Posted on Monday, 13 October 2014 14:53

Ebola: Dithering, then cash and action

By Tolu Ogunlesi in Lagos and Patrick Smith

Photo©DOMINIQUE FAGET/AFPThe sense of international crisis and impending doom caught up with the spread of the Ebola virus in mid-September.

After months of inertia and weak leadership, governments and international agencies finally jumped into the fray to back the valiant health professionals and voluntary workers who have been battling the worst outbreak of the disease in West Africa.

We hear that infected people have been turned away from treatment centres and are going back into the community

Holding an emergency meeting in New York on 18 September, the UN Security Council listened as secretary general Ban Ki-moon told the ambassadors: "The gravity and scale of the situation now require a level of international action unprecedented for a health emergency."

Diplomats and UN officials at the meeting struggled to find language adequate to the crisis.

Without doubt the strongest testimony came from Jackson Niamah, who runs a treatment centre in Monrovia with Médécins sans Frontiers.

He said that people "are sitting at the gates of our centres, literally begging for their lives [...] and they are dying at our front door." He continued: "They rightly feel alone, neglected, denied and left to die a horrible, undignified death. We are failing the sick because there is not enough help on the ground. If the international community does not stand up, we will be wiped out."

Two days earlier, US President Barack Obama had announced that his government would send 3,000 troops to Liberia to build 17 treatment centres with 100 beds each.

A month earlier, Donald Kaberuka, president of the African Development Bank, said the bank would give the worst- affected countries – Guinea, Liberia and Sierra Leone – $60m to train medical workers and buy drugs.

On 12 September, Kaberuka promised an additional $150m for budget support in those countries but it would require "extra effort to improve their health systems and food security".

As Obama was warning that Ebola had become a pressing national security issue for the US, the World Bank and the International Monetary Fund were counting the economic cost of the outbreak.

Losses suffered by Guinea, Liberia and Sierra Leone in the medium term could amount to more than $800m, the bank's chief economist for Africa, Francisco Ferreira, said.

The Bank is putting together a $230m financing package, including $117m in emergency funds.

"That's just the emergency down payment," Ferreira explained. "We're continuing to work on what this crisis might mean to other countries in the region. These three countries are just 5% of West Africa's regional economy."

Chikwe Ihekweazu, an infectious disease epidemiologist who worked with a UN team on an Ebola outbreak in South Sudan, told The Africa Report that the crisis was at its worst in Monrovia.

"We hear that infected people have been turned away from treatment centres and are going back into the community without any protection for them and their families. Lack of healthcare and protection explain the disaster in Liberia, which is accounting for more than half of all new infections in East Africa," Ihekweazu said.

The critical point, said Ihekweazu, is that "controlling Ebola is not rocket science. The small things need to be done religiously. The strategic goal of Ebola control is to catch it early and break the chain of transmission."

He said the Ebola outbreak in Nigeria pointed to a real crisis in the national health service.

Patrick Sawyer, a 41-year-old from Liberia, had flown into Lagos visibly sick.

No one at the airport made the Ebola connection. Sawyer's blood sample was not sent for testing until 36 hours after admission to a private hospital in Obalende.

By the time the results arrived, Sawyer had transmitted it to eight health workers.

One of those infected was doctor Ada Igonoh, who described conditions in the government's infectious disease hospital in Lagos.

It "looked like an abandoned building. The whole Ebola thing had caught everyone by surprise. [The] Lagos State ministry of health was doing its best to contain the situation but competent hands were few. The sheets were not changed for days. The floor was stained with greenish vomit and excrement."

Igonoh and 11 other infected people went on to recover.

Ihekweazu says that while the Lagos State governor Babatunde Fashola led an excellent public information campaign to counter some of the nonsense being pedalled, the Ebola outbreak should concentrate minds on the need for a comprehensive rebuilding of the public health system. ●


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