埃博拉与孕产妇死亡率的关系

埃博拉与孕产妇死亡率的关系

The World Bank warns the Ebola deaths of hundreds of healthcare workers could cause maternal 1 mortality rates to soar in Guinea, Liberia and Sierra Leone. The disease has killed health workers at a higher rate than any other population group.

世界银行警告称，数百名医疗工作者因埃博拉而死亡的后果可能会导致几内亚、利比里亚和塞拉利昂的产妇死亡率飙升，与任何其他人群相比，该疾病导致的医疗工作者死亡率最高。

A World Bank report says maternal deaths could reach levels not seen in the Ebola-affected countries in 15 or 20 years. Rates could increase by 38 percent in Guinea, 74 percent in Sierra Leone and 111 percent in Liberia.

世界银行的一份报告称，在受埃博拉影响的国家，孕产妇死亡可能会达到15到20年来从未有过的水平。几内亚的死亡率可能会增加38%，塞拉利昂增加74%，利比里亚增加111%。

Senior Economist 2 and co-author of the report David Evans reacted to those figures.

高级经济学家兼这篇报告的联合撰稿人戴维·伊万斯对这一数字发表看法。

“What this adds up to is between both mothers and children about 25,000 lost lives per year.”

“这就导致每年有大约2.5万名妇女和额额同死亡。”

That could happen, he said, because Ebola has taken such a toll 3 on health workers.

他说之所以如此，是因为埃博拉对医疗工作者造成这么大的损失。

“The Ebola epidemic 4 has had a dramatically disproportionate impact on health workers in these three countries: Sierra Leone, Liberia and Guinea. For example, in Sierra Leone, health workers have been 50 times more likely to contract Ebola than the rest of the population. And the numbers are similar in the other two countries,” he said.

“埃博拉疫情对塞拉利昂、利比里亚和几内亚这三个国家的医疗工作者影响相当大，比如在塞拉利昂，与其他人群相比，医疗工作者接触埃博拉的几率要高出50倍，在另外两个国家，这个数字都差不多。”

Evans said the three countries were already fragile before Ebola struck because they had “an incredibly limited health care force.”

伊万斯说这三个国家在埃博拉爆发之前就很脆弱了，因为这些国家“医疗工作者队伍规模很有限”。

“Before the Ebola epidemic, Sierra Leone was fifth from the bottom globally in terms of doctors per capita. Liberia was second from the bottom. And Guinea was 28th, which is a little better, but still not a very strong health workforce 5. So, you start from that and then you take away between five and ten percent of the healthcare workforce,” he said.

“在埃博拉疫情爆发之前，塞拉利昂的人均医生数量全球排名倒数第五，利比里亚倒数第二，几内亚排名第28，比前两个国家要好些，但其医疗队伍仍不够强大。所以在这样糟糕的基础上，埃博拉夺走了5%到10%的医疗工作者的性命。”

Liberia, for example, lost 10 percent of its doctors. It only had 51 prior to the outbreak.

比如，利比里亚损失了10%的医生，而疫情爆发之前只有51名医生。

Many have raised concerns that during the Ebola epidemic children did not receive measles 6 vaccinations 7, malaria 8 and HIV/AIDS patients failed to get treatment and testing for HIV plummeted 9.

很多人担心在埃博拉疫情期间，儿童没有得到麻疹疫苗，疟疾和艾滋病毒、艾滋病患者未能得到治疗，对艾滋病毒的检验也急剧减少。

Evans said, “One thing that we noticed is that nobody was really focusing on, specifically, this loss of health workers, which actually has a whole range of effects, including the most fundamental outcomes in the health sector 10, like maternal and infant mortality.”

“我们注意到的一件事是，没有人真正关心医疗工作者损失一事，而事实上这导致了一系列问题，包括医疗领域一些最基本的问题，比如产妇和新生儿死亡。”

But The World Bank report – Healthcare Worker Mortality and the Legacy 11 of the Ebola Epidemic – said all is not lost. Evans said something can be done immediately to keep things from getting worse.

但世界银行的报告《医疗工作者死亡和埃博拉疫情影响》称还有一线生机，伊万斯称可以立即采取一些措施来阻止情况变得更糟。

“In the immediate 12 run, we need to make sure that there are plenty of health workers right now that are available. And so one of the solutions to that, which the World Bank and a number of other international partners – the U.N., the African Union – have been supporting [is] the recruitment, training and deployment 13 of foreign health workers to communities in need in Guinea, Liberia and Sierra Leone. So, about 1,300 have been deployed 14 so far. So, in the short run, this is crucial.”

“就当下来说，我们需要确保能有大量的医疗工作者，因此其中一个解决办法，就是世界银行和多个国际合作者，包括联合国和非盟对招募、培训外国医疗人员的支持，并把他们派遣到几内亚、利比里亚和塞拉利昂需要他们的社区。到目前为止已经派遣了大约1300人，所以从短期来看，这一点很关键。”

The senior economist said, however, a long-term solution is a necessity.

然而，这位资深经济学家说，长期的解决方案仍是必要的。

“It means investing in the local healthcare infrastructure 15, making sure that doctors, nurses, midwives and community health workers are trained and that they have the protection that they need to do their jobs safely. And that they have the pay that they need so that they’re willing to stay in country. There are a lot of local professionals who want to serve their home population if they can do so in reasonable conditions and with some level of reasonable remuneration,” he said.

“这意味着投资于当地医疗基础设施，确保医生、护士、助产士和社区医疗人员得到培训，并得到所需的保护以确保安全工作，得到应得的报酬以确保他们愿意留在这个国家。有很多当地专业人员愿意服务于本国人民，前提是他们能在合适的环境下工作，并得到合适的报酬。”

The World Bank report said to reach 80 percent health coverage 16 -- included in the Millennium 17 Development Goals --more than 43,000 doctors, nurses and midwives would need to be hired across Guinea, Liberia and Sierra Leone.

世界银行的这份报告称，要实现千年发展目标中80%的医疗覆盖目标，整个几内亚、利比里亚和塞拉利昂需要雇佣超过4.3万名医生、护士和助产士。

The World Bank Study was published in The Lancet Global Health.

世界银行的这份研究发表在《柳叶刀全球健康》期刊上。