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PostPosted: Wed Aug 27, 2014 10:56 am 
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MSF has indicated it is overwhelmed in Liberia and international response has been inadequate.

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PostPosted: Wed Aug 27, 2014 10:57 am 
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Liberia: MSF’s new Ebola management centres already overwhelmed

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27 August 2014

Tim Shenk/MSF
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Brett Adamson, MSF project coordinator, helps a staff member prepare to enter the high-risk area of MSF’s ELWA 3 Ebola Management Center in Monrovia, Liberia.

Monrovia, Liberia, August 27, 2014 – Médecins Sans Frontières (MSF) is rapidly scaling up its operations in Liberia as the international response to the Ebola outbreak in West Africa continues to be chaotic and entirely inadequate. In its first week, MSF’s ebola newest management centre – also known as ELWA3 – in the capital Monrovia, is already at capacity with 120 patients, and a further expansion is underway. Meanwhile, in the north of the country, patients continue to flow into the newly rehabilitated Ebola management centre in Foya.

“It is simply unacceptable that, five months after the declaration of this Ebola outbreak, serious discussions are only starting now about international leadership and coordination ,” says Brice de le Vingne, MSF Director of Operations. “Self-protection is occupying the entire focus of states that have the expertise and resources to make a dramatic difference in the affected countries. They can do more, so why don’t they?”

The outbreak is spreading rapidly in Monrovia, overwhelming the few medical facilities accepting Ebola patients. Much of the city’s medical system has shut down over fears of the virus among staff members and patients, leaving many people with no healthcare at all, generating an emergency within the emergency.

"It is simply unacceptable that, five months after the declaration of this Ebola outbreak, serious discussions are only starting now about international leadership and coordination"

Brice de le Vingne, MSF Director of Operations
“In the aftermath of an earthquake it would be unthinkable that there are so few places where women can safely deliver their babies, or where people can be treated for life-threatening conditions,” says Lindis Hurum, MSF emergency coordinator in Monrovia. “This is not only an Ebola outbreak – it is a humanitarian emergency, and it needs a full-scale humanitarian response.”

The number of people seeking care at the newly constructed 120-bed centre in Monrovia, which opened on 17 August, is growing faster than the team can handle, both in terms of the number of beds and the capacity of the staff. Patients are coming from nearly every district of the city. The staff is struggling to screen new arrivals, care for admitted patients, safely remove dead bodies and transport them to the crematorium.

“The numbers of patients we are seeing is unlike anything we’ve seen in previous outbreaks,” says Hurum. “Our guidelines were written for an Ebola centre with 20 beds, and now we are expanding beyond 120 beds. The situation means we have to constantly adapt and we are recruiting and training health and hygiene staff day and night. The priorities now are maintaining a safe facility, separating suspected, probable and confirmed cases, and providing compassionate care.”

Like other Ebola centres, ELWA3 serves an important role in slowing the outbreak by isolating Ebola patients and preventing further infections. However, the unprecedented influx of patients is forcing MSF to reduce the level of care. It is not currently possible, for example, to administer intravenous treatments.

MSF is preparing for further construction and to erect three larger tents with space for 40 beds each.

In the very remote area of Foya, near the border with Guinea, the lack of assistance is compounding the emergency. MSF teams are working around the clock to contain the epidemic and the Ebola management centre currently has 67 patients.

“We have arrived into an extremely chaotic situation, and there are hardly any aid organisations to be seen,” says Hugues Robert, Emergency Manager for MSF. “In some places around Foya, the Ministry of Health is experiencing shortages of protective equipment essential for the medical management of the disease. They also have limited capacity to safely bury bodies, and to provide ambulance services to refer patients. They need support. Aside from the provision of urgent medical care, we will also make it our priority to educate the community about the disease and how to prevent transmission.”

In Nigeria, MSF has also recently started providing technical support to the health authorities in their fight against the Ebola outbreak in the city of Lagos. MSF provides technical expertise in areas such as isolation, contact tracing, training and public education. MSF's assistance is designed to last over a month and is exclusively advisory. At this point, Nigeria does not need MSF’s hands-on support. The six people team is supporting the isolation ward set up at the Infectious Disease Hospital (IDH), the referral centre for Ebola patients in Lagos.

MSF started its Ebola intervention in West Africa in March 2014 and is now present in Guinea, Liberia, Nigeria and Sierra Leone. The organisation runs five Ebola case management centres with a total capacity of 415 beds. Since March, MSF has admitted a total of 1,885 patients. 907 of these patients tested positive for Ebola, of whom 170 have recovered. MSF has deployed 184 international staff to the region and employs 1,800 nationally hired personnel.

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PostPosted: Thu Aug 28, 2014 6:03 am 
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Response to Ebola chaotic and inadequate, group says

Liz Szabo, USA TODAY 6:17 p.m. EDT August 27, 2014

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Doctors Without Borders say help, coordination desperately needed

International response to the West African Ebola outbreak has been "chaotic and entirely inadequate," according to a statement issued Wednesday by the humanitarian group Doctors Without Borders, which has been treating patients in affected countries for months.

Doctors Without Borders' newest Ebola treatment facility — a 120-bed facility in Monrovia, the capital of Liberia — is already overwhelmed. The group plans to construct three additional tents with space for 40 more beds.

Doctors Without Borders' guidelines were written for Ebola treatment centers with just 20 beds. "We have to constantly adapt" to address a crisis of this scale, Lindis Hurum, the group's emergency coordinator in Monrovia, said in a statement. "The numbers of patients we are seeing is unlike anything we've seen in previous outbreaks," Hurum said.

The new treatment center can slow the spread of the outbreak by isolating patients, preventing them from infecting friends and family. But overworked health workers have had to reduce the level of care they provide, according to Doctors Without Borders. They can no longer administer intravenous treatments, for example, which could limit doctors' ability to help dehydrated patients.

"It is simply unacceptable that, five months after the declaration of this Ebola outbreak, serious discussions are only starting now about international leadership and coordination," said Brice de le Vingne, director of operations at Doctors Without Borders. Referring to other countries that have the potential to help, he says, "They can do more, so why don't they?"

In Monrovia, "much of the city's medical system has shut down over fears of the virus among staff members and patients, leaving many people with no health care at all, generating an emergency within the emergency," the group's statement says. Women have trouble finding places to deliver babies, for example.

According to the World Health Organization, Ebola has infected more than 2,600 people and killed more than 1,400 in the four affected countries – Guinea, Sierra Leone, Liberia and Nigeria.

A separate Ebola outbreak has been reported in the Democratic Republic of Congo but appears unrelated.

A number of aid agencies are trying to help.

The United Nations Children's Fund (UNICEF) airlifted 168 tons of health and hygiene supplies to Liberia in the past week.

The aid group AmeriCares sent a shipment of antibiotics, medical supplies and "desperately needed safety equipment," the group says, including 15,000 pairs of gloves and nearly 10,000 protective masks. Getting to West Africa has become more difficult as airlines have canceled flights because of the epidemic. One of AmeriCares' five shipments was delayed after a shipping company refused to go to Sierra Leone, says Garrett Ingoglia, AmeriCares' vice president of emergency response. The group chartered its own plane to get around these difficulties.

In a bleak assessment in The New England Journal of Medicine, nurse Anja Wolz wrote, "We need to be one step ahead of this outbreak, but right now, we are five steps behind."

In the Kailahun district in Sierra Leone, where Wolz works as the emergency coordinator for Doctors Without Borders, there are four ambulances for a region of 470,000 people.

Providing basic care is difficult, Wolz wrote, noting that the process of putting on personal protective equipment – or PPE, the full-body moon suits" needed to prevent infection with Ebola – takes five minutes. A "designated dresser" has the sole job of making sure health workers are properly protected and "not a square millimeter of skin is exposed."

These measures are critical, given that more than 120 of 240 health workers infected with Ebola have died, according to WHO reports.

Health workers can wear the bulky suits for no more than 40 minutes at a time to avoid overheating in the tropical climate, Wolz wrote. Though durable equipment such as boots can be sterilized and reused, most other clothing is burned.

Wolz described the difficulty of comforting a pair of young siblings whose parents, grandmother and caregiver died from Ebola: "When the boy died, we tried to console and calm his sister, but the PPE made it difficult to touch her, to hold her, even to speak with her. She died the next day."

http://www.usatoday.com/story/news/nati ... /14695603/

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