Congolese doctor honored for game-changing 'Ebola Cube'

A Congolese doctor who came up with the concept for a “game-changing” portable Ebola treatment unit has been honoured for his work.

Dr Richard Kojan, an intensive care specialist for French non-governmental organisation Alima, was recognised with an innovation award during the Reaching the Last Mile forum in Abu Dhabi.

He came up with the concept of the Cube – a biosecure emergency treatment unit – after his experiences responding to the Ebola epidemic in West Africa in 2014-15, which killed more than 11,000 people.

Because of the incredibly high risk of picking up the disease from patients, doctors and nurses working in traditional Ebola treatment units have to wear personal protective equipment which is heavy, hot and cumbersome. They are limited to wearing it for just 30 minutes, so can spend only short periods of time with patients.

During the current outbreak of the highly contagious infectious disease in the Democratic Republic of Congo, 163 health workers have contracted Ebola, 41 of whom have died.

“In the traditional suit it’s not possible to give a good standard of care and not possible to monitor the patient properly or stay with the patient,” said Dr Kojan, who was inspired to act after one of his patients passed away.

The patient needed an infusion of intravenous fluids but his 30-minute window only gave him enough time to administer them – he was unable to stay and monitor her as he would have done normally.

“The patient died soon afterwards. I was frustrated as it was not possible to give good care to that patient. At the end of the outbreak in West Africa I said ‘we have to find a way to give really good care to patients’,”.

With his colleagues at Alima he visited hospitals in France and the UK, including the high level isolation unit at the Royal Free Hospital in London where Pauline Cafferkey – the British nurse who contracted Ebola in 2014 – was successfully treated.

Here, he saw that patients with highly infectious diseases, such as Ebola, are cared for in special isolation units with protected arm and head holes which allow health workers to carry out procedures, such as administering fluids and injections, while also protected from the patient.

Working with French firm Securotec, Dr Kojan and his colleagues designed a transportable, transparent structure which has negative air pressure – meaning that the temperature can be controlled and to prevent cross-contamination.

The room can be set up in about 90 minutes and it enables patients to be cared for closer to their communities.

Crucially, it can also enable family members to visit and see loved ones, said Dr Kojan.

One of the challenges in the current outbreak in Democratic Republic of Congo is the high level of mistrust among communities, who see patients being taken away and returned in body bags, with no idea of what has happened to them in the intervening period.

“The family can come and see the patient and the patient can see the family and who is treating them. Life changed with the Cube – it changed for health workers, for patients and families,” Dr Kojan said.

Around 30 of the Cubes are currently being used in DRC, where more than 3,000 people have contracted Ebola.

Professor Peter Piot, one of the award judges and director of the London School of Hygiene and Tropical Medicine, described the Ebola Cube as a “game changer”.

“The problem is that health workers are at a very high risk for acquiring Ebola infection because they are exposed to body fluids. Let’s not forget that in West Africa over 500 health care workers died. That’s the reason you see people walking around in space suits,” he said.

Prof Piot, one of the researchers who first discovered Ebola in what was then Zaire in 1976, said the suits were also very intimidating for patients.

“I’m an old fashioned physician and I think touch is very important in medicine. When you draw blood you need feeling in your fingers. This Cube allows a better dialogue with patients and it brings back the humanity.

“It’s a game-changer for caring for patients with Ebola and other highly infectious diseases,” he said.

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