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This idea could also have been called 'Create a Home Isolation Protocol'. My though was that by focusing on building ETCs we might have missed an opportunity to reduce the rate of infection through specialized national staff working in the community.

I would also add the caveat that home isolation is a poor alternative to in-patient care. I only advocate it to reduce the rate of infection and protect families when there is no alternative. We should continue to build ETCs as fast as possible.

This idea was in the context of a system I imagined for treating patients outside the ETCs. The images of people lying in the streets, and the stories of aid workers having to turn people at the gates away were truly upsetting. It seemed follow-up ends at the gates of the ETCs.

The first step would be to train and equip a large number of community health workers in the three roles that I mentioned in the idea: case finding/contact tracing, home isolation counselling, and body removal/home disinfection. I think all of these activities are currently happening on the ground - but perhaps not in a coordinated process with people specialized in each task.

Quickly sharing information among a network of community health workers would be key to home isolation. The first step would be to have comprehensive contact tracing so that as soon as a patient started to show symptoms they could be put in isolation, before they are very symptomatic and contagious.

Home Isolation Counselors would need to be mobile, well trained, and networked.

Some ideas for the job description:

Basic facts about Ebola transmission

Identify one person as the 'Caregiver' that they will train to take care of patient
Train the Caregiver to protect themselves using the home kit
Work with the caregiver to design an isolation plan
Educate the family about respecting the isolation plan
Designate a transition area, and an off-limits area inside the home (tape on the floor in urban areas? cheap pop up tents in rural?)
Counsel other members of the family to find other accommodation
Conduction contact tracing interview to find who has already been exposed

We should also think about what should go into a home isolation kit and if mobile medical teams would be possible.

Also have a look at our project here:

There might be a way we could collaborate to bring better mobile technology to the fight against Ebola.


William commented on Free telemedicine platform for West Africa

I noticed that in Singapore there is a 71.7 percent smartphone penetration rate, they rank 4th in the world, above the US and all of Europe. Clearly this app works well in that kind of context.

Liberia has a basic cell phone penetration rate of 42 percent, with 2,8 percent of the population with access to internet.

How could this solution be adapted to the current context on the ground there? Would it be possible to use SMS to deliver this information?