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Ebola crisis affects us all

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Australia’s response (or lack of it) to the west Africa Ebola crisis continues to dominate the political landscape, and featured heavily in the most recent Senate Estimates hearings.

Is Australia ready to handle any cases domestically? Are we doing enough to help international efforts to control and contain the outbreak at its source? The jury is out.

But at least – after weeks of calls from the AMA and others – we are seeing some action on the local front, with protective clothing being delivered to hospitals and health experts having regular planning meetings.

As the political wrangling continues, it is a good time to reflect on why it is important that we respond positively and comprehensively to this evolving humanitarian crisis.

I believe that, as the Ebola outbreak accelerates, first world nations, including Australia, must answer critical questions that will define a generation.

For decades, Western nations have wrung their hands, expressing regret and sorrow for their failure to act in African crises such as Rwanda. In 1993-94, the West stood by as at least 800,000 Africans were killed in 100 days.

UN Force Commander to the Rwandan UN Assistance Mission, Lt. Gen. Romeo Dallaire, documented the humanitarian catastrophe and his frustration at the failure of the West to act in his book, Shake Hands with the Devil. This period was salutary for the UN, and for other Western nations such as the United States.

Former US President Bill Clinton and UN Secretary General Kofi Annan record the Rwandan Genocide in their memoirs as one of their great regrets.

Now, 20 years later, a humanitarian disaster of similar proportions is unfolding. The enemy is different and the pace is slower, but the imperative is even greater.

At present, almost 5000 people have died from Ebola virus disease in the west African countries of Sierra Leone, Liberia, and Guinea. However, the number of infections is growing at an exponential rate. There is at present no indication that the outbreak is being contained or controlled.

When senior international health experts use language such as, the only thing like this has been AIDS”, people should take notice. Doctors, particularly public health officials, are trained to be conservative and moderate in language. There is nothing moderate here. The US Centers for Disease Control and Prevention has put estimates of future cases as high as 1.4 million unless there is action.

The leaders of the affected African nations are desperate for international assistance. The World Health Organisation and the UN have appealed to all countries for help. While funding is essential, the assistance must also arrive in the form of physical and human resources. Patients are literally dying in the streets of Monrovia and Freetown. There are not enough beds – not even close, with dying patients being turned away.

Non-government organisations such as the Red Cross and Médecins Sans Frontières, along with the WHO, are providing most of the on-ground support. The US, UK, China, and even Cuba, have committed personnel to go and provide infrastructure and logistical support, as well as health care workers.

Australian volunteers are also doing their bit. Cairns nurse Sue-Ellen Kovack is one such volunteer, providing direct care to patients in Sierra Leone with the Red Cross. She is one of a number of Australians who not only understand the crisis, but who bravely put themselves at risk to provide care for people affected by Ebola.

The commitment and compassion of these volunteers is essential if we are to control the disease.

If the international community, including Australia, fails to act comprehensively now with health care workers and other medical support, hundreds of thousands of lives will be lost. There is a real chance that the disease could become endemic in Africa, meaning that the outbreak will continue indefinitely.

There are other doctors and nurses who are willing to volunteer and provide similar roles. The AMA has been encouraging the Government to resource Australian teams to perform these roles in a coordinated and supported manner.

There are concerns about a lack of contingencies to evacuate an Australian health care worker should they become infected. Appropriate arrangements are becoming available. The UK is building a 12-bed facility for infected international health care workers on the outskirts of Freetown, and some European nations have been accepting infected international health care workers for treatment.

It is disappointing that some commentators have focused on whipping up fear and antipathy for Australian health authorities, and even casting aspersions over the motivation of Sue-Ellen Kovack and our other health colleagues even before the negative results were known.

The risk to the Australian public was essentially zero. Health care workers returning from west Africa go into quarantine for 21 days. People are not contagious unless they show physical symptoms such as fever, vomiting, or diarrhoea. Every appropriate precaution is taken.

The international health care workers, including Australians, are essential if we are going to control the Ebola outbreak. There is a clear humanitarian imperative.

However, there are international economic and security consequences if we do not control the outbreak in west Africa.

I recently met with doctors, nurses and other members of the local Sierra Leone community. They all have family and friends at home in Africa. They, too, can see the humanitarian disaster unfolding in slow motion.

The question for the international community, including Australia, is whether we have learnt from history, or whether we continue to accept massive loss of life in Africa as a regular phenomenon. Will it be another episode described in the memoirs of world leaders as one of their great regrets?

This article was first published by The ABC’s The Drum on 24 October 2014. Check out the blog at http://www.abc.net.au/news/2014-10-24/owler-will-ebola-be-the-wests-next-big-regret/5838850

 

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