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Doctors Without Borders: Ebola efforts need more people in the field

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    Now: the challenge of containing the Ebola outbreak in West Africa.

    Jeffrey Brown has that.


    The World Health Organization today said the epidemic's official death toll now tops 1,200, amid growing concern that local resources of all kinds are being strained to the limit.

    Over the weekend, the aid group Doctors Without Borders opened its largest facility yet for treating Ebola victims, near the Liberian capital of Monrovia.

    The president of Doctors Without Borders, Dr. Joanne Liu, just returned from the region last week. I spoke with her earlier today from the New York Times newsroom.

    Dr. Liu, thank you for joining us.

    Let me ask you about the new treatment center what you are and are not able to do on the ground right now. What kind of treatment are people actually getting?

  • DR. JOANNE LIU, President, Doctors Without Borders:

    Well, in our Ebola medical center, what we offer is treatment in terms of support treatment to patients who are infected.

    So the way it works in our center, we have 120 beds. We have an area of suspected case, probable case and confirmed case. And what we do for patients who are confirmed is we ensure that they are well-hydrated. We give them antibody if they have infections. And we're making sure that they have as well some painkillers.


    There's been a continuing problem of persuading people to seek treatment amid so much fear and doubt about the disease itself, even to the point of a riot to shut down one clinic. How dangerous is this and how is it being addressed?


    Well, this is something that we have been facing since the beginning. And this is a normal, I would say, human reaction.

    Fear has been a constant, I will say, challenge, because if people do not understand what is Ebola, what are the sign of it, and what can we do for it, they will continue to have some sort of behavior that seems to be rational from a distance.

    But the reality is what we need to do now is to increase the health promotion and the understanding about what is Ebola.


    How hard is it to reach people, and how exactly are you and others doing that?


    Well, I think it's a challenge, for sure.

    And right now, we need to mobilize more people to do it. And it needs to happen at the central level. I think we should have a standardized message in terms of what is Ebola, how to prevent it, make sure that we are implementing the universal precaution everywhere. And this needs to happen at all levels, centrally and the — centrally in the country.


    In the meantime, there are reports that the outbreak is having a dangerous impact on the larger health system in these countries. Are you seeing that?



    This is what I call the emergency within the emergency, so the Ebola and the consequences of Ebola. And one of the things we have been facing is the collapse of the health care system. Right now, most of the health care facilities are being closed in Monrovia.

    And we're facing the very distressing and — event of the fact that patients don't have access to basic health care. We saw six pregnant women not being able to deliver over the last week and lost their babies. We saw children with malaria not able to find treatment for their malaria


    And they're just coming into the height of the malaria season, right?


    Yes. The rainy season has just started.

    And this is why I am bringing it up. So, this is why, today, there needs to be increased capacity in the field to respond to Ebola in terms of health promotion, surveillance, contact tracing, safe burial, and treatment. But as well we need to bring some capacity to restore some basic health care access to the general population.


    Several days ago, your organization put out a release saying the response to the epidemic remains — quote — "dangerously inadequate."

    There have been at least some positive signs in recent days and hopes of perhaps stopping a wider spread. Can you update this for us? Where are we now in terms of the overall response?


    Well, it's difficult to say, because I think there's more capacity — or promises of capacity that is going to be sent.

    And the thing is, as far as I'm concerned, until it translates into concrete action in the field, I will wait to comment on this. But I think people are more mobilized. But we need to get people with hands-on in the field who are willing to roll up their sleeves and do the work, not being behind computer.

    We need operational people. They are going to go from house to house to explain what is Ebola. They're going to go from house to house to go find out where are the contact tracing. That's what we need. We need people in the field who's going to do the legwork.


    And is that effort coordinated well enough between groups like yours and respective the governments and the international community? Because there have been some worries about that.


    Well, right now, there is some — they call task force, but the reality, there is not that many players in the field.

    It's not like after a natural disaster, where we have basically the full international community coming and giving a hand. Right now, it's only a few people who have a response to the call. But the reality, of course we need to be coordinated. And this needs to happen centrally with the government. And I think the WHO needs to step up to the plate to do its job.


    There are new numbers out today about death toll topping 1,200. There are also though concerns that the actual numbers are vastly underreported.

    Does that worry you?


    Well, we have some concern about the figures, because the reality, we are not able to do the data collection everywhere in the country, if we take, for example, Liberia.

    So, we think it might be underestimated. We hear a lot about some death in the communities, but this has not been checked. And we don't have the capacity today to go and check to find out if they were deaths secondary to Ebola.


    Dr. Joanne Liu of Doctors Without Borders, thank you so much.


    Thank you very much.

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