Kofi Annan is right to criticise the slow reaction by the west to the Ebola crisis (Follow Britain’s example on Ebola, David Cameron tells world leaders, 17 October 2014). However, I do not agree that “if the crisis had hit some other region it probably would have been handled very differently. In fact, when you look at the evolution of the crisis, the international community really woke up when the disease got to America and Europe.” Mr Annan knows very well that there would be no need for the west to help Africa fight Ebola today if most of the £550bn given to the continent as development aid since independence, had not been diverted to fund local leaders’ luxury lifestyles.
Yet the insinuation of racism is too often used to morally blackmail western governments into taking, or not taking an action in Africa. For example, last year, the African Union passed a resolution that claimed the west was using the international criminal court (ICC) to witch-hunt African leaders.
Sam Akaki
Director, Democratic Institutions for Poverty Reduction in Africa (Dipra)
• Sierra Leone has been a recipient of development aid for many years. The UK and US, the biggest donors, both stress that they prioritise health. Net bilateral aid from the UK in 2012 was £62m. However, reports on the effectiveness of aid from the OECD in 2010 and the UN University in 2013 make no reference to health. The capacity and resilience of the health system in the face of Ebola strongly suggests far too little progress has been made. Unless radical improvements are made to primary healthcare and basic services such as sanitation and clean water, Sierra Leone and a multitude of low and middle income countries will remain vulnerable to chronic ill health and premature mortality and epidemics. We are surely entitled to ask whether the emphasis on trade and economic development in aid is at the expense of the majority of the populations in many states.
Neil Blackshaw
Little Easton, Essex
• We welcome the deployment of medical staff, public health specialists and even the military who are arriving to support their efforts (Report, 16 October). But we must also remember the thousands of local people who have been working flat out on this disease since the first outbreaks. They are doctors and nurses, community health workers, cleaners and those who bury the dead safely. And there are also ordinary people who have volunteered to go into villages and teach people how to protect themselves from the disease and also try to quell the panic and fear that people are understandably feeling.
ActionAid staff and volunteers have been doing this job here in Liberia and in Sierra Leone, as well as going into quarantined areas to provide emergency food rations to those who are not allowed to harvest their crops or go to market to buy food. So, yes we need funds for medical treatment, but let’s not forget, to cut this outbreak off at the source requires a holistic approach involving medical intervention, prevention campaigns and practical aid for those affected, which is centred around community mobilisation.
Ms Korto Williams
Country Director, ActionAid Liberia
• US secretary of state John Kerry speaks of the Ebola “scourge” as comparable with HIV (Report, 18 October). I was a clinical nurse specialist working with people with HIV/Aids three decades ago when HIV was first identified. At the time there was ignorance and fear about “a disease of dark origin” coming out of Africa and seen as a threat to the west. Now we face a similar situation with Ebola; it is forgotten that Sierra Leone has the world’s highest mortality rate for malaria, in excess of Ebola figures. Malaria kills 130/100,000 of its population. How much does the west express concern and demand action? Oh, I forgot: malaria has zero rates in these countries.
Denis Cobell
London
• What are your human rights during quarantine? It is clear that the right to free movement and enjoying family life is restricted for public safety needs. People will be locked away to ensure our wellbeing. We do have a responsibility for their care. Do we have enough secure rooms or will we use prisons? How can we guarantee everybody is treated with respect? Who is responsible for people’s wellbeing during the two months lasting quarantine? Rents? There will be a need for psychological support.
I once was wrongly quarantined for swine flu and something as ordinary as pneumonia was missed in the hysteria, and nearly treated too late. This time, some people with temperatures coming from Africa might be misdiagnosed too. We need compassion for the infected, the NHS staff but also the innocently quarantined. We should not let hysteria dictate our treatment of potential infected people but focus on public health measures that are properly thought through.
Julia Thrul
London
• While the Hong Kong government has been in the news for all the wrong reasons recently (Letters, passim), preventative health measures initiated there during the Sars crisis of 2003 when Dr Margaret Chan, the current head of the WHO, was director of health, included the obligation for lift buttons, door handles etc in public buildings to be disinfected many times a day. These measures are still in force, as is the obligation for all passengers arriving at the international airport to walk through thermal imaging fever-scanners. Border control points between Hong Kong and mainland China also implement disease prevention and control measures. These are not fail-safe measures by any means, but at times of crisis like the current Ebola outbreak, such actions most certainly help educate the public about how diseases can spread, and how individuals can monitor their habits to help prevent further rapid spreading.
Paul Tattam
Teignmouth, Devon
• After the screening confusion at Heathrow (Report, 14 October), perhaps the UK could seek advice from Nicaragua. I passed through Managua airport on Monday en route from Houston, stood in line with everyone else to have my temperature checked, and today received a precautionary follow-up visit from a doctor. Nicaragua’s national health budget, by the way, is less than a typical NHS trust.
John Perry
Masaya, Nicaragua
• I see travellers are being checked for symptoms of Ebola at departure points in affected countries. A further precaution would be to advise the public against unnecessary international travel for the time being. This would buy time for doctors to contain the virus at source.
Susan Roberts
Sterrebeek, Belgium
• Is fear of Ebola on aeroplanes the spur to video-conferencing that businesses have been long waiting for?
Godfrey H. Holmes
Withernsea, East Riding
• For any infective disease, the basic reproduction rate is the number of new cases produced by a single case in a susceptible (ie unvaccinated) population (Simon Jenkins, 17 October). If the figure is less than 1, the infection will die out. If greater than 1, an epidemic can result. With Ebola the rate is just above 1.5, which means that every two cases produce three more. That is the basis for the WHO prediction that new cases in West Africa will double every month. Without an effective vaccine, the disease will become progressively more difficult to control as the number of cases increase, and unless quarantine measures are introduced, spread to the rest of the world seems inevitable.
Dr Robin Russell-Jones
Stoke Poges, Buckinghamshire
• Simon Jenkins is right to inveigh against the habit of politicians keeping the populace in a state of fear. The tragedy is that this epidemic could have been nipped in the bud months ago if governments had paid heed to organisations such as Medecins sans Frontières whose newsletters portrayed the horror of the situation in unemotional terms. The cutting of the WHO budget and aid to the health systems of West Africa by the World Bank and others is now revealed as the grossest false economy, for which we will all pay dearly in terms of both human misery and money.
Dr John Hurdley
Birmingham