Via The Globe and Mail: Canadian doctor describes heart-breaking scenes of Ebola outbreak. Excerpt:
Joanne Liu, the international president of Médecins sans Frontières (Doctors Without Borders), returned last week from a 10-day trip to Sierra Leone, Guinea and Liberia, the centre of an unprecedented Ebola outbreak that has killed at least 1,350, according to the World Health Organization.
What Dr. Liu, a Canadian pediatrician, saw on her West-African tour stunned her. The health-care system has collapsed in the areas worst hit by the crisis, meaning that even basic infection-control supplies like gloves and body bags are hard to come by.
Dr. Liu is calling on the WHO to dramatically step up its efforts to combat a viral hemorrhagic fever that, as she points out, often leads to heart-breaking deaths in isolation wards, with victims separated from the people they love.
Why do you think the international response has not been adequate to the size of this crisis?
I think it’s multifactorial. First of all, right now we already have a few crises called level 3 in the world, which is the highest level in terms of emergency for the UN to intervene. People did not expect this kind of evolution [of the Ebola outbreak.] If you look at the past, most of the epidemics that we’ve had were in isolated, remote villages. Basically, when it happened it was self-contained within a few weeks because the chain of transmission was stopped pretty quickly.
What happened here is we have cases in urban settings. We’ve never faced that before. [And] when it’s something remote, something difficult to understand, it’s hard to get people’s interest. But with the fact that we had some foreigners infected, that drew a lot of attention. All of sudden, people said, ‘Oh my god, it’s knocking at my doorstep.’ All of sudden, people are paying attention.
Those cases of foreigners being infected in West Africa also drew attention to experimental medicines. What do you make of the WHO decision to support, in theory, providing experimental medicines in the Ebola outbreak? Is it helpful?
There’s never been enough research and development in trying to find either a vaccine or treatment for Ebola. There were some, but this will probably be a catalyst in that respect, which is something that we welcome. I think [the WHO] has done it a bit under pressure. To be realistic, for this epidemic, it’s unlikely that it’s going to make a difference in terms of the course of events.
In the case of the 1,000 Canadian vaccines being offered here, what do you see as the potential value, if any, of having an experimental vaccine that could be available to a much larger number of people than any of the other experimental treatments we’re discussing?
The thing is, we know very little about this vaccine. It hasn’t been tried on humans so it’s very difficult to have a point of view on this. We are having, actually, an [internal MSF] task-force meeting on this [Wednesday] in Geneva.
What’s the conclusion you’re hoping to come to? Is it just about the provision of the Canadian vaccine?
No, it’s just for us to have a greater guideline in terms of what we’re ready to do. Because the reality is doing clinical trials is a huge production. It’s not just you gave [the drugs] and this is it. There’s going to be some blood tests that will be done, some monitoring, we need to be clear what the criteria is for using it. It needs to be well-framed. If it’s not well-framed, first of all it’s going to be hard to draw conclusions. Second of all, you might put some of the patients at risk.