workers, Kenema, Sierra Leone, 2014-2015."  The paper reached similar conlusions as the original one, with a need for better practices in infection control and prevention. 

The study was funded by the WHO Country Office for Sierra leone.

            This past spring break (2016), on a Monday night while at home, I responded to a motor vehicle accident as a Good Samaritan. The accident happened at approximately 19:00 hours on my street in Blackstone, Massachusetts. My father was on our front porch when he heard a car barreling down our back country road which has a long straight away before taking a sharp turn. Before the impact he knew that the driver would not anticipate the curve fast enough at the speed he was traveling. Sure enough, there was a loud bang and the sound of a car rolling over, which I could hear from inside the house (approximately ¼ mile from crash).

I grabbed both of my personal first aid kits and a flashlight while my father called emergency services. I walked to scene with my father and younger brother. I sped walked and arrived at the crash site first.

The vehicle was a ‘90s sedan that went straight into a telephone pole, which broke like a toothpick, and rebounded backwards and flipped 90 degrees on its left side. Parts of the car, tools, and glass were on ground, airbags deployed. There was a car seat in back, and for a moment I thought a child but it was just clothing. Front right tire was up inside front passenger compartment. Hazards flashing. Driver window was rolled down. No people in the car.

My brother and father directed traffic on either end of the crash site. They almost certainly prevented at another crash by a car who didn’t see the accident but saw my brother flag them down with his light.

I saw man standing 20’ from crash site, talking to people in a gold SUV. When I arrived I start asking medical questions and the people in the SUV leave – they were by standards who pulled up but left after I started taking over. The man in question appeared to be a lower/middle class white/Hispanic, male in his 30s. He was driving an older car with lots of tools in the back which were now all over the road. Our neighborhood is a small country community and I know he was not from our neighborhood. I assumed he was some kind of mechanic, bases on tools in car. He was wearing dirty jeans and stained hoodie. He was definitely a blue-collar worker. He may have been from downtown Blackstone which is largely lower middle class and blue collar, or he may have been from Woonsocket, Rhode Island, which is known as “the Detroit of Rhode Island”.

As I tried to obtain basic medical information from the patient, it was apparent he had an altered mental status, and did not appear to understand fully what was going on. I am not certain if it was alcohol and/or drugs as for safety reasons I did not get close enough to the patient/suspect to tell. He was ambulatory and verbal. The interesting part of our conversation was to the best of my ability as follows:

“Are you sure you’re okay? Umm yeah. Are you hurt anywhere? I’m fine. [I did visual inspection of patient using flashlight which revealed no major injuries other than minor cuts from airbag]. [He starts to edge away from scene]. You should wait for ems to check you out. Wait, you’re right! I might die?! You appear to be okay externally but things like internal bleeding, and a full assessment could reveal other problems. Naaaa [turns and starts to walk away down street]”

I attempted to convince the patient to wait on scene but he was going through several mode swings during my interactions with him from fear, anxiety, agitation, and anger. While I was talking to the patient, the first officer from the neighboring town arrived on a motor cycle. I informed the officer at the scene of the situation about the patient/suspect fleeing the scene. The officer took note of it and continued to work to secure the crash site. Another officer arrive from my town from the west. I informed the same and he stated that he would need me to make a witness statement and proceeded to the crash site. A third and fourth officer arrived together the same time as two ambulances (indicated because of rollover) from the east. One of them told me again that they would need a witness statement.

I met back up with my dad and brother who were no longer needed to control traffic with law enforcement on scene. Neighbors had started coming out to see the commotion. We were all talking near the scene while waiting for officers. Finally one of the officers asked another officer if he should go look for the suspect. He left approximately 20 minutes after my last contact. I never spoke with the arriving EMS as they came from the east and I was on the west of the accident but officers told them that the patient was missing. Eventually multiple officers and cars were out looking for patient/suspect but was not found as far as I am aware. I finally was given the chance to give my testimony which, to the best of my knowledge, mirrors this report. After reading out loud in front of the officer and my father and brother to confirm accuracy, the officer asked me something very strange. First, he asked me to add what the suspect was wearing (which I had forget to include), but then he also asked me to state that I saw the suspect drive into the telephone pole and that I smelled alcohol on the patients breath. Neither of these things were what I told any of the officers and ran counter to my testimony as written. I include the suspect’s clothing description but I did not add the second mention and stated that I had not witnessed those things. After my report I left the scene with my brother and father.

Some of the policies and procedures relevant to this case were: scene safety, dealing with aggressive/combative patients, and HIPPA did not apply to me as a bystander so I gave full testimony including medical status to the officers.

After reflecting on the education I received and didn't receive, there are a few things that would have allowed me to be better prepared for this incident. How do I convince patients to stay on scene? When do you give up? I wish my EMT class was a little better scene on safety training. Being distracted by the emergency at hand, I did not truly take into account the fact that the power lines were live and drooping with half of the telephone poll pulling on them. Only supported by the next and previous poll but not drooping more than 3’ from normal, more than 15’ from ground, and 10’ above vehicle. Reflecting on it, I did not really consider the threat as I should have, and neither did the officers on scene. I don’t understand why it took so long for police to search for the suspect who could have had major medical issues. Should I have followed suspect/patient alone? When is a citizen arrest allowed/appropriate? Should I have asked for the badge number of the officer who asked me to misrepresent the truth on an eye witness testimony? What is the process to do that anyway? If I had the answers to these questions I feel I may have been able to provide better assistance, but then again perhaps not.