Prevention and preparation for large-scale outbreak situations are having a serious price tag, but by neglecting the outcome of risk assessments do have disastrous consequences that turn crisis situations into a worldwide disaster. Read what happens when doctors and nurses are doomed to treat highly infectious patients without any Personal Protection Equipment, no amount of vaccinations and new drugs would be able to prevent the escalating disaster. Read about what the international president of Médecins sans Frontières (MSF) Dr Joanne Liu explains that the world is 'losing the battle' as cases and deaths continue to surge. As one of the leading health experts she urges military teams to be sent to west Africa immediately if there is to be any hope of controlling the Ebola epidemic. During a meeting with the United Nations on Tuesday, doctors working on the frontline of the outbreaks painted a stark picture of health workers dying, explaining that patients left without care and infectious bodies lying in the streets. Although alarm bells had been ringing for six months, the response had been too little, too late.

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Ebola outbreak: call to send in military
to west Africa to help curb epidemic
Head of Médecins sans Frontières says the world is 'losing the
battle' as cases and deaths continue to surge
Sarah Boseley, health editor
The Guardian, Tuesday 2 September 2014 15.23 BST
Medical workers of the John F Kennedy hospital of Monrovia show the aprons they have been wearing during a
strike. Photograph: Dominique Faget/AFP/Getty Images
Military teams should be sent to west Africa immediately if there is to be any hope of
controlling the Ebola epidemic, doctors on the frontline told the United Nations on
Tuesday, painting a stark picture of health workers dying, patients left without care and
infectious bodies lying in the streets.
The international president of Médecins sans Frontières (MSF), Dr Joanne Liu, told
member states that although alarm bells had been ringing for six months, the response
had been too little, too late and no amount of vaccinations and new drugs would be able
to prevent the escalating disaster.
"Six months into the worst Ebola epidemic in history, the world is losing the battle to
contain it," Liu said.
"In west Africa, cases and deaths continue to surge," she said. "Riots are breaking out.
Isolation centres are overwhelmed. Health workers on the frontline are becoming
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infected and are dying in shocking numbers.
"Others have fled in fear, leaving people without care for even the most common
illnesses. Entire health systems have crumbled."
She said Ebola treatment centres had been reduced to places where people went to die
alone.
"It is impossible to keep up with the sheer number of infected people pouring into
facilities. In Sierra Leone, infectious bodies are rotting in the streets," she said. "Rather
than building new Ebola care centres in Liberia, we are forced to build crematoria."
The World Health Organisation estimated last week that 20,000 people in Guinea,
Liberia and Sierra Leone have been infected over three months. Médecins sans
Frontières has doubled its staff of volunteer doctors in the region but is unable to cope.
The epidemic can be stopped, said Liu, but only if governments send in biohazard teams
and equipment.
"Many of the member states represented here today have invested heavily in biological
threat response," she said at the UN. "You have a political and humanitarian
responsibility to immediately utilise these capabilities in Ebola-affected countries.
"To curb the epidemic, it is imperative that states immediately deploy civilian and
military assets with expertise in biohazard containment. I call upon you to dispatch your
disaster response teams, backed by the full weight of your logistical capabilities. This
should be done in close collaboration with the affected countries. Without this
deployment, we will never get the epidemic under control."
Money is no longer the main issue, according to MSF, and voluntary help is not enough.
Skilled and well equipped teams are needed on the ground.
Governments should send in military and civilian experts who can increase the number
of isolation centres and deploy mobile laboratories that can be used to diagnose more
cases.
Military-style operations are required to establish dedicated air bridges to move
personnel and equipment around west Africa and a regional network of field hospitals
must be built to treat medical staff who are infected or suspected of being infected.
About a tenth of the deaths have been among health workers.
"We must also address the collapse of state infrastructure," Liu said. "The health system
in Liberia has collapsed. Pregnant women experiencing complications have nowhere to
turn.
"Malaria and diarrhoea, easily preventable and treatable diseases, are killing people.
Hospitals need to be reopened and newly created."
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Lastly, she said, there must be a change of approach by affected countries. "Coercive
measures, such as laws criminalising the failure to report suspected cases, and forced
quarantines, are driving people underground.
"This is leading to the concealment of cases, and is pushing the sick away from health
systems. These measures have only served to breed fear and unrest, rather than contain
the virus."
Liu was speaking as nurses in Liberia went on strike for better pay and equipment to
protect themselves from Ebola.
John Tugbeh, spokesman for the strikers at John F Kennedy hospital in Monrovia, said
the nurses would not return to work until they are supplied with "personal protective
equipment (PPEs)", the clothing that guards against infectious diseases.
"From the beginning of the Ebola outbreak we have not had any protective equipment to
work with. As a result, so many doctors got infected by the virus. We have to stay home
until we get the PPEs," he said.
The surgical section at John F Kennedy hospital is the only trauma referral centre in
Liberia. The hospital closed temporarily in July owing to the infections and deaths of an
unspecified number of health workers who had been treating Ebola patients.
"We need proper equipment to work with [and] we need better pay because we are going
to risk our lives," Tugbeh said.
The UN has also warned of serious food shortages as a result of restrictions on
movement in the Ebola-hit countries. "Access to food has become a pressing concern for
many people in the three affected countries and their neighbours," said Bukar Tijani, the
UN Food and Agricultural Organisation regional representative for Africa.
"With the main harvest now at risk and trade and movements of goods severely
restricted, food insecurity is poised to intensify in the weeks and months to come."
A UK Government spokesman said: "Britain is working with agencies like the World
Health Organisation and Médecins Sans Frontières to prevent the spread of this deadly
disease. A wide range of further options are under discussion to contain this outbreak."
Dr Paul Cosford, director of health protection at Public Health England, said: "We will
continue to offer every support to the international efforts to contain and manage the
Ebola outbreak led by the World Health Organisation, working closely with government
colleagues, and partners including MSF and UNICEF."
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