Ebola outbreak creates 'wartime' situation

Doctors Without Borders says the epidemic in West Africa could take six months to bring under control.

An agent of the national public health institute poses with a thermometer at the airport, in Abidjan on 12 August, 2014. Picture: AFP.

GENEVA/MONROVIA - The Ebola epidemic in West Africa has created a "wartime" situation, including the threat of food shortages, and could take six months to bring under control, medical charity MSF and the Liberian government said on Friday.

With global alarm rising over the worst outbreak of the virus that has killed more than 1,000 people so far, MSF (Doctors Without Borders) questioned whether the World Health Organisation (WHO) had moved quickly enough to declare it a "public health emergency of international concern", which it did on 8 August.

On Thursday, the WHO said its staff had seen evidence in the numbers of reported cases and deaths vastly underestimated the scale of the outbreak and said it would coordinate "a massive scaling up of the international response".

MSF President Joanne Liu, speaking after a 10-day trip to West Africa, compared the outbreak, which has ravaged Sierra Leone, Liberia and Guinea and touched Nigeria, to a "wartime" situation. "It's like a frontline, it's moving, it's advancing, but we have no clue as to how it is going to go around."

She told reporters in Geneva the WHO needed to "take leadership" and more experts were urgently needed on the ground. "I think the wake-up call was too late," Liu said.

On 1 April, the WHO's official spokesman Gregory Hartl had described the West African outbreak as "relatively small still" after MSF Director General Bruno Jochum had warned it was "unprecedented" and "exceptional".

The death toll from the world's biggest outbreak of Ebola stood on Wednesday at 1,069 from 1,975 confirmed, probable and suspected cases.

The majority were in Guinea, Sierra Leone and Liberia, while four people have died in Nigeria.

In Liberia, which like its neighbours Sierra Leone and Guinea has deployed troops to quarantine a tri-border zone most affected by the deadly virus, Information Minister Lewis Brown said his country still needed more health personnel and aid.

"The reaction quite frankly is not where we would want it to be to give any serious level of comfort," Brown told Reuters, although he said there had been an improvement.


"If we don't stabilise Liberia, we will never stabilise the region. Over the next six months we should get the upper hand on the epidemic, this is my gut feeling," MSF's Liu said.

Brown said his country had "pockets all around the place reporting infection", including the border farming county of Lofa, where a drop in agriculture output because of the outbreak and quarantine measures had created a threat of food shortages.

Liberia had requested emergency food aid from donors.

"We can establish as many checkpoints as we want, but if we cannot get the food and the medical supplies into affected communities, they will leave," Brown said. "We can't ask our people to starve."

International agencies are looking into emergency food flights and truck convoys to reach people in Liberia and Sierra Leone cordoned off from the outside world, a World Bank official said.

Alarm over the risk of the disease, which can kill up to 90 percent of those it afflicts and is spread by contact with the bodily fluids of infected persons and animals, has triggered a wave of travel warnings and restrictions, cancellations of events and flight suspensions to the region by some airlines.

The International Olympic Committee (IOC) said on Friday it was prohibiting young athletes from the Ebola-affected region of West Africa from participating in certain events at the Youth Olympic Games in Nanjing, China.

Fear of the virus, which causes fever, vomiting, and in its advanced form, severe haemorrhaging and organ failure, is also curbing business in Africa and threatening to taint the continent's image as a rising economic star.

"Lets ... keep in mind that this is not an African problem, but a humanitarian one that happens to occur in a small part of Africa," World Bank chief Jim Yong Kim and African Union head Nkosazana Dlamini Zuma said in a joint statement.

"We need to move quickly to deploy more health workers and provide more mobile laboratories, more clinics, and more rapid testing equipment," they said in the statement.


MSF's Liu said the "emergency within the emergency" of the current outbreak was the heavy toll inflicted on health workers who treat Ebola patients.

"We found that in the four countries, in terms of healthcare workers, there were 80 deaths and 170 infected," she said, noting that the rainy season was starting in the region.

"What we face today ... is that people don't have access to basic health care. So more today are dying of malaria than are dying of Ebola," Liu said.

The worst-affected countries are recovering from a decade of civil wars and have some of the weakest health systems in the world. Liberia has one doctor for every 70,000 people, Sierra Leone one for every 45,000, compared to one for every 360 people in Britain and one for every 410 in the United States.

Sierra Leone has declared Ebola a national emergency as has Liberia, which is hoping that two of its doctors diagnosed with Ebola can start treatment with some of the limited supply of experimental drug ZMapp.

Canada's Tekmira Pharmaceuticals Corp is also exploring making more of its experimental Ebola treatment, Chief Executive Officer Mark Murray said.

Nigeria also has declared a national emergency, although it has so far escaped the levels of infection seen in the three other countries, with four dead and 10 infected.