Ebola response lacks leadership

There is still no clear leadership for the international response to the Ebola epidemic. We need better coordination and more experienced staff to prevent the spread of the deadly virus, a panel of experts concluded at a seminar in Stockholm.

More human resources, not more money. The importance of leadership and well-trained staff was stressed during a panel discussion at Karolinska Institutet (KI) on October 8. According to the panelists, aid is not being used effectively in the countries plagued by the Ebola virus.

“No agency has taken responsibility for coordinating the international response as a whole. This highlights the main problem, lack of leadership, which has worsened the situation significantly. WHO has not stepped up as they should”, medical doctor Johan von Schreeb from KI’s Centre for Disaster Medicine says.

“For example there should be a coordinated effort to secure safe burials. The corpses are full of viruses and they should be dealt with properly. There should be a system for rewarding and motivating locals who bury people, paying them and offering some kind of insurances if the get sick”, he adds.

von Schreeb recently returned from Sierra Leone where he worked at a Ebola management center for one month. He stresses the importance of experienced staff. One has to use extreme precision with the protective clothing. A minimal mistake, such as touching one’s eyes when taking off the clothing, can lead to an infection.

Local leaders can build trust

Another of the panelists, NAI researcher Mats Utas, has researched Liberia and Sierra Leone for nearly 20 years and lived for several years in the region. He emphasizes the need for foreign medical staff to work together with the local community.

“We need to get traditional local leaders on board and get them working with their communities for a common cause”, Utas says.

“Life in West Africa is so fragile that many do not plan their lives years in advance. This can lead to risk behavior. We need help from local leaders whom the people trust. These leaders can help spreading information about how to protect yourself from the virus.”

Transparency important

The third panelist Anneli Eriksson from KI’s Centre for Disaster Medicine recently returned from a one-month assignment to Liberia where she nursed Ebola patients.

“The Monrovia clinic was the biggest that MSF [Doctors Without Borders] has ever built. At first it was quite chaotic. We simply couldn’t take everyone waiting at the gate. First we had to wait for someone in the clinic to get well or pass away. Lack of hospital beds was one of the major obstacles”, she says.

Eriksson stresses the psychological aspects of working together with the local community. Building trust is crucial for an effective response to the epidemic.

“An Ebola clinic should not be closed from visual insight. You should never cover the whole clinic in white plastic. Otherwise people get suspicious when they can’t see what’s going on there.”

Johan von Schreeb suggests that universities should start working together ad hoc to share knowledge about disease control and support international leadership. KI is in collaboration with NAI offering a two-day crash course in Ebola prevention for professionals who are likely to work in the region.

“This is not about helping poor Africans, it's a global emergency. We need more staff in West Africa and we should support volunteers as much as possible”, von Schreeb says.

“We need more boots on the ground. If we can offer decent health care we also motivate people to seek help faster”, Eriksson concludes.

All tweets from the seminar below.

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