Interview. The president of the Italian humanitarian organization Emergency explains the expertise they acquired working to protect populations in Sierra Leone. ‘We remained Ebola-free throughout the epidemic.’

Emergency NGO: Apply the Ebola model against the coronavirus pandemic

It’s like fighting the Ebola epidemic that broke out in Africa: put aside the ordinary procedures and follow the protocols that doctors from the Emergency NGO have used in Sierra Leone with great success, explains the president of the humanitarian NGO, Rossella Miccio. “We were there in 2015, and our hospital facilities were never infected, either by a medical worker or by a patient.”

What can Emergency do to help resolve the COVID-19 crisis?

Together with the Lombardy Region and the Civil Defense, we are discussing how we can support the hospitals. We have been contacted by many doctors in Italy. Our doctors are also part of projects abroad, and in order to help them we have tried to identify protocols and procedures to keep the pathways safe on the front lines, in order to avoid the spread of the virus inside them. 

We did not expect such a high level of contagiousness: particularly in the beginning, very many medical staff became infected, especially outside the specializations that have to do with COVID-19. In infectious disease units or ICUs, certain types of protocols are always followed, but outside these areas—most importantly at the beginning—a number of safety precautions were not in place or certain procedures were not followed, and this caused the disease to spread among healthcare workers, weakening the system. We are identifying the hospitals where we can help, together with the regional authorities.

Your procedures are the result of experience in the field.

We worked in Sierra Leone during the Ebola epidemic in 2015. We had two facilities: one was a surgical hospital, the other was a center for Ebola patients. We ensured the ordinary functioning of the surgical hospital, which remained Ebola-free throughout the epidemic. The other facility had the only intensive care unit for Ebola patients on the whole continent. Our coordinator, Gina Portella, was the only doctor in the world who was managing multiple Ebola patients who were intubated or on dialysis. In the West, such cases were one per hospital, but we had 12 beds and four or five occupants on average. You need to know how to stop possible contamination, how to manage flows of people and dirty/clean material.

There are already two Emergency projects underway in Milan.

In collaboration with the municipality, through the “Milano aiuta” (“Milan helps”) platform, we have set up a coordination center with volunteers in the local area to bring food and medicine to at-risk or quarantined people. Also in collaboration with the administration, we are monitoring and managing the COVID-19 emergency among vulnerable groups: homeless people, unaccompanied minors, asylum seekers. These are population groups who are exposed to the virus but do not have a home or are living in group reception facilities, where isolation and hygiene standards are not guaranteed. Many do not have a doctor they can call if they develop symptoms.

How do you intervene?

Emergency has activated teams, mapped out the facilities and identified priorities according to the number of people hosted and the conditions of the places. Since Saturday, we’ve checked around 36 accommodations. Where necessary, we indicate to the managers the changes which must be made to the spaces: different logistics, bed spacing, hand washing devices, meal management. We provide health supervision (to monitor any symptoms) and staff training. 

Finally, the municipality has identified a building with 70 seats in the area of Quarto Oggiaro, in Via Carbonia: since Wednesday, it has been used to isolate people who develop symptoms and who can no longer stay in collective accommodation as a result. There are about 5,000 homeless people, unaccompanied minors and asylum seekers in Milan who might need such spaces. At this facility as well, we will provide support with medical staff and training.

How are your clinics operating in Italy?

Since 2016, we have been present everywhere from the south to the north, including in the earthquake zones in central Italy. We treat everyone: migrants, Italians, the elderly, the chronically ill, people who do not have the money to pay for nursing at home. Healthcare must be public, free, universal and high-quality. If any one of these elements is missing, it becomes a privilege exclusively for those who can afford it.

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