Salome Karwah

Salomé Karwah (c. 1988 – February 21, 2017) was a Liberian nurse who was named co-Person of the Year by Time magazine in 2014 for her efforts to combat the West African Ebola virus epidemic in Liberia.[1][2] She appeared on the cover of Time in December 2014 with other health care workers and colleagues working to end the epidemic.[1] Karwah survived ebola herself before returning to work to help other patients afflicted with the disease.[1] The actions of Karwah, who worked with Médecins Sans Frontières (Doctors Without Borders) (MSF) and other health care professionals, are believed to have saved lives of thousands.[1]

However, two years later, Karwah died from complications of child birth, possibly due to the widespread, mistaken belief that ebola survivors can still transmit the virus, according to accounts by her husband.[1][2][3][4][5] Even before the ebola outbreak, Liberia had one of the highest rates of maternal mortality in the world.[1]

Biography

Karwah's father was a doctor.[3] She met her future husband, James Harris, at a mutual friend's in 2013 after both had recently ended previous relationships.[3] They began dating shortly afterwards.[3]

Ebola work

Salome Karwah Time cover
Time magazine's 2014 "Person of the Year" with Karwah on the cover.

One year after Karwah and Harris began dating, the West African Ebola virus epidemic struck Liberia, as well as neighboring Guinea and Sierra Leone, in 2014.[3] Her family was among the first to become ill with ebola during the summer of 2014.[3] Her father was the first to die from ebola, which ultimately killed both her parents and seven other relatives.[1][3] Karwah, her sister, Josephine, her mother, and Harris were all soon stricken with ebola as well.[3] Salome, Harris and Josephine Karwah were all placed in a Doctors Without Borders medical unit in Monrovia with other ebola patients to be treated.[3] Salome Karwah's priority was to care for her sister, Josephine Manly, who was pregnant at the time she contracted ebola.[3] Salome cared for Josephine, who nearly died, by changing her clothes and cleaning fluids that contained ebola. She withheld the news of their mother's death from Josephine, fearing that it would have a detrimental effect on her health.[3]

By September 2014, both the Karwah sisters had recovered, determined free of the disease, and discharged from the hospital.[3] Salome Karwah was released from the ebola unit on August 28, 2014.[6] Karwah's boyfriend, James Harris, also recovered and was released from the medical unit a few days later.[3] The staff at Doctors Without Borders (MSF) had noticed that Karwah and Harris had both shown an ability to care for other ebola victims, regardless of the risk to their own health, while they had been patients.[3] Shortly after their discharge from the hospital, MSF hired them to serve as mental health counselors in their ebola units.[3][5] Salome Karwah returned to the unit, this time as a counselor and nurse, one month after her release.[6] As survivors, she and Harris had developed a natural immunity to that particular strain of ebola.[6]

Karwah, who was interviewed on her work by NPR in 2014, recalled that "It was not hard to come back [to the Ebola treatment center]. Of course I lost my two parents here...but if I can help someone survive, I will be very happy."[3][6] She remained at the unit until the end of the ebola epidemic.[3][6]

In October 2014, Karwah wrote a guest piece in The Guardian noting that helping others with ebola brought meaning to her life.[4][7] In the same essay, Karwah reiterated that "if someone has Ebola, it isn’t good to stigmatize them, because you don’t know who is next in line to contract the virus."[4][7]

Time magazine named Salome Karwah as its co-Person of the Year, alongside several other "ebola fighters".[4] She appeared on the worldwide cover of Time in December 2014 just months after being released from the hospital.[2][1][4]

Harris and Karwah became engaged. They were married to January 2016 while Karwah was pregnant with their third child, who was born a few months later.[3] In the summer of 2016, Karwah became pregnant with their fourth child, which they agreed would be their last.[3] The couple, who were religious but already had three small children, thought of having an abortion, but chose to keep the baby.[3]

Passing from complications of child birth

Salome Karwah went through a difficult pregnancy. In February 2017, Karwah underwent a caesarean section though she was suffering from high blood pressure at the time.[1][3] Although she had high blood pressure, Karwah was discharged from Eternal Love Winning Africa Hospital (ELWA) on the outskirts of Monrovia several days after undergoing the caesarean.[3] She and Harris returned to their home to care for their new infant son, Jeremiah Solomon Karwah, and their other children.[3] Karwah continued to feel unwell, exhibit spikes in blood pressure, and confided to family members that staff at ELWA hospital had neglected her complications.[3] Just hours after arriving home, Karwah collapsed and began foaming from her mouth.[3]

Her husband rushed her back to ELWA hospital on the night of February 19, 2017.[3] However, the hospital's doctor who specialized in treating ebola survivors was not on duty at the time. Another doctor refused to treat Karwah, who remained in the car for "three hours" while suffering from convulsions and seizures.[3][5] Harris eventually went to the emergency room himself and brought out a wheelchair to bring his wife into the hospital.[3] According to Harris, the doctor and nurses on duty still refused to see or touch Karwah, telling him that he would have to take her to another hospital. Harris gave his account to NPR in an interview, saying ""[The doctor] was checking Facebook...I had to rush into the emergency room myself to get a wheelchair, but I was struggling to take her from the car to put her in it. Other nurses came to help me, but the doctor told me that she would not touch her, and that if [Salome] stayed [at the hospital] she would die."[3]

He managed to contact an epidemiologist named Dr. Mosoka Fallah, who arrived at ELWA three hours later and finally admitted Karwah to the hospital.[3] Despite his efforts, Salome Karwah, who had survived ebola, died from complications of child birth on February 21, 2017, at the age of 28, just four days after giving birth.[1][3][4][5] She was survived by her husband and their four children, including the youngest, Jeremiah Solomon Karwah.[3]

Harris and Karwah's sister, Josephine, accused the ELWA staff of malpractice due to her status as a former ebola patient.[3][8] They accuse the medical staff of providing inadequate care because they were afraid to touch her.[3][8][4] Josephine Manly, Karwah's sister who also survived ebola, reiterated Harris's claims of poor treatment by hospital staff, saying "They said she was an Ebola survivor. They didn't want contact with her fluids. They all gave her distance. No one would give her an injection."[4] Manly believes that Karwah would have survived the child birth complications if she had received proper, timely emergency medical treatment.[4]

The mistaken belief that ebola survivors can still transmit ebola remains widespread across the country, including among medical staff, which may have contributed to Karwah's death.[1] According to the Associated Press, the country's chief medical officer, Dr. Francis Kateh, echoed this falsehood when he told reporters that "the hospital knew she had Ebola and they operated on her, which put them at more risk."[1]

Tributes came in from around the world, including her former employer, Médecins Sans Frontières, who wrote in a statement, "Salome's own experience of Ebola gave her incredible empathy for the patients that she worked so hard to care for...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."[1] Ella Watson-Stryker, a MDF health promoter and colleague of Karwah, told Time magazine of the shock of her death, "To survive Ebola and then die in the larger yet silent epidemic of health system failure … I have no words."[4]

Karwah's life was remembered on BBC Radio 4's obituary programme Last Word by Time magazine’s Africa correspondent, Aryn Baker.[9]

References

  1. ^ a b c d e f g h i j k l m Paye-Layleh, Jonathan (2017-03-02). "Ebola health care worker dies after childbirth in Liberia". Associated Press. CBC News. Retrieved 2017-03-15.
  2. ^ a b c Baker, Aryn (2017-02-27). "Liberian Ebola Fighter, a TIME Person of the Year, Dies in Childbirth". Time. Retrieved 2017-03-15.
  3. ^ a b c d e f g h i j k l m n o p q r s t u v w x y z aa ab ac ad ae af ag ah Mukpo, Ashoka (2017-03-01). "A Husband Loses His 'Best Friend' – Salome Karwah, Ebola Hero". NPR. Retrieved 2017-03-15.
  4. ^ a b c d e f g h i j Ryan, Lisa (2017-03-01). "Ebola Fighter Dies From Childbirth Complications After Hospital Staff Reportedly Refused to Help Her". New York Magazine. Retrieved 2017-03-15.
  5. ^ a b c d McVeigh, Karen (2017-02-28). "Ebola survivor and frontline fighter dies after childbirth complications". The Guardian. Retrieved 2017-03-15.
  6. ^ a b c d e Hersher, Rebecca (2014-10-25). "Producer's Notebook: Coming home from Monrovia to confusion and fear". NPR. Retrieved 2017-03-15.
  7. ^ a b Karwah, Salome (2014-10-11). "I survived Ebola for a reason – to help others recover". The Guardian. Retrieved 2017-03-15.
  8. ^ a b "Ebola nurse Salome Karwah died after hospital neglect, husband says". BBC News. 2017-03-01. Retrieved 2017-03-15.
  9. ^ Presenter: Matthew Bannister; Producer: Neil George; Interviewed Guest: Aryn Baker (26 March 2017). "Martin McGuinness, Chuck Berry, Sir Derek Walcott, Salome Karwah, Colin Dexter". Last Word. 17:07 minutes in. BBC. BBC Radio 4. Retrieved 26 March 2017.
2017 in Liberia

Events in the year 2017 in Liberia.

3-Deazaneplanocin A

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93 Days

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Bundibugyo ebolavirus

The species Bundibugyo ebolavirus ( BUUN-dee-BUUJ-aw) is the taxonomic home of one virus, Bundibugyo virus (BDBV), that forms filamentous virions and is closely related to the infamous Ebola virus (EBOV). The virus causes severe disease in humans in the form of viral hemorrhagic fever and is a Select Agent, World Health Organization Risk Group 4 Pathogen (requiring Biosafety Level 4-equivalent containment), National Institutes of Health/National Institute of Allergy and Infectious Diseases Category A Priority Pathogen, Centers for Disease Control and Prevention Category A Bioterrorism Agent, and is listed as a Biological Agent for Export Control by the Australia Group.

Cuevavirus

Cuevavirus is a genus in the family Filoviridae, which is included in the order Mononegavirales. Cuevavirus includes a single species, Lloviu cuevavirus, with one member, Lloviu virus (LLOV). It was discovered in the Cueva de Lloviu in Asturias, Spain, in a species of bats known as Schreiber's long-fingered bats (Miniopterus schreibersii). LLOV is a distant relative of the more widely known Ebola and Marburg viruses. Members of the genus are referred to as cuevaviruses. Cueva is derived from the Spanish word for cave.

Ebola River

The Ebola River, also commonly known by its indigenous name Legbala, is the headstream of the Mongala River, a tributary of the Congo River, in northern Democratic Republic of the Congo It is roughly 250 km in length.

The name Ebola is a French corruption of Legbala, its name in the Ngbandi language which means "white water". During the Belgian administration these names were interchangeable along with the French names Eau Blanche and rarely L'Ébola.In 1976, Ebola virus (EBOV) was first identified in Yambuku, 60 miles from the Ebola River, but Professor Peter Piot decided to name it after the river so that the town would not be associated with the disease's stigma. Thus, the river is eponymous to the terms Ebola virus, Ebolavirus, and Ebola virus disease (usually referred to as simply "Ebola").

Ebola Syndrome

Ebola Syndrome (伊波拉病毒) is a 1996 Hong Kong Category III exploitation film starring Anthony Wong and directed by Herman Yau.

FGI-103

FGI-103 is an antiviral drug developed as a potential treatment for the filoviruses Ebola virus and Marburg virus. In tests on mice FGI-103 was effective against both Ebola and Marburg viruses when administered up to 48 hours after infection. The mechanism of action of FGI-103 has however not yet been established, as it was found not to be acting by any of the known mechanisms used by similar antiviral drugs.

FGI-104

FGI-104 is the name for a family of chemical compounds that act as broad-spectrum antiviral drugs, with activity against a range of viruses including Hepatitis B, Hepatitis C, HIV, Ebola virus and Venezuelan equine encephalitis virus. Compound R19 is the most preferred compound listed in the patent covering this family.

Galidesivir

Galidesivir (BCX4430, Immucillin-A) is an antiviral drug, an adenosine analog (a type of nucleoside analog). It is developed by BioCryst Pharmaceuticals with funding from NIAID, originally intended as a treatment for hepatitis C, but subsequently developed as a potential treatment for deadly filovirus infections such as Ebola virus disease and Marburg virus disease. It also shows broad-spectrum antiviral effectiveness against a range of other RNA virus families, including bunyaviruses, arenaviruses, paramyxoviruses, coronaviruses, flaviviruses and phleboviruses. BCX4430 has been demonstrated to protect against both Ebola and Marburg viruses in both rodents and monkeys, even when administered up to 48 hours after infection, and development for use in humans is being fast-tracked due to concerns about the lack of treatment options for the 2013-2016 Ebola virus epidemic in West Africa. BCX4430 also showed efficacy against Zika virus in a mouse model, though there are no plans for human trials at this stage.

Kent Brantly

Kent Brantly is an American doctor with the medical mission group Samaritan's Purse. While treating Ebola patients in Liberia, he contracted the virus. He became the first American to return to the United States to be treated for the disease.

List of Ebola patients

Thousands of individuals have suffered from Ebola virus disease (EVD), with some individuals notable as index cases or for having been doctors who treated other patients before becoming ill.Ebola was discovered in 1976, with periodic outbreaks and cases noted since then.

Lloviu cuevavirus

The species Lloviu cuevavirus ( YOV-yoo KWEV-ə-VY-rəs) is the taxonomic home of a virus that forms filamentous virion, Lloviu virus (LLOV). The species is included in the genus Cuevavirus. LLOV is a distant relative of the commonly known Ebola virus and Marburg virus.

Mayinga N'Seka

Mayinga N'Seka (1954 – October 19, 1976) was a nurse in Zaïre, now Democratic Republic of the Congo. She died from Ebola virus disease during the 1976 epidemic in Zaïre. She has been incorrectly identified as the index case by several sources, but a World Health Organization commission report on the outbreak lists a man from Yambuku as the index case, Mabalo Lokela.

Mengla virus

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The species Sudan ebolavirus is a virological taxon included in the genus Ebolavirus, family Filoviridae, order Mononegavirales. The species has a single virus member, Sudan virus (SUDV). The members of the species are called Sudan ebolaviruses.

Taï Forest ebolavirus

The species Taï Forest ebolavirus () is a virological taxon included in the genus Ebolavirus, family Filoviridae, order Mononegavirales. The species has a single virus member, Taï Forest virus (TAFV). The members of the species are called Taï Forest ebolaviruses.Tai Forest ebolavirus has been seen in a single human infection due to contact chimpanzee from the Tai Forest in Ivory Coast.

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United Nations Ebola Response Fund is a special fund set up by the United Nations Foundation to allow donations to support U.N. institutions to respond to the Ebola virus epidemic in West Africa. The U.N. has received other money for Ebola, but the fund is more flexible in how it can be spent. The U.N. announced the fund on 12 September 2014.They asked for one billion dollars to be donated, and by 21 October 2014 50 million had already been pledged. On November 11 the Philippines government announced it would donate 1 million to the fund.Countries that have pledged or committed money to the fund by 7 November 2014 include Australia, Azerbaijan, Canada, Chile, China, Colombia, Denmark, Estonia, Finland, Germany, India, the Republic of Ireland, Japan, Kazakhstan, Luxembourg, Malta, New Zealand, Norway, Romania, South Korea, Sweden, the United Kingdom, and Venezuela.

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