Hi Folks, I am posting a letter I wrote to a friend who asked me about the epidemic in Liberia I am angry, so I apologize in advance for any ruffled feathers. Some of you may feel that I am being unfair. Perhaps I am. I dont see the whole picture of how any of you, especially any of you CDC, NIH, WHO or Government of Liberia people might be contributing to the fight. My point of view is narrow, it is very personal and it is passionate. Nevertheless you need to hear it. Believe me. I am not the only one saying these things. My hope is to spur us on to finding an effective coordinated way to fight this and prevail. So please take it in that spirit. aloha *** Hey John, Ive been meaning to write you but things are just moving faster than I am capable of moving. Sorry. Ive been back in Hawaii since August 4 but Ive been very involved in writing, blogging and trying to forge some kind of positive action. All to no avail. I am so depressed man. This situation could have been so avoided. I am pissed at CDC and WHO, both I think have just totally dropped the ball. Honestly, I hope I am wrong but when I watched the detachment of the CDC people that I interacted with my cynical sense wondered if maybe somewhere in their heart of hearts they allowed this to happen just to see if their models were correct. Certainly I have to wonder the same about USAMRIID. I am so pissed. All of the poor poor people who are dying awful, awful deaths. This really didnt have to happen. Even a month ago, when I got to Liberia at the beginning of July, it would have been manageable. If CDC and WHO had provided some strong decisive leadership and political pressure -- providing the resources and the manpower to allow for good case investigation, along with a goal of quarantining houses on a case by case basis coupled with a cogent education message and increased hygiene. With that simple strategy I honestly think we could have licked this epidemic. CDC was here, WHO was here, they could have pushed for this. They saw the hospitals closing down, they watched as the health care system collapsed with their mouths agape in senseless wonder. What a pity! I think control of this could have been totally achievable while the numbers were still low, But no. Everybody acted like we had the luxury of time, even the scientists and professional epi people acted like weve got time and pretended like the government of ONE OF THE POOREST COUNTRIES IN THE WORLD had the where with all and the competence to deal with this. In the end, Im sorry but I am forced to utter, you know, these guys have huge salaries and homes in safe places. They have no skin in the game. CDC Director Frieden has this quote on the CDC website: “The bottom line with Ebola is we know how to stop it: traditional public health. Find patients, isolate and care for them; find their contacts; educate people; and strictly follow infection control in hospitals. Do those things with meticulous care and Ebola goes away.” This could have worked weeks ago but CDC deferred its leadership role so now its just a nice, out of touch ivory tower kind of statement. You do realize of course that the medical system in Liberia collapsed weeks ago. When I left Liberia on August 3 there was not one hospital or clinic open in all of Monrovia, a city of 1.3 million people. No running water. No electricity. No sewage nor toileting facilities in shanty towns where people live packed like sardines sometimes ten people to a tiny corrugated metal room with one mattress. Traditional public health?? As for the sudden interest in experimental interventions like vaccines and monoclonals, where does the World Health Organization even get off convening an ethics panel ten days ago to study the ethics of experimental, non-tested treatments. SERIOUSLY????!!! Just now, ten days ago???? They have seen this thing coming for months and they wait until now! What does it take to make them interrupt their dinners on Lake Geneva??? The slum they want to quarantine, West Point, has 50,000 people in it. If they really mean that no one can leave and no one can enter what do they predict will happen???! I think that food will run out in a couple of days. Im not sure where the water comes from but there cant be a lot of good sources on West Point, the crowded filthy sandy spit of land that lies between the Atlantic Ocean and the Mesurado River. The place is dirty, DIRTY, and crowded beyond imagination for any American or European or even Liberian sensibility. This could go very badly and it could be a genocide. The killing of the poorest of the poor. WEVE GOT TO DEMAND TO SEE OR HEAR THE GOVERNMENTS PLAN. I think really all of us, we the World, should want to know, absolutely, what the plan is for supporting and sustaining the healthy uninfected population of West Point? How do you plan to provide food and water? What will you do for the sick? What about people that do not have Ebola virus disease? Babies being born? People suffering accidents? Other diseases like malaria and hypertension and etc? How will you support healthy people taking care of sick people? What about hygiene? Are you looking at community service and volunteerism? Are you considering recruiting community members and church congregations to help provide manpower? What about community education programs? As far as I can tell it has been Doctors Without Borders, (MSF), that has been handling the medical angle of this practically alone. Who is going to step up to help them? The news this morning on NPR is that the police fired into a crowd of demonstrators in West Point. This is chaos on top of chaos. We need to convene a summit of all stakeholders. Now. This weekend. To plan and map out an intervention of unprecedented scale. Or would we rather continue to pretend? aloha --jb
Posted on: Thu, 21 Aug 2014 07:57:47 +0000
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