LIVING

Won't be easy, but immediate global action can solve Ebola crisis: MSF

09/29/2014 05:15 EDT | Updated 11/29/2014 05:59 EST
TORONTO - The scale of the task is daunting, but the Ebola epidemic ravaging West Africa can be brought under control if countries deliver on promises of manpower and funding immediately, the international president of the medical response group Medecins Sans Frontieres said Monday.

Last week's unanimous passage of a UN Security Council resolution declaring the outbreak a threat to international peace and security suggests that increasingly vocal calls for help from MSF and the World Health Organization have been heard. But Dr. Joanne Liu, MSF's international president, said she is worried nations still don't get that the additional bodies and supplies they are pledging need to be put in place immediately if they are to achieve the desired effect.

"I think people have heard our message. But ... the sense of urgency of deploying now — now! — I don't think has sunk in yet," she said in an interview from Montreal, her home.

"Unless it translates into immediate action, it will have no additional benefit. ... Every single day matters."

Liu noted the world is grappling with a number of crises now. And some, like the conflict in the Middle East, appear to defy solutions. Ebola can be resolved, she insisted.

"If there's one thing that we can fix today, if we were to put the means behind it, it's Ebola," she said. "And I think even for the world to know that we can get our act together and do something together and make a difference for individuals, that would be great."

But getting resources and people in place and setting up additional care facilities has been a slow process in this outbreak, one impeded by the fact that many airlines have stopped servicing the affected countries.

And generally speaking, countries are sometimes far quicker to make pledges of assistance during international crises than they are to deliver on them. Liu noted that a year after the devastating 2010 earthquake in Haiti, less than 30 per cent of the promised aid had been delivered.

The world doesn't have that kind of time with the Ebola epidemic, Liu warned, saying that with case numbers doubling every three weeks, plans for what is needed are quickly overtaken by the spread of disease in an outbreak unlike anything seen in modern times.

The most recent case count from the WHO — based on numbers current as of Sept. 23 — suggest there have been nearly 6,600 infections and nearly 3,100 deaths so far. The largest previous Ebola outbreak involved 425 cases and 224 deaths, making this outbreak about 15 times larger than any the world has seen before.

Projections from the U.S. Centers for Disease Control suggest that between 550,000 and 1.4 million people could be infected by late January if the response isn't stepped up substantially.

"We're in a completely different league. It's another matrix. It's another world. And this is what people have to understand and what I'm trying to tell them," said Liu.

"Unless we're deploying now, massively, we will be facing an epidemic that will be so difficult to tackle. Because the more we wait, the more there will be different sites of focus, different sites of transmission, and the more the response will be complex. And this is why it needs to happen now."

Treatment facilities in the affected countries — Guinea, Sierra Leone and Liberia — are woefully inadequate to serve the current need. People who are sick are being turned away because hospitals and treatment centres are full.

Leaving the sick to be cared for by their families is a recipe for amplifying the disaster. It ensures that this week's caregiver will be next week's new Ebola case. Separating the sick from the well is the only way to break Ebola's hold in affected communities.

Another crucial piece of a successful Ebola response is identifying the contacts of known cases and monitoring their health. The goal is to isolate quickly any who appear to be coming down with the disease so they don't spread it. (People only transmit Ebola when they have symptoms.)

But with case numbers this large, tracing contacts is a gargantuan task. And it will be larger next week than it is this week.

Fear of Ebola is getting in the way of the international response, said Liu, who admitted she had not anticipated how big a problem this would be. "Fear is a big, big problem here."

"You need three things to intervene in Ebola. You need courage, organization and discipline. And the thing is, I never thought that the courage would be such a big issue. But it's a huge issue," she said.

"Countries ... have cold feet in sending people and putting them at risk. They want zero casualties, zero exposure, zero risk. It just doesn't exist."

But MSF — also known as Doctors Without Borders — has developed stringent systems for its treatment centres. The amount of time medical team members spend in the hot and cumbersome space suits that protect them is limited. And people degowning — doffing the layers of protective equipment — are closely monitored. Taking off contaminated gear can be the riskiest part of a responder's work.

"You need to do the right thing. And if you do the right thing, and you're disciplined and you're organized, you most likely will not get infected. But you need to be very rigorous," Liu said.

She suggested Canada could be playing a bigger role in the response. "It's an opportunity as well of showing leadership in a huge epidemic that will have ... for years consequences on a region in Africa."

Canada, which had made only modest contributions to the fight over the spring and summer, announced last week it would donate an additional $30 million to the effort.

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