Why is Ebola being treated as an 'African disease?'

A health worker checks the temperature of a woman entering Mali from Guinea at the border in Kouremale, Mali, on October 2 (Joe Penney, Reuters)

A health worker checks the temperature of a woman entering Mali from Guinea at the border in Kouremale, Mali, on October 2 (Joe Penney, Reuters)

The head of the African Development Bank expressed concern on Saturday that some donors responding to the Ebola crisis were repackaging aid money, funnelling it away from other areas in need in the three countries at the centre for the epidemic.

In an interview, Donald Kaberuka said moving funds from already allocated development projects in Liberia, Guinea and Sierra Leone was unhelpful in the long term and would make their rebuilding harder.

“I have told donors that I hope what they are announcing is additional resources because if it isn’t ...once [Ebola] is gone we will have no resources to build healthcare systems and continue reconstruction,” Kaberuka told Reuters on the sidelines of meetings in Washington of the International Monetary Fund and World Bank.

“We need to put new money on the table,” he said, adding that he feared that once the crisis eased countries would be left without funding for development projects earmarked before Ebola arrived.

Ebola, a haemorrhagic fever, has killed more than 4 000 people since March in an epidemic centered around the three impoverished countries.

The outbreak has reverberated throughout the three countries’ economies, hampering mining, disrupting the farming and service sectors and prompting concerns that it will scare away the huge investment interested that existed before Ebola.

After getting off to a slow start, the international response to the Ebola crisis has gathered steam with donors pledging hundreds of millions of dollars in aid.

Kaberuka has criticised the international response to the Ebola outbreak as too little, too late.

“It was treated as a small, local public health problem in a remote part of Africa with no global significance,” said Kaberuka, a former finance minister from Rwanda. It should be treated just as SARS or mad cow disease were and not as a disease of Africans, he said.

Kaberuka said it was vital that the aid money go through budgets of the governments of the three countries to help them better coordinate the response. The bulk of foreign aid was going toward supporting aid agencies, international care and food supplies, he added.

“We need to make sure that the governments of Sierra Leone, Liberia and Guinea have money in their budgets to pay health workers, to ensure they have the ability to coordinate all of this,” he said. “In a situation like this there are so many little things happening but somebody has to tie it together and that can only be a government.”

The AfDB itself has pledged $210-million to the three countries and is open to putting more on the table if needed, said Kaberuka.
The World Health Organisation estimated that $1-billion will be need to be spent to limit the spread of Ebola.

The region needed to quickly show it was in control of the situation to maintain investor confidence, said Kaberuka.

But he said businesses also had to step up to help with logistics, including cellphone companies, soft drink firms, and mining companies.

Screening starts at JFK

Medical teams at New York’s JFK airport, armed with Ebola questionnaires and temperature guns, began screening travellers from three West African countries on Saturday as US health authorities stepped up efforts to stop the spread of the virus.

John F Kennedy Airport is the first of five US airports to start enhanced screening of US-bound travellers from Guinea, Liberia and Sierra Leone.

Nearly all passengers travelling to the United States from those countries arrive at JFK, Newark Liberty, Washington Dulles, Chicago O’Hare and Hartsfield-Jackson Atlanta. The new procedures will begin at the other four airports on Thursday.

Mohamed Dabo, a 22-year-old Indiana man who arrived at JFK from Guinea after a stopover in Paris, said he was surprised by the intensity of the screening.

“I don’t really know what was going on in there but it was kind of crazy,” he said. “I sat down there for two hours.”

The screenings, which will affect only a fraction of overall passengers arriving at JFK, are being conducted by the department of homeland security’s customs and border protection (CBP), under direction of the centres for disease control and prevention (CDC).

There are no direct flights from the affected countries, so CBP staff identify passengers to screen by looking at trip information and checking passports, R Gil Kerlikowske, the CBP commissioner, told a news conference at JFK on Saturday morning.

Using infrared temperature guns, staff are checking for elevated temperatures among passengers whose journeys began or included a stop in one of the three African countries.

Screeners will also assess passengers for signs of illness and ask about their health and whether they may have come into contact with an Ebola patient.

Buntouradu Bamgoura (54) who was born in Guinea and lives in the United States, said she was handed a list of guidelines for screened passengers who were allowed to enter. The sheet offers tips for self-monitoring and instructions for doctors treating patients with Ebola-like symptoms.

For those with a fever or other symptoms or possible exposure to Ebola, the CDC said, authorities may decide to take a person to a hospital or quarantine the patient.

In a sign of how serious US medical authorities view the prevention effort, members of an NBC News crew who worked with a cameraman who contracted Ebola in Liberia were ordered late on Friday by New Jersey medical authorities into mandatory quarantine after failing to comply with a voluntary agreement to sequester themselves.

Meanwhile, the condition of the freelance American cameraman continues to improve. At Nebraska Medical Centre, Ashoka Mukpo (33) has received the experimental drug Brincidofovir and a blood transfusion from Dr Kent Brantly, who earlier recovered from a bout with Ebola at an Atlanta hospital.

‘Stigmitising West Africans’

JFK is the entry point for nearly half the roughly 150 travellers who arrive daily in the United States from the three West African countries, and those passengers amount to about one-tenth of 1% of all international daily arrivals at the airport, the CDC said.

Edward Lama Wonkeryor (60) a professor of communications and African studies at a Liberian university, said going through the enhanced screening was educational for him, but he said the push to staunch Ebola was stigmitising West Africans.

“There seems to be an over-exaggeration of the impact of this deadly disease where stigmatisation becomes apparent in the process,” Wonkeryor said after a trip from Liberia via Brussels.

“That is wrong because this is a disease that can be controlled based on what medical experts are telling us.”

The CDC said the airport screening is just one aspect of an overall strategy to fight the spread of Ebola.

“No matter how many of these procedures are put into place, we can’t get the risk to zero,” said Martin Cetron, director of the CDC’s division of global migration and quarantine. “This new entry-screening procedure is just one part of a multi-layered approach,” he told the JFK news conference.

That said, Lawrence Gostin, who teaches global health law at Georgetown Law School, believes such monitoring “had virtually no effectiveness” when used in Canada and Asia during the SARS outbreak in 2002. He said travellers with a fever can evade detection by taking over-the-counter medication.

People also could lie on questionnaires, said Dr David Mabey, a professor at the London School of Hygiene and Tropical Medicine. “People may not fill them in very truthfully. They don’t want to be delayed for hours,” Mabey said.

Passengers are also screened when they depart from the three West African countries. In two months since those screenings began, only 77 of 36 000 travellers were denied boarding, the CDC said. Many were diagnosed later with malaria, none with Ebola.

Thomas Eric Duncan, who died of Ebola in Dallas this week, did not have a fever when screened in Liberia before departure. He said on a questionnaire that he had not been in contact with anyone infected with Ebola. Liberian officials said he was in contact with a woman who later died. A friend of his family said Duncan did not know the woman had Ebola. - Reuters

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