PartnersInHealth

In Sierra Leone, starting in 2018, we have rebuilt the oldest psychiatric hospital in Africa, opened in 1820, in Freetown. In a country of 8 million people, with 2 psychiatrists, we have started a new psychiatry residency program that was last year accredited by the West African College of Physicians. Separately, but linked, in Eastern Sierra Leone, in Kono, and linked to Koidu Government Hospital, we have developed a continuum of mental health care that includes a range of providers. They go into the community and work with people directly. The heart of this work is non-specialists, that is, community members who provide support at a household level. We are excited to continue this commitment!

Learn more: https://storymaps.arcgis.com/stories/f133e3f4f4a64710ba559944eb10777c

These are very important and helpful links as we review the evolving epidemiology of the current outbreak. It is true that the current outbreak of monkeypox has been affecting clusters of people that belong to a specific group at a higher rate, but as we know, monkeypox can be spread to other populations if close contact happens with an infected person. In endemic countries, before this outbreak, monkeypox was known to affect people from many different communities: including children, women, elderly people, etc. Not only those from or in specific sub-sets of the population or those with specific sexual practices. With this in mind, we need to be careful to not create stigma around those who are homosexual or a part MSM communities.

Monkeypox is a viral infection transmitted through close contact and droplets with someone who is infected, regardless what social group they belong to. It is not a purely sexually transmitted disease. Sexual contact implies a close contact, skin-to-skin, and that can make it more easily spread if one of the sexual partners is infected.

Hi u/Matisaro, thanks for a great question!

The probability of monkeypox mutating to a higher transmissible virus is very minimal. Our concern is more that it may affect populations that are vulnerable like children, pregnant women, and people with low immune systems—those who can get more seriously sick with this infection.

This is why we want to perform good surveillance of cases and contact tracing to make sure it does not affect people who can develop more severe diseases beyond just skin lesions.

In previous outbreaks of monkeypox on the African continent, we have seen that a small proportion of cases continue to develop complications or even face death from the infection’s complications; again, these cases are mainly in vulnerable populations: children, pregnant women, malnourished people or with weak immune systems.

Overall, these are reasons to follow monkeypox closely.

Self-screening for a mental health condition using validated scales could be one way that someone can begin to describe what is happening in their lives. It would be important for people screening positive for any mental health condition to be linked to care and to be able to access professional evaluation as a follow-up. This is much easier said than done given the limitations in mental health care availability and delivery across the US and in other settings. Across our Partners In Health sites, we focus on building human resource capacity among both mental health providers and non-specialist providers to deliver care in places where there are few mental health resources. 

Learn more: https://www.pih.org/mental-health/program-planning-and-clinical-guidelines-development

Hi u/mikeblas and u/d0rf47

These are both very strong and real points!!!

COVID was a new disease that we knew very little of when it started. Because of its novelty, it created a lot of trial and error in the methodology from the science community, and politics also ended up being involved in the process.

Monkeypox, on the other hand, is not a new disease. As a disease, it has previously produced outbreaks on an annual basis in some African countries. Therefore although it seems new to those in many higher-income countries as monkeypox has not been endemic to these areas, monkeypox is not new for the overall scientific community. The difference is that monkeypox has been affecting those in poorer countries that don't get the attention that this current outbreak has.

I strongly believe that the approach to monkeypox should transcend our trust in governments and go towards how important promotion of Global health is… There are diseases that affect more vulnerable populations and those in poor countries that only become important when they come within Western society’s borders.

We need to fight against this social and health injustice. Vaccines, antivirals… these need to be developed, promoted, and studied for the wellbeing of all humanity, not only rich countries.

We need to continue working together—as a scientific community and as a population—to ensure that we achieve a model of Global health that can protect everyone, regardless of where one is born or lives.

And we need to work strongly to avoid pollicization of health inequalities and social injustice. Take together, this is what is needed to strengthen community trust in measures that are required to fight against the occurrence of any new outbreaks.