It’s easy to focus on what makes us unhealthy. In the past four years alone, there have been over 500 disease outbreaks in developed and developing countries alike ranging from the more common flu to the more extreme Ebola and Zika.
But this World Health Day, we’re focusing on who keeps us healthy: skilled health professionals like nurses, midwives, and doctors. Because these are the individuals that so often determine how a disease outbreak will end: with swift containment or a prolonged health crisis.
Take, for example, Canada’s response to the deadly H1N1 (swine flu) pandemic in 2009 that occurred in 214 countries and killed over 18,500 people.
When the swine flu hit Canada, Canada’s health system sprang into action, enacting the largest vaccination campaign in the country’s history. At the national level, the Canadian federal government purchased and distributed vaccines to the provinces, which in turn determined the best way to administer the vaccine.
At the local level, health workers in hospitals and labs helped identify, treat and prevent cases of H1N1 in real-time. Canada’s health workforce, combined with a strong surveillance system and high-level of coordination led to control of the epidemic.
Contrast Canada’s example with the case of Liberia in the 2014-15 Ebola epidemic that infected over 28,000 people across 10 countries, primarily in West Africa.
Civil war in Liberia destroyed over a third of the country’s health facilities and depleted the country’s health workforce. In fact, there were fewer skilled Liberian health workers then than students at Harvard and Johns Hopkins medical schools combined. The number of cases rapidly overwhelmed health facilities that lacked treatment beds, supplies, and essential medicines. Healthcare workers weren’t adequately protected, resulting in over 400 health workers becoming infected and the three largest hospitals in the capital of Liberia closing. More people died of Ebola in Liberia than in any other country and its economy was devastated. Liberia lost $300 million due to the epidemic – a whopping 15% of its GDP – and 40% fewer people, especially women, were working since the crisis’ onset.
There are a number of reasons why the case of Canada and Liberia are different. For example, Canada has more financial resources, better ability to control national borders, and swine H1N1 had a vaccine whereas Ebola did not. These are not insignificant factors. But at the most basic level, the presence of a strong health workforce who can find patients, administer treatments and promote healthy behavior matters, and often makes the difference between stopping an epidemic from the outset or not.
The World Health Organisation recommends that a country ideally has 44.5 doctors, nurses, and midwives per 10,000 people. Canada has 118; Liberia has just 3.
A country’s investment in its own health system, with support from foreign aid when needed, is essential to building health workforce capacity and emergency preparedness. Consider Liberia, which since the Ebola outbreak has put its health workforce at the center of their recovery efforts, investing in a community health worker initiative to deploy 4,000 health workers to serve the 1.2 million Liberians living too far from the nearest health center.
Disease outbreaks happen, but the prolonged health and economic backlashes don’t have to. Investing in health systems and the healthcare workers that make them work today – especially in the world’s poorest countries – can stop disease outbreaks tomorrow both at home and abroad.