The Australian Government has been urged to step up its response to the global Ebola crisis and take a leadership role – in boosting Australia’s role in relief efforts, as well as in contributing more usefully to public debate.

The call comes from Christopher Cliffe, CEO of CRANAplus, an organisation representing remote area health professionals – two of whose members have recently returned to Australia from Red Cross deployments in West Africa.

Remote area nurses Sue Ellen Kovack and Libby Bowell are scheduled to present via link-up to the CRANAplus conference, which begins tomorrow in Melbourne.

Kovack worked in a hospital in Sierra Leone while Bowell was involved in coordinating community treatment facilities and mobile teams in Liberia.

Cliffe said he hoped the conference presentations would help shift the focus of public debate from fear-mongering to the “amazing work” that people are doing on the ground – and the importance of the Australian Government taking a more proactive role.

“People are doing some amazing work, we need to get that out – it needs to be the story rather than the hysteria around this fear,” he said.

Cliffe said Kovack was worried was that the sensational media coverage about her case would discourage other health professionals from volunteering.

“Her biggest fear is that people won’t volunteer because of an unnecessary fear based, not on evidence, but on hype,” he said.

These concerns have also been raised by the AMA, whose president Dr Brian Owler recently described Federal MP Bob Katter’s comment, that health workers who go to Africa are putting their humanitarian ambitions ahead of the risk to the Australian public, as “disgraceful”.

Owler said:

“This nurse did exactly the right thing by home quarantining, and then at the first sign of any sort of illness, a mild temperature, reported that; she’s been tested as negative so far. …to strike fear into the hearts of Australians and suggest that this person has put her own ambitions above the interests of the community I think is a disgraceful comment really, when we know that this is a person who is creating humanitarian work.

“Thank God we have people like her that are actually going and doing this work, and are selflessly giving up not only their time, effort, and pay, but also putting their life on the line for their fellow humans.”

Cliffe, who has himself worked in many conflict and disaster crises, expected Bowell and Kovack would share with conference delegates some of challenges facing clinicians working under extraordinarily difficult circumstances.

He said:

“Ebola is such an indiscriminate disease. The people you are working with are at risk and their families are contracting the disease, so it’s a very tragic time and this adds a level of stress for the clinician.

“The other thing is the absolute difficulty associated with the protective equipment that you need to wear. You need a whole team of people to dress you and decontaminate you. The process around that and the coordination is very, very challenging.”

Dr Margaret Chan, the director general of the World Health Organization, warned this week the Ebola outbreak was “unquestionably the most severe acute public health emergency in modern times,”  and had progressed from a public health crisis to “a crisis for international peace and security”.

She said in a statement: “I have never seen a health event threaten the very survival of societies and governments in already very poor countries. I have never seen an infectious disease contribute so strongly to potential state failure.”

According to the New York Times, Chan said the outbreak emphasised “the dangers of the world’s growing social and economic inequalities.”

“The rich get the best care,” she said. “The poor are left to die.”

More than 4,000 people have died from the Ebola virus, all but a handful of them in the West African nations of Guinea, Liberia and Sierra Leone, according to WHO estimates. 

As previously reported at Croakey, many health leaders and organisations have been lobbying the Australian Government to contribute human resources to the global response. The AMA has called for the urgent dispatch of portable hospitals and fully equipped medical teams.

Many have noted, by comparison, Cuba’s announcement that it will send a medical team of 165 people to Sierra Leone to help in the frontline in the Ebola response efforts.

The Cuban team consists of 100 nurses, 50 doctors, 3 epidemiologists, 3 intensive care specialists, 3 infection control specialist nurses and 5 social mobilization officers – the largest offer of a foreign medical team from a single country during this outbreak.

Chan says that while money and materials are important, they cannot stop Ebola virus transmission, and that “human resources are clearly our most important need”.

She said: “We need most especially compassionate doctors and nurses, who will know how to comfort patients despite the barriers of wearing PPE (personal protective equipment) and working under very demanding conditions”.

Like the AMA, Cliffe disputed Federal Government claims that it was not logistically feasible to send Australian teams to the Ebola response.

He said:

“I’d like to see the Government get more involved, not only in the response but also in the public debate around it. Some of the responses have been a little bit simplistic; for example, the concerns raised by the Foreign Minister that there’s no pathway for returning sick Australian workers.

Quite obviously, there’s large international organisations already working over there. You would not return somebody with Ebola to Australia; you would have agreements to have them treated.

It would be nice to see the Australian Government work in partnership with other countries … I think there are solutions to this. I’m surprised they’re not leading with solutions.”

Cliffe said that in addition to humanitarian grounds, it was in Australia’s national self interest to contribute health workers to the response efforts.

“People are going to continue to go and help; so we’re better off being on the front foot, supporting these people, giving them the right supports during this period, so they can do what they need to do,” he said. “That’s in Australia’s best interests.”

Cliffe said remote area health workers were well placed to respond to crises like Ebola because they are used to working in remote areas with few resources, and practising community-level, comprehensive primary health care.

He was optimistic that the Australian Government was looking to lift its game: “I’d be very surprised if they’re not trying to work out how to respond more effectively.”

Also on the CRANAplus conference agenda are concerns about the new primary health networks, and the need to develop Government understanding that GP-based models of care do not work in remote Australia.

“We need to advance the acknowledgement and understanding that comprehensive primary health care in remote Australia is not a general practice model,” Cliffe said.

While primary care providers in remote areas tend to not be GPs, many government initiatives were rolled out with a focus on mainstream general practice, rather than the needs of remote communities.

“There are such disparities in health and access to healthcare in remote areas,” he said. “Yet we’re out of sight and out of mind most of time,” he said.

• Follow Croakey’s coverage of the CRANAplus conference here.

• On Twitter, follow #CRANAplus14 and @CRANAplus and @BenCrough

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Further reading

• Australasian College for Emergency Medicine response to the management of Kovack’s care, and the suspension of two doctors from Cairns hospital.

• Watch Dr Paul Farmer, c0-founder of Partners In Health and Harvard professor talk about the global response to Ebola. Interestingly, the discussion is hosted by Google.org

http://youtu.be/lb11QbP3tOg

Meanwhile, public health leaders add their voices to calls for Australia to step up.

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