The Ebola Epidemic Part II

The Ebola Epidemic 2

4: Alone against Ebola

In March 2014, MSF ‘s field workers noticed a worrying increase in sickness in parts of Liberia, Guinea and Sierra Leone. Teams were immediately dispatched to provide increased assistance and treatment. It quickly became clear to MSF field workers that they were facing the biggest Ebola outbreak in the world ever. Long before the international media had made a single media report about Ebola, the entire MSF had launched full crisis mobilization. The organization sent doctors, nurses and administrative staff from all over the world to the affected areas, recruited local health workers and set up field hospitals and clinics.

In the absence of help from other quarters, MSF was in many places the only one to treat Ebola patients. It is difficult to say how many more would have died without this help, but it is certain that thousands of victims would have survived if others had also come to the rescue before it was too late. Many MSF hospitals and clinics were overcrowded. Field workers had to turn away thousands at the hospital doors, and could do nothing to help while many suffered and died outside. Lindis Hurum, Médecins Sans Frontières’ Norwegian emergency aid coordinator summed up the desperate situation as follows: “We are doctors without borders, but we are not without limits”. In total, MSF treated more than a third of all Ebola cases, which shows how dependent the local health authorities were on outside help.

Throughout the spring and summer of 2014, MSF’s international team and local health authorities got their hands full trying to limit the spread of Ebola. Both lacked resources and personnel, and since Ebola outbreaks are something that happens very rarely, there was also a shortage of doctors and nurses who had experience with Ebola.

5: The turning point

What was needed was therefore that governments and citizens in other, richer countries became involved and could provide concrete help to much-needed health authorities and relief organizations.

However, Ebola was still low on the international agenda. Few politicians in other countries were willing to invest resources in a health problem that had only spread to a handful of poor countries in western Africa. The media in other countries still showed little willingness to make Ebola a big issue.

By the end of July, more than 1,000 cases of Ebola had been confirmed, and now the number of Ebola victims is increasing . However, it was not the increase itself that finally turned the world’s spotlight on the Ebola crisis. Media attention and political will came only after two US citizens who had volunteered for the relief organization Samaritan’s Purse was confirmed infected with Ebola. Shortly afterwards, it was revealed that a nurse in Spain had contracted Ebola. Suddenly, Ebola was no longer something that only affected people in a poor, remote part of the world. Western media and politicians opened their eyes to the fact that this could spread at home. There was never any danger that Ebola could spread to and in Western countries, but Western media gave the impression that a global epidemic was on the horizon, and panic was spreading. Paradoxically, this helped shed light on Ebola, and the world’s attention was finally focused on the disaster in West Africa according to

On August 8, the World Health Organization (WHO) issued a statement officially referring to Ebola as an “international health crisis”.. And now the world’s spotlight was on the Ebola-affected countries, and MSF received more in support and funding. Nevertheless, the global reaction came far too late. It takes about two months to train health personnel in dealing with Ebola cases. An even bigger problem was that the virus had now been spread over such a large area that it would be extremely difficult to stem the spread, which continued unchecked. By August 2014 – when funds, personnel and facilities finally began to emerge in the area – Ebola had claimed just over a thousand victims. But despite the increased efforts, Ebola has so far killed a total of eleven thousand people.

6: The Ebola epidemic has ripple effects

Some new cases of Ebola are still emerging, but most affected areas have now been declared free of Ebola . Each possible case must still be followed up before it can be determined that the danger is over. Here is a danger: Since the impression is that the crisis is over, the global commitment to invest in the work that still needs to be done decreases, to finally be able to determine that the epidemic is over.

So far, a total of 27,642 people have been infected with Ebola; of them, 11,261 have died . This in itself is a great tragedy, but the outbreak has had ripple effects beyond the enormous personal suffering. Ebola has seized many resources in already hard-pressed health care in West Africa, and thus all other health services have suffered greatly. Treatment of conditions such as HIV-AIDS, heart disease and diabetes has been greatly reduced. In addition, both routine procedures and examinations related to pregnancy and vaccination have been neglected. It is therefore difficult to measure exactly how much the population has actually suffered as a result of Ebola.

The future of health care in the countries of West Africa also looks bleak. The Ebola epidemic took over five hundred health workers in Sierra Leone, Liberia and Guinea – countries that even before the crisis struggled with understaffing in the health care system. The health services in these countries also struggled with low confidence in the population ; it has been further undermined. All indications are that the health service here will suffer for many years to come.

7: Will Ebola break out again?

The tragedy is made even greater if possible by the fact that the spread of Ebola could have been prevented, as the examples from Nigeria and Senegal show. Will this crisis lead to better preparedness the next time something like this happens? Medical experts agree that the best protection against new Ebola epidemics is a functioning health care system. Health authorities must be able to follow up and track cases ( logistics and infrastructure ), have enough treatment centers and personnel ( capacity ) and the population and medical personnel must know the risks of infection with Ebola and how cases are to be treated ( knowledge). In this respect, many West African countries are still very vulnerable, and there is little indication that they are better equipped to deal with similar outbreaks in the future.

Equally disturbing is how the Ebola epidemic revealed a global paralysis of action . It was obvious that local authorities did not have the capacity to deal with the crisis. Only MSF and a few smaller relief organizations came to the rescue.

Poorly equipped health care was undoubtedly a factor that contributed to the crisis growing to dire proportions, but the tragic effects of the Ebola outbreak could still have been avoided if the rest of the world had engaged earlier . For the time being, the Ebola epidemic stands as an example of how the international community ignores crises that only affect poor countries far away. Only when Westerners became infected did the outbreak receive international attention.

8: The way forward

Unfortunately, the Ebola epidemic is an example of a crisis that could have been avoided . A combination of poor preparedness, late warning, ineffective monitoring and follow-up of cases, late international response and lack of leadership and strategy allowed the epidemic to grow into a regional disaster . To prevent it from happening again, there are several things that are important to follow up:

  • a better, global contingency plan must be developed to ensure that the world community is able to respond more effectively in similar situations.
  • Vulnerable countries must be helped to build up their health care system
  • the world must stop closing its eyes to crises that “only” affect poor countries far away.

Facts about Ebola

  • Deadly virus that spreads through body fluids
  • Causes fever, lethargy, headache, diarrhea and vomiting
  • There is no treatment. One can only treat the symptoms and make sure that the patient gets enough fluid.
  • Mortality varies greatly – between 25 and 90% of those who get Ebola die

Doctors Without Borders

  • International Medical Aid Organization founded in 1971, also known as Médecins Sans Frontières(MSF)
  • MSF Norway
  • Saves lives through medical work where no one else can or will provide health care
  • Has field workers and field hospitals in over 70 countries
  • Received the Nobel Peace Prize in 1999

The Ebola Epidemic 2