Magazine article New Internationalist

What Is the Right Response to the Ebola Crisis?

Magazine article New Internationalist

What Is the Right Response to the Ebola Crisis?

Article excerpt

'NGOs are taking over the health services. Médecins Sans Frontières (MSF) and the Red Cross were winding down here since the war. But now those organizations are back running services. There's a danger that if we invest only in NGOs we'll restore a situation where the NGOs run the health system for a couple of years and then leave. We're turning the clock back to what we were trying to get away from: a pop-up NGO, aid-run system, ratherthan a strong, government-led health system run and led by Sierra Leoneans.

'We need massively more support from the international community to strengthen government hospitals, so that normal services can continue and staff can be safe and not die. We need to keep staff confident to make sure patients keep getting a good quality of care. We don't want to create a parallel NGO structure.

'We need NGOs to be willing to work in government hospitals and a lot of them are afraid.'

We invited MSF to respond. They said:

'Dr Johnson is quite right to say that, more than 10 years after the end of the war, the health system in Sierra Leone should have been getting back on its feet under the leadership of the government, with external support.

'The health system had been slowly improving over recent years, though serious weaknesses remained, not only with low staffing but also low morale, weak management and lack of basic materials like gloves and disinfectants. Nevertheless, the country was clearly in a phase of development rather than acute emergency. Before the latest Ebola crisis, Médecins Sans Frontières, which focuses on emergencies, was getting ready to hand over our last project in the country. We had been working for over 20 years across the country, including through some of the most bitter fighting. We were reducing our activities and only providing paediatric and maternity care in a dedicated hospital.

'Then Ebola arrived and changed everything. We immediately stepped up our activities in Sierra Leone to respond to this crisis, and set up specialist treatment centres. Ebola requires strict protection measures and discipline to avoid health facilities becoming sources of contamination or even fuelling the epidemic. Ebola management centres are best kept away from general health services, to avoid intra-facility contamination, so MSF is now operating two stand-alone units in Bo (35 beds) and in Kailahun (80 beds).

'The Ministry of Health, supported by WHO, is planning to set up about 20 more specialized centres. …

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