Zika outbreak: Conversations from the Global Health Nursing field

Zika virus

Zika outbreak: Conversations from the Global Health Nursing field

Editors note: Dr. Sarah Gimbel, co-director of the UW School of Nursing Center for Global Health Nursing, conducted an interview in April with Karin Huster, BSN ’05, MPH ’13, about the Zika outbreak.

Huster worked for nine years as a Registered Nurse at Harborview Medical Center, seven of them in the Trauma Intensive Care Unit. Since 2013, she has been working in humanitarian emergency settings – in Gaza, then in Lebanon, working with non-governmental organizations and the United Nations High Commissioner for Refugees on Syrian refugee issues. Most recently, she has focused her energy on the Ebola epidemic in Guinea, Sierra Leone and Liberia, where she served most recently as the Senior Humanitarian Adviser to the Office of Foreign Disaster Assistance (USAID branch), focusing on post-ebola risk reduction programming  strategies. She was also a clinical lead of an Ebola treatment unit with Doctors without Borders (Guinea) and Partners in Health (Sierra Leone). 

Sarah Gimbel

Sarah Gimbel

Sarah Gimbel: Hello Everyone, Greetings from UW School of Nursing Center for Global Health Nursing! In true global health nursing fashion, I am conducting this interview virtually from my field research site in central Mozambique. My friend, collaborator, and fellow nursing advocate, Karin Huster, has agreed to respond to some critical questions concerning the Zika outbreak, while she is en route home from her recent 3 month assignment in Guinea. Karin has spent the last 18 months deeply engaged in Ebola work in west Africa.

Gimbel: Karin, thanks for agreeing to respond to these questions. Now, we are aware that you are not a Zika expert, however you are an expert in Ebola. Much of the media has been evoking both Zika and Ebola in their reporting. From your experiences in Liberia, Sierra Leone and Guinea over the last 18 months, can you draw any corollaries between the two viruses? Specifically what common system level facilitators of these viruses do you see?

Karin Huster

Karin Huster

Huster: I don’t think we should be comparing Zika and Ebola. They are two very different entities: Zika is far less dangerous than Ebola — you don’t die from it. We also still have to establish a formal link between Zika and microcephaly. As well, while Ebola was allowed to spread out of control for a long time because the affected countries had no health systems to speak of, this isn’t really the case for Zika.

That being said, where we can draw a corollary between the two is in ensuring that interventions we devise are designed in partnership with the affected communities – to ensure their acceptance and support. This was our Achilles heel in our fight against Ebola. Let’s make sure we’ve learned from our mistakes.

Gimbel: How do you feel income disparity contributes to the rise of epidemics, both within countries and globally?

Huster: Income disparity is the source of many evils. But the rise of epidemics is complex and multi-factorial. Broken health systems, a lack of preparedness and response, climate change, and social and economic conditions that allow an epidemic to take hold – these are a few of the factors contributing to rises in epidemics or pandemics.

Look no further than home in the United States, where we are brewing our own perfect storm: our healthcare facilities have been plagued by dangerous strains of antibiotic-resistant staphylococcus (MRSA) or Clostridium Difficile (C-Diff). And income disparity actually has little to do with it.

Sarah: Do you see any similarity with the media reaction?

Karin: Communication about potential public health issues in the era of social media, where bits of information zoom across the internet at the speed of light, ought to be careful, measured and accurate. Politicians, who almost always aren’t health experts, should refrain from dispensing any advice, distilling fear and setting up measures that are falsely designed to protect their constituencies.

When the World Health Organization (WHO) declared Zika a public health emergency, it did not recommend any travel restrictions. Yet the United States chose to do this, which inevitably fueled more fears. Things are relatively quiet compared to Ebola – but let’s see what happens as the Olympic Games draw nearer.

Sarah: How will or can nurses have an impact in slowing the spread of the Zika virus?

Karin: Education and prevention (risk reduction) immediately come to mind. That’s what nurses do best. That’s what we are trained to do. Conveniently, it happens to be one of the most important things we can do to reduce transmission.

Educating communities about Zika itself, providing accurate information about the illness – what it is, how it is transmitted, who is most at risk, what symptoms to look for and what to do when you are sick. Educating about Zika and pregnancy risks.

When it comes to prevention, explaining the steps can one can take as an individual, or as a community, to reduce the risk of getting Zika: from removing stagnant pools of water to using repellents, wearing long sleeves, or other such measures.

Sarah:  Thanks Karin, safe travels!