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3 things we must do right now to fight Ebola

Anjali Kwatra's picture
Anjali Kwatra Head of News

As the Ebola death toll nears 5,000 and the World Health Organisation warns of 10,000 new cases a week by Christmas if we don't stop the spread, we asked Dr Colin Brown, Infectious Diseases Registrar at King's College Sierra Leone Partnership what three things we must do right now to fight the Ebola crisis in West Africa. This is what he said.

Dr Colin Brown, Infectious Diseases Lead, King's Sierra Leone Partnership

We need to do them right now. We're running out of time. And we need your help.

  • £25 can pay for cleaning and disinfectant materials for three families at risk from Ebola.
  • £50 can buy three sets of personal protective equipment for volunteers supporting people under quarantine.
  • £100 can provide training to a community on how to keep themselves safe and help stop the spread of Ebola.

Learn more about Ebola

In this guest blog, leading HIV and AIDS activist and former CEO of the Terrence Higgins Trust, Sir Nicholas Partridge draws comparisons between the fight to defeat HIV and AIDS and Ebola and looks at how we can use this knowledge to limit Ebola's spread.

Sir Nicholas Partridge addresses an international audience of HIV/AIDS activists in Lisbon, Portugal
Sir Nicholas Partridge addresses an international audience of HIV/AIDS activists in Lisbon, Portugal
Photo: Terrence Higgins Trust

Thirty years ago, the little known HIV virus brought illness, isolation, stigma, fear and anger to the UK. The terror and fear felt then, now haunts Sierra Leone and Liberia. They are grappling with the horror of Ebola and its power to devastate and inflict an appalling death on loved ones.

The differences and similarities between the spread of HIV and AIDS and the Ebola outbreak

While there are some obvious differences between HIV and AIDS and Ebola, there are many very real similarities. Before the advent of anti-retroviral drugs, HIV was too often a death sentence for all who contracted it, albeit on a longer time frame than Ebola; seven in ten will not survive the Ebola virus but will die within weeks of showing symptoms.

Long-term HIV survivors in the UK can empathize with the anguish those in Liberia and Sierra Leone must feel, knowing that effective treatment is unknown, uncertain and unavailable.

The underlying causes that drove the rapid spread of the HIV virus were complex and in the eighties still unknown. Yet we already knew that the impact was much worse in the USA, so were fortunate to gain early, important lessons from Americans who were sharing our pain: how to build effective community support through buddying, the importance of education and prevention campaigns and the critical role of good evidence, robust science and rigorous medical intervention.

We also saw rash and foolish decisions which did nothing to halt the spread of the virus – travel bans, alarmist and misinformed messages and attacks on those affected. We even saw children banned from schools as happened recently in the north of England with an eight year old child from Sierra Leone.

Stigmatization of those affected and infected by the Ebola virus

We understood very quickly that invisible walls, such as border controls or the stigmatization of those affected and infected, created fear and panic and impeded the open dialogue which should align activists, scientists, health workers and government on the same side; working together to deliver education, care, effective prevention and accelerated treatment options leading to positive solutions. And neither should we underestimate the importance of the rapid scaling up of medical treatment and its delivery by skilled and committed staff, as is now vitally necessary to contain Ebola. 

In the case of HIV, early investment and genuine honest dialogue with all stakeholders including affected communities, local health services, scientists and the voluntary sector created an alliance which had a dramatic effect on the growth of the epidemic in the UK.

We also understood very early on that this positive alliance had to be strengthened across borders and around the world. We saw the changing nature of the epidemic in those who came forward for help and we knew that the pace of the virus in Africa would need intense in-depth response.

When Noreen Kabila of ActionAid came to speak to me in the eighties I shared what we had learnt from the USA. She went back to Uganda and TASO, The AIDS Support Organisation was born. It became the most successful community mobilization initiative in Africa working on HIV/AIDS and its lessons were carried across the world.

A key learning was that it is only through the impressive efforts of community leaders like Noreen that the real challenges serious infectious diseases pose in terms of fear, stigma and exclusion can be addressed.

Ebola response must be swift, committed and serious

As with HIV and AIDS, so with Ebola. The response must be swift, committed and serious. It must also be inclusive and global – a world alliance of scientists, international agencies such as ActionAid, MSF and the Red Cross with their complementary range of approaches, institutional funders, governments and most importantly community organisations working together with compassion and integrity – and with the right resources and commitment.

The Ebola virus can only be defeated by sharing learning and investing in the critical responses that are needed – robust health systems, effective surveillance, positive community involvement, empathy and proper evidence. And response must be to scale. As Dr David Nabarro, the UN’s special envoy on Ebola said, a "20-fold increase" in the global response is needed compared to efforts at the end of August.

Nigeria has shown Ebola can be controlled with swift action, effective surveillance and containment. That’s based on the lessons they learned from their battle with Polio. Although Ebola is now ubiquitous in Sierra Leone, Guinea and Liberia, it can still be slowed and eventually halted if enough capacity and resources are dedicated to supporting the sick and their families, stopping transmission and dealing with Ebola’s social consequences.

Success or failure of West Africa’s battle with Ebola is our responsibility as much as theirs

What HIV shows us is that the success or failure of West Africa’s battle with Ebola is our responsibility as much as theirs and our problem as much as theirs.

This is an epidemic that needs a global response. We are tied together by bonds of obligation, the consequences of inequality and poverty and also by our own failure to support those institutions, be they health ministries in West Africa or the World Health Organisation, that are essential to halting the suffering and the threat of the virus.

With all the similarities however, there is one big difference. Given Ebola’s very short cycle of contagion, sickness and transmission of infection, time is of the essence. The lessons and approaches that took years to evolve in the fight against HIV and AIDS must in this case be done in weeks.

More on this story:

Ebola virus is an automatic death sentence, and other Ebola myths

Jane Moyo's picture
Jane Moyo Head of Media Relations

As the Ebola outbreak extends its grip on Guinea, Liberia and Sierra Leone, global concern has escalated, especially now that nations including the USA and Spain have reported some sporadic Ebola cases. It's time to dispel some myths about the virus. 

A Liberian health worker in Monrovia. ActionAid is donating clorox, chlorine and buckets to patients, survivors and affected families.
A Liberian health worker in Monrovia. ActionAid is donating clorox, chlorine and buckets to patients, survivors and affected families.
Photo: ActionAid

While the Ebola outbreak is undoubtedly a humanitarian disaster for West Africa, global panic and fear has caused worldwide confusion about the disease. This is not only unnecessary but is also diverting attention and resources to western nations and away from the real battle to contain the disease and save hundreds of thousands of lives in West Africa.

We asked Mike Noyes, ActionAid UK's Head of Humanitarian Response and Dr Colin Brown, Infectious Diseases Lead for the Kings College Sierra Leone Partnership to help challenge some of the more persistent Ebola myths doing the rounds.

Ebola is very contagious

That’s tricky to answer. If you are in the wrong place at the wrong time and don’t take basic precautions when dealing with infected patients, Ebola is easy to catch.

Certainly in West Africa every person with Ebola is currently infecting a further two people. But that’s not as contagious as other diseases such as measles where one infected person can cause infection in a further 16 to 18 people.

You can catch Ebola from someone who is infected but isn’t showing symptoms

Doctors consider that highly unlikely. Ebola’s incubation period ranges from two to 21 days and scientists believe that people do not carry enough of the virus in their blood before they exhibit symptoms.

Casual contact with someone who is not showing symptoms should not spread Ebola. That includes shaking hands. Even kissing is thought to carry little risk unless someone is just about to develop a fever and has started bleeding from their gums.

You must have very heavy amounts of the virus in your bloodstream to pass Ebola on. Once symptoms emerge, people become more contagious as they get sicker and are still contagious after they die. That’s why the management of the sick and of dead bodies is so important in stemming the outbreak.

You can catch Ebola just by touching someone with the disease

It’s not as simple as that. The infected person must have large amounts of the virus in their blood to transmit Ebola and that can only be via bodily excretions; so blood, urine, diarrhoea, vomit, semen and perhaps sweat – although doctors are not certain about that last one.

Even so, transmission can only occur via contact with mucus membrane – that's through contact with the mouth, eyes or nose – or through a break in the skin. It's also why it is very important to wear protective gloves and face masks and disinfect regularly when dealing with people who are ill; people with Ebola lose control of their bodily functions and can bleed spontaneously.

Ebola is just like HIV and AIDS. You can catch it through having sex with an infected partner

Ebola is not HIV. It’s always sensible to be very careful about sexual partners and practices but as Ebola is only thought to be transmissible when showing symptoms – fever, vomiting, diarrhoea, weakness and severe aches and pains – having sex prior to having a fever is not necessarily a problem.

The only exception is after a man has recovered from Ebola because the virus is still present in semen for three months after infection. It’s important to remain celibate after recovery or at the very least to use condoms.

Once you’ve got Ebola you’re definitely going to die

Ebola's certainly very dangerous but not necessarily a death sentence. While the current West African outbreak has a death rate of seven in 10 that’s because poverty is the engine that drives Ebola. People who are poor are often not fit enough to withstand infection. Health services are weak, underfunded and now overwhelmed.

Sierra Leone and Liberia had less than 200 doctors in each of their countries before the epidemic and very little in the way of equipment or medicine. But if you seek early treatment and notify the authorities you stand a much better chance of living.

People travelling from affected countries should be screened for Ebola and all West Africans should be stopped from travelling

Travel bans won’t work. They are not policeable and anyway seeking to isolate the problem in West Africa is not dealing with Ebola.

Screening has its uses but the most effective screening happens at the point of departure, not entry, because it only picks up people who are already displaying symptoms, not carrying the virus. High quality departure screening is a key part of the efforts of the international community to strengthen wider health services into the region, but it is just part of the solution.

The best way to protect West Africa and indeed the world from the Ebola outbreak is to ensure that all efforts are made to tackle the virus at source on the ground.

It’s only a matter of time before Ebola becomes a global pandemic

There is absolutely no chance of that. Ebola is not airborne – which would be much more dangerous – and universities and drugs companies are working flat out on a vaccine. And there is reason to be hopeful about that. We’re already in Phase 1 of drug trials and will move to Phase 2 in the New Year and Phase 3 a few months later.  Keeping the costs low and rolling out mass vaccination programmes will be crucial.

In the meantime, massive and sustained medical intervention coupled with prevention programmes should halt the epidemic if there is the political and financial will. The danger right now is that the global community is not doing enough in West Africa. That means we may fail to bring this outbreak under control in time to avoid devastating consequences for the people in the affected region.

Not even the UK’s health system could cope once Ebola is in the population

Don’t be silly. The UK has detailed risk processes in place which have been updated since the outbreak and all medics, from GPs to hospital A&Es, work to an early warning cascade system.

Generally, the western world has excellent health services and infection control procedures which will quickly contain any outbreaks. They also have the resources to learn from and overcome the type of weaknesses in health systems that we saw recently in the USA and Spain.

And we can also take confidence from Nigeria's response. As soon as an Ebola case was announced, they swiftly responded with effective surveillance and containment based on their battle to combat polio.

ActionAid staff are working around the clock to stop the spread of Ebola and save lives in West Africa. Please help us.

More on this story:

With thanks to Mike Noyes, ActionAid UK's Head of Humanitarian Response and Dr Colin Brown, Infectious Diseases Lead for the Kings College Sierra Leone Partnership for their advice in writing this blog.

Photo: ActionAid.

Why we won’t shut up about girls' rights

Michelle Lowery's picture
Michelle Lowery Communications Team

Ahead of tomorrow's International Day of the Girl we've just heard the incredible news that inspirational schoolgirl Malala Yousafzai has been awarded the Nobel Peace Prize 2014 for her campaigning work on education and child rights. This makes her the youngest ever winner of the prize. It's a brilliant achievement and fantastic recognition that the world is paying attention to the voices of girls. 

Rosaleen in Kenya was forced to have female genital mutilation by her parents
Rosaleen in Kenya was forced to have female genital mutilation by her parents
Photo: Kate Holt/ActionAid

It's been a huge summer for women and girls taking to the stage to champion their rights. Emma Watson talked at the U.N about the need for gender equality, this summer we saw two high profile conferences on women and girls' rights, and this weekend another UN day – International Day of the Girl Child – throws light on the inequality girls face globally. Why do we need so many of these ‘days’ or moments?

Women and girls face appalling injustices every day. Being forced to marry a man they don't love when they should be in school, having their vaginas mutilated to prepare them for marriage and not having access to education or the opportunities many of them so desperately want.

Celebrities are championing girls' rights

It's great that many celebrities have used their voices in 2014 to bring the subject of violence against women and girls to the forefront of people’s minds. Angelina Jolie, Emma Watson and Frieda Pinto are just some who are opening up the conversation to new and wider audiences.

The power of celebrity is at its best if it causes people to say enough is enough and demand governments, policy makers, leaders and communities work to change the situation for young girls around the world.

It’s vital we don’t shut up. Consider the facts:

  • 1 in 3 women will be raped or assaulted in her lifetime
  • 280 million girls alive today are at risk of child marriage
  • Up to 140 million girls worldwide have been subjected to female genital mutilation.

And so this weekend on International Day of the Girl we have another chance to speak out for the girls who potentially can’t. Take inspiration from the girls here who, with ActionAid’s help, are working to create a different future away from early forced marriage and children.

A life after female genital mutilation in Kenya

Rosaleen,16, from Pokot in Kenya is just one example of the many girls who have been forced to undergo female genital mutilation by her parents. She had to drop out of school because her parents couldn’t afford to pay her school fees and as female genital mutilation is often seen as a precursor for forced marriage this was the likely path for Rosaleen.

Rosaleen

However, Rosaleen sought help from the ActionAid-funded Kongelai Women’s Network and she fought to stay in school to continue her education.

Encouraging girls education in Nigeria

16-year-old Simon Abigail works with an ActionAid funded girls club in Nigeria, where 10 million children are out of school.

Simon - girl's club member

Simon takes what she learns in girls clubs and reaches out to girls in her community to teach them about the importance of going to school rather than staying home and having children at a very early age. 

Escaping early marriage in Uganda

Martha and her friends ran away from the threat of early forced marriage and female genital mutilation and fled to the Kalasi Girls School in Uganda, where over three quarters of the pupils are girls who have run away from home.

Martha chelengat(centre) and her collegues ran away from a forced marriage. They can now smile again after ActionAid fully intergerated them into school.

Around three new girls arrive at the school every single day, where with ActionAid’s help girls like Martha are empowered to speak up for themselves and their fellow girls.

You can make a difference to more girls like Simon, Rosaleen and Martha this International Day of the Girl Child.

More on this story

Photos: Kate Holt/ActionAid, ActionAid.

Containing the Ebola virus: the challenges to aid delivery

Jane Moyo's picture
Jane Moyo Head of Media Relations

It is vital that the international aid response - from governments, major international institutions and aid agencies - recognises the urgency and gravity of the Ebola epidemic. Getting this right is a matter of life and death for hundreds of thousands of people across Sierra Leone, Liberia and Guinea.

ActionAid staff loading up rice and bleach for Ebola-hit rural communities in Liberia.
ActionAid staff loading up rice and bleach for Ebola-hit rural communities in Liberia.
Photo: ActionAid

Ebola is a global emergency and as the President of the World Bank says, every developed country should send trained medical staff to West Africa in addition to giving wider assistance.

That's why it is good to see the three major donors to West Africa dividing their aid mainly along country lines, the UK to Sierra Leone, the US to Liberia and France to Guinea.

Such coordination is necessary as is news that army medics are making their way to West Africa from all three countries. Their job will be to set up field hospitals and support beleaguered health services.

But more is needed to defeat the epidemic. ActionAid is advocating an urgent holistic approach.

Recognise Ebola symptoms, control the Ebola outbreak

In the short term, international aid must support three broad areas:

  • Running prevention campaigns because without that, the epidemic will not be stopped – people need to recognise the symptoms of Ebola and know how to respond.
  • Medical intervention to care for the sick and dying and to control the contagion – and that includes help with high quality screening and contact tracing as well as treatment.
  • Providing affected families with food aid and other relief items because of the appalling social and economic impact of the disease.

Yet ultimately, the world will also need to help cash strapped nations rebuild their economies as the epidemic is already reversing years of economic gains.

Ebola is driven by the motor of poverty

People across Liberia and Sierra Leone are losing friends and family, and as one person told us, life has gone back to how it was during the war. 

Driven by the motor of poverty, Ebola has brutally exposed the deficiencies of West Africa’s health and governmental systems.

A disease that was first identified five months ago, has since spiralled out of control and now threatens the lives of over a million people shames the world.

Currently every person who gets Ebola is infecting up to another two people and the US Centres for Disease Control estimates that 1.4 million people could be infected by January if urgent action isn’t taken.

While resources are needed now to tackle the crisis, that in itself is not enough.

After the crisis is over, there will be a need to support rebuilding of economies and to build – not rebuild – health services that can both protect the right to life and provide decent health care for all.

How ActionAid is tackling the Ebola virus

So grave is the situation that our offices across the region are on emergency alert  as we continue to ramp up our response.

From the very first we’ve educated people about how to stop the virus spreading, helping to keep them safe. This remains a vital strand of our work and the epidemic will not be stopped without it.

But we're doing more. We have been giving food aid to families quarantined for more than three weeks, vital equipment to local health workers including rubber gloves, protective overalls and bleach, and education materials to children – schools have now been closed for months and are not set to open any time soon.

In Liberia we’re also giving discharged Ebola patients, survivor kits – a change of clothes, soap and toothpaste – as these are people who lost everything when their belongings were incinerated as a preventative measure.

Defeating Ebola demands urgency, rigour and imagination if the world is to overcome this deadly epidemic.

Transparency – what are the benefits?

Judith Davey's picture
Judith Davey Director of People, Performance and Accountability

What exactly is transparency? I’ve been thinking about this a lot lately – what it means, why it matters and crucially, how it can make a difference to the people ActionAid works with around the world.

Hafeza Khatun and other women at a circle at Fathapur, Shahrasti, Chandpur, Bangladesh
Hafeza leads a Reflect Circle to help women discuss and learn from each other in Chandpur, Bangladesh
Photo: G.M.B. Akash/Panos/ActionAid

We asked 16 organisations to tell us what transparency means to them. What they told us is fascinating - and it's all here in our transparency report.

Here's the Cambridge Dictionaries definition: “Transparency: a situation in which business and financial activities are done in an open way without secrets, so that people can trust that they are fair and honest.” I found this a useful starting point for ActionAid's approach.

Transparency can be empowering

At ActionAid we know that transparency can be transformational. Access to accurate, timely and relevant information can make a world of difference to the lives of the poor and marginalised people that we work with in communities around the world.

Knowledge is power, and transparency is a stepping stone to increased empowerment. ActionAid is known for our participatory methods which include involving beneficiaries (or rights holders, to use our terminology) in decisions that affect them in a meaningful way. Transparency Boards in communities describe the work we are doing, who the donor is and how much the project costs.

What does transparency mean for our supporters?

We communicate clearly what we do to our supporters. Where possible, we ask people what information they want from us about our impact and effectiveness. Then we aim to deliver it succinctly, in the right form, and in the most cost-effective way.

Connecting supporters with people living in poverty overseas

Being transparent supports ActionAid’s mission and connects supporters with people living in poverty overseas. So for example, we linked up our UK supporters with women in Bangladesh who were survivors of acid attacks – a particularly brutal form of violence against women and girls. Through social media they were able to exchange messages and our supporters expressed solidarity and support.

Both UK supporters and the women in Bangladesh were hugely affected by the experience – they found it emotional, engaging and uplifting. I doubt there could be a better way of getting across the impact of our work.

Being open about how we spend our money is important

Openness about our financial affairs and how we spend our money is important and we always make financial information available on our website and when we talk to supporters.

We publish financial data to the International Aid Transparency Initiative (IATI), a small but important aspect of our approach to transparency. But complying with standards like these can involve a lot of time and resource. Full compliance presents us with some challenges, particularly given the current lack of evidence about the usage and effectiveness of such initiatives.

How the UK public and beneficiaries regard the IATI data is not yet clear. At ActionAid we believe it’s important to focus on ways of being transparent that are proportionate and meaningful.

Join the debate to help us improve

No organisation is perfect, and ActionAid is on a journey to improve our policies and practices. This report is part of that journey and it explores some thought-provoking perspectives, from Amnesty International to the Department for International Development, the BBC to John Lewis Partnership. We might not agree with all of them, but they’re all worth reading and we’d love to know what you think too.

Photo: G.M.B. Akash/Panos/ActionAid.