As health workers in the DRC deal with the news that Ebola has not yet been defeated, they reflect on the lessons the epidemic has taught them
The medical nongovernmental organisation Médecins Sans Frontières (MSF) has launched a scathing attack on the international community for its slow and patchy response to the effort to stamp out Ebola in West Africa.
It says the response risks creating “a double failure” because ill-equipped locals in Sierra Leone, Liberia and Guinea have been left to run hospitals and treatment centres.
Three months after MSF called for international intervention, its international president, Dr Joanne Liu, said it was “extremely disappointing that states with biological-disaster response capacities have chosen not to deploy them”.
She urged the world not to be complacent. “We can’t let our guard down and allow this to become a ‘double failure’: a response that is slow to begin with, and then is ill-adapted in the end.”
Liu criticised the concentration of international efforts on the construction of Ebola treatment centres without also providing staff and training, transport and laboratories.
“How is it that the international community has left the response to Ebola – now a transnational threat – up to doctors, nurses and charity workers?” asked Liu.
MSF’s briefing paper on the three countries hardest hit by the disease came after the World Health Organisation (WHO) declared it was optimistic about the region, despite rising numbers of reported cases.
‘Far from under control’
Bruce Aylward, assistant director general of emergencies at WHO, said “there has been a real slowdown in the spread of new cases” in Sierra Leone, where the disease is on the rise, and that “across West Africa we are no longer seeing exponential growth and, in some areas, a steady decline”. MSF said the situation was “far from under control” in Sierra Leone, that the “situation is alarming” in Guinea and, while progress was being made in Liberia, there was no room for complacency.
“The outbreak is far from over, as a single case can start a localised epidemic,” it said, reporting infection chains starting in remote areas that had no treatment centres or testing facilities.
MSF said case numbers had dropped in the Liberian capital, Monrovia, where there was now surplus bed capacity, but added that many international agencies “seem unable to adapt to the rapidly changing situation” with outbreaks in Bong, Margibi, Gbarpolu, Grand Cape Mount and Rivercess counties.
In some areas, such as Rivercess, patients must travel for up to 12 hours by road to reach a laboratory and a care centre, it said.
Guinea, where the outbreak started, was “long overlooked by international efforts”, according to MSF, which said the response was “painfully slow”.
It said Guinea’s task force for dealing with Ebola was improving but that the caseload in November, month on month, was up 25%. “New areas are reporting infections and 17 of Guinea’s 33 prefectures have reported cases in the past three weeks.
“Like in Sierra Leone and Liberia, the absence of implementing partners willing and able to manage case management centres and a lack of trained staff have been a bottleneck and the source of large delays.”
Infection was increasing “alarmingly” in Sierra Leone, said the report, and local healthcare workers were carrying the burden. The latest number of confirmed cases in the country is 5 978.
Limited knowledge about Ebola was still a major issue and would prevent its containment, MSF said. “Our teams are still finding that misconceptions about Ebola are widespread and stigma is intense, leading some people to avoid seeking treatment or report cases,” it said of Liberia.
In a recent example, MSF found that people who had been in contact with the sick were fleeing into the bush so they could not to be traced. – © Guardian News & Media 2014