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Table 2 Risk factors faced by medical team

From: Experiences and challenges in the health protection of medical teams in the Chinese Ebola treatment center, Liberia: a qualitative study

Phrases Risk factors Example citation
Phase one (before-deployment) Socio- psychological factors
1. Disturbed social network due to closed training
2. Anxiety and fear about infection of diseases (EVD, malaria, HIV and TB)
3. Worry about heavy workload, the underdeveloped public health system, hard living environment, social chaos and unsafe social environment, and different cultural in Liberia
There are other epidemics such as cholera, yellow fever and malaria…. All felt anxiety because EVD is deadly disease and the mortality of patients is high (General head nurse in ETC)
Phase two (during-deployment) Socio- psychological factors
1. Disturbed social network as separating from their families and friends
2. Cultural differences
3. Unsafe living environment like anopheles, unsafe food and water and social chaos
4. Shortage of food and health resources (medical supplies and professionals to run ETC)
5. Anxiety and fear about infection of diseases (EVD, malaria, TB and HIV)
6. Worry about complex PPE dressing
7. Worry about families where they were unable to look after them if needed
Social and political unrest in local place make we feel unsafe. (Foreign affairs official in ETC)
The local fruits and water are possibly contaminated with Ebola virus. The fruit like banana is very good. But we feared to eat local fruits or drink local water. It is difficult to know whether the banana is contacted by money with Ebola virus. (Leader of logistics support group in ETC)
HCWs met patients every day to provide health care such as transfusion. So they felt pressure. They worry about separating from families whom they could not look after when needed. They need to get used to local living environment. (Psychological experts)
HCWs who work for long time with PPE would sweat a lot and felt uncomfortable. (General head nurse in ETC)
Behavioural factors
1. Contacting with local patients as providing care for them
2. Recruiting and training local people to work in ETC
3. Incorrect operation with PPE due to fatigue
During providing healthcare for patients, HCWs easily forget self-health protection. We recruited local people to work in ETC due to shortage of personnel. Those local people lived in different communities in different area. We cannot know whether their families and friends have risk of infection. Local people were paired with PLA HCWs which would increase risk of infection (Deputy director of ETC)
Biological factors
1. Susceptible to infectious disease in Liberia due to living environment which included mosquitoes, possible exposure to contaminated food and water
Local epidemics, such as cholera, yellow fever, malaria, tuberculosis. We all are susceptible to those epidemics in Liberia. (General head nurse in ETC)
Phase three (Post-deployment) Socio- psychological factors
1. Isolated living environment to prevent them from infection or transmission
2. Inconvenient communicate with colleagues and families
3. Worry about infection of diseases
We could not meet with families and friends during 21-day’s medical isolation. (Clinical doctor in ETC)
Nobody knows whether we are infected with any infectious diseases. We still worry about the risk of infection. Our social network is still disturbed. It is possible to have psychological influence. (Psychological experts in ETC)
Biological factors
Physical fatigue after long time hard work
We felt very fatigue after long time hard work in Liberia and long travel from Liberia back to China. (General head nurse in ETC)
  1. Notes: EVD refers to Ebola virus disease, HIV refers to Human Immunodeficiency Virus, TB refers to tuberculosis, ETC refers to Ebola treatment centre, HCWs refers to healthcare workers, PPE refers to personal protection equipment, PLA refers to People’s Liberation Army