To stop Ebola killing thousands more, we need doctors who are willing to put their lives on the line

So far the plague has been fought almost single-handedly by one French aid agency

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The Independent Online

Médecins Sans Frontières (MSF), the French-founded aid agency, is back in West Africa, where it started its work 43 years ago when its pioneering doctors and nurses flew out to bring medical assistance to victims of the Biafran war.

Today, the emergency is the Ebola plague, and according to Joanne Liu, the organisation’s president, the international response so far has been “lethally inadequate".

With more than 2,600 fatalities, 5,300-plus infected, a mortality rate for those untreated of 90 per cent and the numbers doubling every 24 days, the epidemic is “exploding like a bomb in the community”, as a spokesman described it to me. MSF finds itself almost single-handedly tackling the largest epidemic of its kind in history.

I say “almost single-handedly” because the Red Cross is also involved, and President Obama is sending 3,000 US soldiers, with their logistical and engineering capabilities, to the worst-affected areas. But with the entire health system of Liberia, the worst-affected country, in a state of collapse, this tightly focused, single-minded agency remains at the sharp end of the response to the crisis, and it is dramatically over-stretched. As things stand, it simply cannot cope.

That’s why it is urgently seeking to recruit medical professionals to bolster its teams in the field. The work is obviously not for everyone. The pay is poor compared with working for the NHS. And after a one-month tour, fieldworkers are obliged to take an unpaid 21-day layoff because the work, as the organisation does nothing to disguise, is testing in the extreme. Doctors and nurses are bottled up in their protective suits and obliged to work in conditions of strict military-style discipline inside the treatment centres. That discipline continues  outside working hours, with an absolute ban on physical contact of every sort and fanatical attention to cleanliness.

 

“It’s really exhausting to live in conditions like that,” the spokesman said, “which is why we have short rosters, so people don’t  lose their vigilance. We want staff to be sharp and fresh, and we don’t even allow them to volunteer for a second tour until they have been off for at least three weeks.”

MSF’s role in containing the epidemic is vital because the capacity and readiness of other aid agencies to tackle emergencies of this sort have fallen away over the past few years, as they concentrated instead on working with and empowering local organisations, rather than being the shock troops of response. That’s why MSF has found itself in the unprecedented position of appealing to the US and other countries to send in military teams trained to deal with nuclear, chemical and biological emergencies.

The other reason MSF finds itself so exposed is because the authorities in these states barely functioned, even before the outbreak. “It is difficult for people in the West to imagine the extent of disorganisation in these countries,” Adam Nossiter wrote in The New York Times this week. “There is a near-total absence of effectively functioning institutions of any sort,  let alone those devoted  to healthcare.”

When Ebola broke out in Uganda in 2000, the government immediately imposed tough measures to stop it exploding. In Liberia there is no one to play that role. MSF, the only game in town, is fighting to get ahead of the epidemic curve instead of behind it, where it has been until now.

For any nurse or doctor tempted to put their life on the line in the best possible cause, opportunity knocks.

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