Only the military can get the Ebola epidemic under control: MSF head

Only the military can get the Ebola epidemic under control: MSF head. HT: Crof.

When Dr. Joanne Liu speaks, I stop what I'm doing and listen, as I just did when she was on CBC Radio news a moment ago. Via The BMJ: Only the military can get the Ebola epidemic under control: MSF head. Excerpt from a long interview:

Médecins Sans Frontières (MSF), the humanitarian medical charity, has been on the front lines of the Ebola epidemic since it began. It has had a major role in the international effort to control the outbreak, caring for two thirds of the 8000 people in Guinea, Sierra Leone, and Liberia who have been infected. 

But in early September, after six months of battling Ebola in vain, and with the death toll mounting exponentially, MSF effectively admitted defeat and said that it would take major military mobilisation by wealthy countries with biohazard expertise, not just international aid, to stop the disease. The charity had doubled its staff, MSF’s president, Joanne Liu, told the UN members, but it still was overwhelmed. 

Liu, a Canadian paediatrician who has worked for MSF in war zones and natural disasters for the past 18 years, called upon UN members to dispatch their disaster response teams, backed by the full weight of your logistical capabilities. “Without this deployment, we will never get the epidemic under control,” she said.  

Peter Piot, director of the London School of Tropical Medicine and Hygiene and the microbiologist who first identified the Ebola virus in 1976, also called in September for a “quasi military intervention.” He suggested that a major UN peacekeeping force should be deployed to Sierra Leone and Liberia, with huge donations of beds, ambulances, and trucks as well as an army of clinicians, doctors, and nurses. 

The message came as the numbers of deaths from Ebola began to spiral, particularly in Liberia. There have been over 3800 reported deaths in the region, according to the latest World Health Organization figures, 40% of which have been recorded since September. WHO has estimated that there could be 20 000 infections before the outbreak is brought under control, and the US Centers for Disease Control has predicted that, in a worst case scenario, as many as 1.4 million may be infected by the end of January. 

As the economies and health infrastructures of the three countries, home to over 22 million people, risk total collapse, the UN Security Council declared the outbreak was a threat to international peace and security. 

Limited response 

Yet a month after the first calls for military deployment, forces are only now starting to be mobilised in any numbers. The US, UK, Germany, and France have responded, although not exactly as Liu had hoped they would. The US has said it will send 4000 troops to build new isolation units and treatment facilities in Liberia, a country created by US citizens as a colony for former African American slaves. But President Obama has made it clear that US troops will not be staffing those units and coming into contact with Ebola patients. 

The UK has pledged to send 750 troops to establish new Ebola treatment centres in Sierra Leone, its former colony, and a training academy for those working in treatment centres. 

Around 5000 German troops have volunteered to work in west Africa but they have not yet been deployed, and the government has now admitted that it would not have the resources to fly any troops home for treatment should they become infected. 

So far no other countries have offered their armed forces, and President Obama warned in early October, if most countries choose to remain on the sidelines and watch the US do the bulk of the military work, the outbreak will continue to be a global threat.  

Liu says she is exasperated at the slow, hands-off response. “Countries are approaching this with the mindset of going to war,” she says. “Zero risk. Zero casualties.” 

Liu describes the current military efforts as the equivalent, in public health terms, of airstrikes without boots on the ground. Pledges of equipment and logistical support are helpful—“The military are the only body that can be deployed in the numbers needed now and that can organise things fast.” 

But there is still a massive shortage of qualified and trained medical staff on the ground. “You need to send people not stuff and get hands on, not try to do this remotely,” Liu says, “Local doctors have been extremely brave, but we are running out of staff and that is why we are asking for a major workforce to deploy.”