Ebola and Sierra Leone – money is the easy bit

In the incongruously sumptuous setting of London's historic Lancaster House, representatives of governments and humanitarian organizations listened in silence as a British nurse, Will Pooley, recently recovered from Ebola, evoked the squalor of the Ebola wards in Kenema where he had worked, and told of the painful deaths of two Sierra Leonean children he had befriended, a young brother and sister. 

Then they were asked to make their pledges, led by the UK, which is committing more than US$200 million to tackle the disease.

The UK Foreign Secretary, Philip Hammond, said that although the UK was leading and coordinating the response in Sierra Leone, it needed international help, and the meeting had brought significant progress; new partnerships had been forged and he expected those to lead to significant further pledges. 

“What we have done today,” he said, “has increased the odds of success in the battle against [Ebola] and increased the chances of hundreds of thousands of people in the region of surviving the disease.” But he warned that this was only the start of the process not the end. “The fight against Ebola will be crucial over the next months; it will be won as a result of the actions that are taken over the next three or four months.”

Ten months from the start of the outbreak, there is now a greater sense of urgency, but the help promised this week will not arrive immediately. This is largely because although Sierra Leone and the other affected countries do need cash, they also need things which money alone cannot buy. One of the officials who organized the conference told IRIN that offering money was an easy decision, but pledging medical staff, equipment and logistical help took a lot more working out.

Volunteers will want to know they can be evacuated back home

Cuba alone has been quick to send doctors and nurses, but in general committing health workers and members of the armed forces to what could be a dangerous mission cannot be done lightly. Sanjayan Srikanthan of the International Rescue Committee, said this was a role for governments; NGOs on their own simply did not have enough staff to scale up their response.

“As a measure of last resort, we are calling on governments to release military capacity to set up facilities and help manage them... and to expedite the deployment of volunteers from health services and agencies. Governments must also create an enabling environment for volunteers,” he told the meeting.

“More people are now volunteering, but to access this huge and priceless resource requires a guaranteed medevac system, and other logistical and financial support. We call on states to solve this obvious and critical problem here today, by agreeing to operationalize and fund a dedicated medevac system for all staff, regardless of their nationality or organizational affiliation,” said Srikanthan.

The call was echoed by the Claus Sorensen, director-general of the European Union aid body ECHO. He said that promising volunteers good treatment locally was not enough. “There is also a psychological aspect,” he noted, “that they will want to know that they can be evacuated back home. So we need to establish an evacuation facility and we have to streamline the protocols for putting patients on planes.” 

UK Foreign Secretary Hammond then appealed to countries that had suitable military transport planes to make them available, either directly to be used in West Africa or to fill in behind planes diverted from other places like Afghanistan. But with military transport capacity currently stretched in the Middle East and elsewhere, this was another request that would not receive an immediate response.

Moral leadership and rubber gloves

Not every country represented at the meeting can afford to pledge planes or millions of dollars. Ghana, for instance, already agreed to host transit facilities for the aid effort, at a point when other countries in the region wanted to cut themselves off from their affected neighbours. 

President John Mahama himself set an example. Victor Smith, Ghana's High Commissioner to London, told IRIN: “Our president happens to be chairman of ECOWAS [the Economic Community of West African States], so the whole crisis is on his doorstep. He has to be a father to the region, so he had to visit those states, even though a lot of people were against it and saying, 'This is a very dangerous virus'. He had to do it to show that you shouldn't just start running away, because that was what had started to happen.”

The Philippines, which exports medical staff world-wide, previously said it was reluctant to expose its doctors and nurses to Ebola, but the UK is suggesting that they could still provide training for medical staff. Japan is providing personal protection kits. Malaysia is one of the world's biggest producers of rubber gloves; the UK is talking to them about supplies.

One of the disappointments of the London meeting was that the plane due to bring President Ernest Koroma was unable to take off from Freetown. Sierra Leone was represented by its high commissioner, Edward Touray. He told journalists that whereas the country had felt isolated and unable to cope, it now felt much better supported. "What I get from this conference is a willingness of the international community to come in and donate.”