Analyze

I followed up on the Fukushima 50 what they experienced, their lack of food and water. How they faded into the background after the event was over. The government nor the public realized the ramifications of what they had done and how they had saved them all from radiation. https://www.theguardian.com/environment/2013/jan/11/fukushima-50-kamika…

I followed up on emergency nuclear response groups if they did exist as a cause of Fukishima and came across the possibility of using robots in the place of humans in these situations. The robots could go where the humans could not saving life and limb.http://www.scientificamerican.com/article/fukushima-disaster-inspires-b…

I finally looked up the statisitcs of how much cancer was prevelant in the population after the small doses of radiation to the villages surrounding Fukishima. It was interesting to find that there were more then expected and it could be a fluke due to overlooking scanning for Thyroid cancer in children in the past. There is also no definite way to prove these cancers were a direct cause of radiation or not.http://www.sciencemag.org/news/2016/03/mystery-cancers-are-cropping-chi…

I looked up

1. International response to the Ebola epidemic

- from http://ebolaresponse.un.org/liberia

   I learned about how the UN coordinated various organizations, including UNICEF, the World Food Programme, and the WHO in their individual persuits to end the transmission of ebola in Liberia, including providing food, hygene kits, medical supplies and care, and how within 3 months of international joint operations the transmission rate of ebola was deacreased to zero.

2. Health Care in Liberia

Source http://www.aho.afro.who.int/profiles_information/index.php/Liberia:Index

While physical access to primary health care has improved dramatically across Liberia, from one health facility serving an average of 8000 population in 2006 to one health facility per 5500 population in 2009, it is still not nearly enough, and the existing resources of medications, supplies, and facilities can and do become overwhelmed when faced with new challenges. 

3. Liberain public health response to the ebola crisis.

- http://www.nytimes.com/2014/11/20/world/africa/ebola-response-in-liberi…

As international support came into the country at the outbreak of ebola, Liberian public health structures and political institutions were unable to cope with the new strains and were rendered ineffective. Meetings between liberian health officials and international organizations that were lauded to the public as being "effective" were consistantly bogged down in politics, resulting in the inefficient implimentation of programs and the poor distribution of despritely needed resources.

The family followed during most of the film was able to get several members out of Liberia during the Ebola crisis, I was under the impression that travel across the border of affected nations was prohibited. The CDC webpage was able to confirm that travel bans were imposed to and from Guinea, Liberia, and Sierra Leone during the Ebola crisis. Travel to and from these places was only permitted for health officials and aid worked, and required a 21 day quarantine upon returning to the US. However, several cases in surrounding countries were reported and it is known that people would first travel to a different country before attempting to fly to the United States.

I was also interested in how health care workers and emergency responders kept themselves safe while working with such a dangerous virus, the CDC webpage was also able to clarify the PPE used when dealing with suspected or confirmed cases of Ebola, including gloves, gowns, respiratory protection and boots. Protocols also exist for training responders in the proper methods of donning and doffing PPE to protect themselves.

As a portion of the film focused on the public outrage concerning the quarantine, I read an article “Encouraging Compliance with Quarantine: A Proposal to Provide Job Security an Income Replacement” by Mark A. Rothstein which explains in greater detail the effectiveness but also challenges posed by a quarantine, and how this directly effects the infected and uninfected individuals inside.

1. I first looked up travel to and from Liberia during the Ebola outbreak, since it had been seized. There was a ban, which has since been lifted after, but people coming to and from West Africa are still screened and recommended to visit physicians. As of mid-2015 there wa still a 21 day monitoring period needed. http://www.infectioncontroltoday.com/news/2015/05/cdc-downgrades-travel…'
2. I was interested if there had been any progress on treatment for Ebola, but found that the main form of treatment is supportive care. Doctors are informed to provide IV fluid and ensure that the patient's immune response and other bodily functions are functioning properly. A vaccine is being worked on but has not gone through a trial to prove safety and effectiveness. https://www.cdc.gov/vhf/ebola/treatment/index.html
3. I looked further into the vaccine being produced for Ebola. Currently, there is a combined phase 2 and phase 3 trial occurring in Sierra Leone called STRIVE (Sierra Leone Trial to Introduce a Vaccine against Ebola). The study is unblinded, so patients know whether or not they have received the vaccine. The vaccine is a rVSV-ZEBOV, or recombinant Vesicular Stomatitis Virus Zaire ebolavirus vaccine. This vaccine is also being used in phase 2 and phase 3 trials in Guinea and Liberia http://www.cdc.gov/vhf/ebola/strive/qa.html

-I looked up UN response efforts in Liberia during the time of this outbreak. Doing this, I was able to learn about the process that was taken in an attempt to decrease the transmission of the disease. I also learned about specific numbers in terms of confirmed cases as well as deaths. The UN was mentioned but not explicitly talked about in the film, so I wanted to further my understanding of the actions and role they played during this outbreak. 

http://ebolaresponse.un.org/liberia

-I wanted to research the general healthcare in Libera and see if there is a lack in healthcare in this area, which may have aided in the severe devastation caused by the outbreak. As mentioned, the civil war really effected many outcomes of the country, one of them being healthcare. Communicable diseases were a factor that was already a topic of concern in this area before the outbreak of Ebola. Currently healthcare in Libera is being reformed, yet after reading this report, it is easy to see why the government and public health workers struggled so much to contain this outbreak.

https://csis-prod.s3.amazonaws.com/s3fs-public/legacy_files/files/publi…

-I wanted to learn more about the Ebola virus in general but also learn more about the diagnosis and the symptoms that those infected would display. I also wanted to learn more about the progression of the virus after being infected as well as the incubation period. I researched the virus on the World Health Organization website. Here I was able to find all this information out from the virus' origin to the diagnoses process and symptoms.

http://www.who.int/mediacentre/factsheets/fs103/en/

1)      How is Ebola best contained? From a report studying how Ebola was handled in Nigeria, there were several practices that were credited with its relatively quick eradication.  "The dense population and overburdened infrastructure create an environment where diseases can be easily transmitted and transmission sustained" (cdc.gov). In Nigeria, all 900 or so people who came in contact with the original patient zero were identified and monitored in isolation. The Nigerian CDC made over 18 thousand visits to screen suspected patients who would be moved to isolated treatment centers if highly suspect. Nigeria also holds a virology laboratory in Lagos University Teaching Hospital which allowed for quick and accurate testing. (http://www.livescience.com/48359-nigeria-how-ebola-was-contained.html)

2)      I also investigated the shooting of the boy who died, and why they shot him and what the circumstances were. I found that the boy, Shakie Kamara, was with a group of people trying to leave the neighborhood— against the government directive quarantine. The soldiers who fired on him and two other men were trying to prevent them from leaving. (http://www.nytimes.com/2014/08/22/world/africa/liberian-boy-dies-after-being-shot-during-clash-over-ebola-quarantine.html)

3)      The last point I investigated further was why it took international aid so long to arrive in West Africa (almost six months). The main reason for the long delay was due to logistics. Sites need to be located to store supplies and medical equipment which has to be transported to their sites in West Africa via underdeveloped roads. Just the transportation alone, mind sake organizing the manpower to run it, is an enormous task. Trying to find trucks, helicopters, and ambulances to move gear and get them in place takes time on the logistics end. "I need everything. I need it everywhere. And I need it super-fast." (http://www.bbc.com/news/world-africa-29654974)

The number of emergency workers lost during 9/11:

343 Fire Fighters - http://nyfd.com/9_11_wtc.html

60 Police Officers

8 EMTs and Paramedics - http://www.world-memorial.org/Tribute/EMS/medics.html

EMS Lesson's Learned from 9/11

http://www.jems.com/articles/2006/08/lessons-learned-911.html

Changes were made to the mutual aid system. Resources that had, in the event, run out or were needed sooner than they were used are now better stocked and available. Some new trainings were implemented.

More stories from 9/11 by EMS

http://www.nyc.gov/html/fdny/pdf/mck_report/ems_response.pdf

I looked into the wide varitey of illnesses that stemmed from the cleanup. I also investigated where the hazards came from - the get fuel, the burning chemicals and computer parts and building materials.

The entire video was very compelling.

When I see the movie, I was questioned that are the MSF are always keep helping one areas, and how long they can help. After research, I have found the projects that MSF closed are depends on the specific project and it is always a difficult decision. For example, some projects in Liberia are closed because of after many years, they had improved the emergency and health services.

There are also Medical issues offer by MSF, and they provide services within basic vaccination, maternal, pediatric care, fighting neglected diseases and complex surgery.

There are many ways to support MSF, within Foundation support, corporate support and so on.