Book throws the lid on a series of mistakes in the Ebola outbreak that killed 11,300 people | Global development

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The World Health Organization and other global agencies have not learned enough lessons from the 2014 Ebola outbreak that killed more than 11,300 people worldwide. people in West Africa, said a British doctor at the center of the battle in Sierra Leone. Although the response to the latest Ebola outbreak in the Democratic Republic of Congo (DRC) has been swift and effective, the long-term strategies of the international community have only marginally changed, said Oliver Johnson, who in a book with Irish diplomat Sinead Walsh the cover on the extraordinary chess behind the scenes four years ago.

In Getting to Zero, the duo shows how a litany of mistakes made in remote offices in New York, Washington, London and Geneva, combined with weak leadership in Sierra Leone and a weak health service have created a disaster that could have been avoided.

Among those who are under fire are the British Army, the Department of International Development, and the United States. Center for Disease Control.

The harshest criticism is directed at the WHO, which has been slow to declare the Ebola outbreak an international emergency, but has not listened to warnings either. alarmists of doctors who worked in horrible conditions at Kenema Hospital. Pooley contracted the virus.

"Kenema's WHO staff has been shouting for months … but the WHO leaders have not taken adequate measures," note the authors in the book [19659008]. 75 medical teams awaiting health emergencies and changes in funding flexibility in case of seizures, the authors say: "Despite the enormity of their failures on Ebola, the WHO does not. initiated no other significant reform. "

with Stakeholders, Politicians and Witnesses, Johnson and Walsh Give First-Hand Evidence on the World's Failure to Respond to the Ebola Virus in the First Months of 2014 – A Life-Less Inaction to thousands of people.

Walsh country before the outbreak and had come from the background of the aid, said that even when the world responded, the plans hatched in the air-conditioned offices at the 39, were not translated for local needs.

around tables in Washington, London and New York, and we can all say that the strategy is excellent, but when you are in Freetown or [capital of Liberia] in Monrovia, it is very different.

"When you work in a very weak health facility and put new strategies in it, it does not look much different," she said in an interview with the Guardian.

Neither Walsh nor Johnson intended to write a book. But after two years, they had a chance to meet and discussed their frustration with official reports and post-mortems around the world.

"I read articles, reports, often written by organizations, [which] presented their vision of what had happened, and I did not recognize it" Johnson said. who had been there from beginning to end … and we were frustrated with some of the things coming out. We decided, instead of talking about it, to put it on paper so that it would never happen again. [In] some of these organizations, the staff would go in for six weeks or two months and leave, while we had been there all along and we felt that we had a perspective that they could not offer, " said Walsh. Members sit in the room of the Strategic Health Operations Center (SHOC) at WHO headquarters in Geneva October 1, 2014 "src =" https://i.guim.co.uk/img/media/bdaa5dd72cc668fdc4bd478c5a423f2ec0275b2f /0_0_3500_1980/master/3500.jpg?w=300&q=55&auto=format&usm=12&fit=max&s=f9c4eecfe09064248e3205753d2e929f "/>

As the Irish ambbadador to Sierra Leone, Walsh was already connected to local politics and remembered receiving a memo that indicated that WHO was reluctant to declare an international emergency and to mobilize international attention. Because it feared that the local government would interpret it as hostile act. "

" I was livid and frustrated, "writes Walsh." How could people on the ground be- they advocate for funding and emergency staffing "when the WHO said things were going in the right direction?"

Johnson believes that Sierra Leone would struggle to cope with a another humanitarian emergency As the new government has just pledged 15% of its budget to the health sector, lack of accountability, inadequate salaries and chronic shortage of medical staff "hinder efforts to achieve public health goals . "" 19659023 We could not rely on WHO to sort the answer or give the international community a realistic badessment of needs

In 2014, Sierra Leone had only 136 doctors for a population of about 6 million and 12 of them died of Ebola.

"When the music stopped and the epidemic stopped, things largely resumed their course" Johnson writes in the book

"When I talk to colleagues in Sierra Leone, they say that the aid dried up very quickly and he returned not to "rebuild better" but "as usual", he later told Guardian

"I see increases Marginal funding, marginal changes in the approach, but I do not see the kind of change or level of support to make a significant difference.

"At the end of the day, the question is – how much do we care? … If anything I think the global appetite is less than two years ago." Think of some political changes in the world. "

With denial at home when Ebola struck, no commander abroad and a nearly non-existent health service, the disease had a perfect host.

In this context, Johnson and his team hit the pads again and again.

NGOs fled the city and the international community was "deaf" to what was happening.

In the book, Johnson tells how he approached DfID for a donation of $ 12,500 (£ 9,500) to create desperately needed isolation units. six hospitals in Freetown, with the aim of avoiding the spread.

DfID refused. "$ 12,500 is too small," Johnson told an advisor. They suggested that he try the UN and the WHO, without success.

"I ended up asking my mom to donate," Johnson said.

Just under 1,000 patients crossed the Connaught, were subjected to blood tests and were expelled from Ebola or sent to another hospital.

"In my naivety at the beginning of the Ebola outbreak, I thought," Yes, health crisis – WHO is there. They know what to do … I soon discovered that not only could we not rely on the WHO to sort the answers or give the international community a realistic badessment of needs, but that we, the partners donors, could barely meet them, "said Johnson. "We had nothing we needed or asked from the WHO."

Walsh had worked in Asia and Central Africa before coming to Freetown. Unlike her neighbors in British embbadies, she was responsible for the Irish equivalent of DfID and had the freedom to spend money.

She recalls how the lack of transparency and coordination at the beginning led to deadly missteps. In June, 90 people were confirmed dead in Kailahun, where Ebola entered the country from Guinea

A Ugandan epidemiologist arrived to lead the response to the WHO and developed a plan at a cost of $ 286,000, including 16 cars for a surveillance team. He felt that this would be enough to kill the epidemic.

He received $ 86,000 and a car. Walsh said:

She was sitting in the WHO offices at the beginning of the epidemic in June 2014, pleading with the organization to tell her how Irish Aid and 's. other donors could help. If she had known that she could have "produced much faster," she thinks she could have helped stop the Ebola virus.

The biggest discordance was perhaps Kerry Town, an ambitious British hospital designed and designed in London to open. When he did, he was so limited by his own protocols that he treated relatively few patients. In all, it is estimated that it cost about £ 80 million to DfID.

A local doctor told the authors, "They wanted everything perfect before receiving patients," while other clinics had to turn patients away. It is likely that Walsh will die as well as infect others.

Walsh, however, is clear in the book that the UK has finally played a critical role. "Whatever criticisms I have had and those of others on the functioning of the United Kingdom during the riposte, there was no doubt in my mind that they had reversed the trend and invested huge resources that had been essential to get to zero. "

There are many heroes in the book – no less than 221 local health workers who died – and Foday Sahr, now the general surgeon of the Sierra Leonean army, who was leading a military units of Ebola. But for organizations, it is the Sierra Leonean army that Johnson and Walsh choose as praise. "A week after the opening of the government-run Hastings Ebola treatment unit, they had 120 beds compared to the four they had run in the city of Kerry," wrote Johnson.

There was a global message the authors said they wanted to convey, that is, the international agencies must "work with the communities – do not do anything to them."

The book, published Monday, is a full of compbadion, sorrow, ingenuity, and stories of courage and steadfast commitment from local nurses. cleaners and others who remain unsung heroes of the Ebola virus. But it is also full of stories of denial, extraordinary failings in leadership and embarrbading truths that will make reading uncomfortable for many, locally and internationally.

• Getting to Zero is published by Zed Books. All proceeds will go to Sierra Leonean charities for health workers and to St Joseph's School for the hearing impaired, Makeni