I am beginning to sense that this Ebola outbreak (the first significant one since 1976) will be a game changer. It is already clear to see that epidemiologically it is becoming both complex and concerning. The fact that we are where we are today (prediction of 10,000 new cases a week by Christmas as reported by WHO) needs some reflection. The argument will always be – let’s not look for who to blame now, let’s get on and solve this problem – is a compelling one. The problem is though, somebody has to start looking for causation because in cause may well be the solution.
Before we drill into the nitty gritty we need to ask a fundamental question. Why has the concern about this outbreak only surfaced in any scale recently? The first recorded death from this outbreak happened in December 2013! I can only speak for Australia, but I suspect it holds good elsewhere and that is our focus has moved from a more general interest in current affairs, including what is going on in the wider world, to more self-interest. On a recent trip to Paris I visited the Louvre. It was an evening visit but nevertheless still quite busy. In the room displaying the Mona Lisa I noticed that the front three rows of people all jostling to catch a glimpse of Leonardo da Vinci’s masterpiece appeared to have their backs to it rather than looking at it as one normally would i.e. front on. I quickly realised that was because people were taking ‘selfies’. A very recent and striking example of self-obsession.
Our failure or lack of willingness to keep aware of what’s going on in the world meant that we haven’t been able to push our governments into precipitate action. It would seem that both the media and policy makers have issues with multi-tasking. With the reporting of issues in the Middle East and Ukraine the Ebola issue often failed to pop its head high enough to get noticed. Here’s the thing though. Avoidance, denial or inaction don’t make the issue go away, they just make its potential for disaster greater. It is beholden on us as world citizens to become more aware of what’s happening in a world that is now much closer to us through the advances in telecommunications and the web. We truly are world citizens so we need to treat the world as our community.
Admittedly there has been a lot going on. YOU CAN SKIP THIS PARAGRAPH IF YOU WATCH BBC, SBS OR PBS. Anarchy in Libya, political change in Cuba, western spying under the microscope (Snowden and Assange), tensions in the Middle East between Israel and the Palestinians, Syria, Iraq, the rise of ISIS, civil war in South Sudan, trouble in Kenya with al Shabab and the missing girls and Islamic radicalism in Nigeria with Boko Haram, student uprising in Hong Kong, simmering tensions in Thailand between red and yellow shirts and a military dictatorship now in place, el-Sisi leading Egypt in what is effectively a military junta, the jailing of innocent Al Jazeera journalists, fluctuating tensions between North and South Korea, Russia’s annexing of the Crimea and hostility on the border with Ukraine, tensions between the Turks and the PKK, increasing tension in the South China Sea over the disputed islands controlled by Japan, piracy off the coast of Africa, murderous drug cartels in Mexico, an ever more aggressive and nationalist Japan, racial tensions in some US States, anti-European sentiment in the UK and the rise of nationalist parties in Europe opposed to the European Union, disenchantment in the Wallabies camp…. Have I missed anything out? You bet – but you get the picture.
Had we as citizens spotted Ebola earlier for what it is, we could have put pressure on our Governments to do something about it. Even now as the West slowly builds momentum to do something about it, the response appears both glacial and clunky. We tooled up to go back into Iraq much quicker. There is a great danger that Ebola will get away from us. There are already deaths from patients who have not had direct contact in the three most affected countries Liberia, Guinea and Sierra Leone. One of the most confronting aspects of the statistics is that we appear now to be worried only because WE might be affected. When it was killing hapless Africans in some of the world’s poorest nations we didn’t appear too concerned. The inevitable conclusion drawn by some will be that there is an unwritten soulless economic rationalist policy that suggests that 1 Western life is worth 100 African lives (or whatever multiplier takes your fancy). The very same argument, by the way, that Palestinians level against the West in relation to casualties in Gazza. On the face of it it’s hard to argue against this line of reasoning.
Because we are starting late we have a lot of catching up to do. How long before the outbreak is such that it overwhelms the local and imported medical teams to handle the ever increasing numbers of patients? Not too long we are told. The traditional response by clinicans and public health experts may be too slow to cope. It is time we took a radical and creative approach. Teams addressing this problem need to be multi-disciplinary by nature. We need heads of transport companies, IT gurus, app writes, project managers, logisticians, army planners, simulation experts, mining engineers etc. as well as the epidemiologists, infectious diseases experts and public health physicians. I think we also need real innovation and creativity so I would go so far as to put artists and ethicists into these teams, even philosophers.
Why you may ask would such a random collection of people be required? Well the current approach of narrowly focussed clinicians hasn’t worked thus far. The infamous ‘breach of protocol’ in Texas which has resulted in a home-grown Ebola case in the US cannot be explained in terms of which protocol was broken. The Chief Medical Officer of Queensland Health presided over the nonsensical isolation of an suspected Ebola patient in Cairns in an ER – one of the busiest and least able to cope parts of a hospital. Rather than call for advice and get some fresh thinking on the matter, the energy appears to have been put into silencing the Doctors who brought the situation to the public’s attention. This is not the way to do things.
It’s no time for search for the guilty and glory for the uninvolved. In such times of real crisis we need expert management to take control, drawing together a vast array of skills, talent, ideas and data and synthesise these into a rapidly produced but thorough plan that can be easily communicated and effectively implemented. Not perhaps qualities that traditionally educated medical staff have in abundance. It is time for our managerial elite to step up and become less self-absorbed. Time for some of us to look at the Mona Lisa front on.