I had a chance to attend Thursday’s high level emergency meeting at the United Nations on the Ebola outbreak. For two hours, world leader after world leader pledged solidarity with the countries of Guinea, Liberia and Sierra Leone, the three West African countries hardest hit by the Ebola virus. From Japan to France, Cuba to the United Kingdom, many speakers used the opportunity to announce their government’s intentions to ramp up their donations to the disease-stricken countries and to urge their fellow world leaders to do the same.
The United Nations established the U.N. Mission for Ebola Emergency Response (UNMEER), based in Accra, Ghana, to spearhead the efforts to manage the outbreak, which has to date claimed more than 3,000 lives across West Africa.
Almost every world leader noted the bravery of first responders to the Ebola crisis, calling them ‘heroes’. Despite all of the rhetoric seemingly laced with care and concern for the the victims, the fact remains that no African doctors or health workers have been evacuated as of yet to Western facilities for treatment. No Western leaders announced specific frameworks to evacuate African doctors or other health personnel who contract Ebola, which, at this stage of the outbreak, is indefensible.
Very recently, Dr. Olivet Buck, a Sierra Leonean doctor, died after the World Health Organization denied a request that she be transported to Germany for treatment. In July, Dr. Sheik Humaar Khan, an eminent physician that headed up Sierra Leone’s Ebola response, died after negotiations for his evacuation. On Sunday, health officials reported that Liberia’s chief medical officer, Dr. Bernice T. Dahn, has been placed under a quarantine after her assistant died from Ebola on Thursday. Sierra Leone officials have criticized the WHO for its sluggishness on decisions to evacuate their country’s infected doctors.
President Ellen Johnson Sirleaf said during the meeting on Thursday that the Ebola virus in Liberia had killed over 1,700, including “85 trained to save lives.” She added that the projected losses from the virus threatens to “reverse our gains in malaria control and child and maternal mortality.”
“Partners and friends,” Sirleaf said, “based on understandable fears, have ostracized us; shipping and airline services have sanctioned us; and the world has taken some time to fully appreciate and adequately respond to the enormity of our tragedy.” If the grim projections for Ebola fatalities come to pass, West Africa’s hard fought economic and development gains of the past decade are at serious risk. The world cannot allow this to happen.
The European Commission President José Manuel Barroso announced during the high level meeting that the European Union would set up a hub to facilitate air transport for medical evacuation of health workers from Ebola-affected countries. It is not immediately clear whether this plan is for foreign workers or African workers. The U.S. Agency for International Development came under fire briefly after it was reported that the field hospital it was setting up in Monrovia was intended to treat only foreign workers. The agency now says that the facility will treat health workers of all nationalities.
Guinea, Liberia and Sierra Leone simply cannot afford to lose a single doctor. According to World Bank data, Guinea had just one health-care worker per 10,000 people in 2010, with Liberia and Guinea employing even fewer health-care workers than that. (To put these numbers in perspective, the United States has 122 health-care workers per 10,000 and the United Kingdom has almost 130.) After 2003 in Liberia, after the country signed a peace accord to end its disastrous civil war, only 30 physicians remained to care for 3 million people. Many sub-Saharan African doctors and health-care workers who stay in their countries to help their compatriots face supply shortages, low pay and a lack of government spending on health-care outcomes even in situations that are not following a conflict.
None of this is to say that doctors or nurses deserve to live or die more than anyone else who falls victim to the virus. But these African nations were already operating under severe shortages of health-care workers. With the influx of attention, pledges of hundreds of millions of dollars of support and resources, one hopes that the new efforts by the U.N. and its partners will help prevent Ebola from claiming more lives of African doctors and researchers.
To accomplish this, travel and air service bans must be lifted. Bureaucracy must be replaced with compassionate decisiveness. Health workers must be provided with adequate protective gear. We cannot allow “medical apartheid” to characterize the international treatment of the African medical personnel and health workers from Europe or the United States. After all, the African doctors will be the ones to be on the front lines to help their countries against malaria, child mortality, malnutrition and other diseases that threaten African nations but not foreign workers.
The African doctors fighting Ebola are heroes, just as much as any foreign volunteers. We cannot leave them behind to die.