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Ellen begs Obama

President Ellen Johnson-Sirleaf has asked that the US government to set up and operates at least one Ebola Treatment Unit (ETU) in Monrovia, conceding that the wave of outbreak across the country has overwhelmed containment and treatment measures attempted thus far by the Government of Liberia.

In an 11-paragraph letter to President Barrack Obama over the weekend, President Sirleaf indicated that at the current rate of infections in Liberia, only governments like the United States and other Western countries have the resources and assets to deploy at the pace required to arrest the spread.

“Branches of your military and civilian institutions already have the expertise in dealing with biohazards, infectious diseases and chemical agents.

They already understand appropriate infection control protocols and we saw these assets were deployed in Aceh after the tsunami and in Haiti after the earthquake.

It is in appreciation of the difference in kind of disaster, that we requesting assistance from units with expertise in managing biohazards.”

The Liberian leader further requests that the US government assists in restoring regular basic and secondary health services to at least 10 non-Ebola hospitals in the country.

President Sirleaf: We have been told by healthcare workers on the frontline that only 80% of patients presenting symptoms at ETUs are infected with the virus. The other 20% need to be treated at non-Ebola health facilities.

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However, we need appropriate infection control protocols and testing facilities to protect health care workers and non-Ebola patients in these facilities. Currently, in Monrovia there are 8 hospitals, ranging from 50 to 418 beds. Across the rest of the country we need to reopen at least one large public health facility to prevent deaths from treatable diseases and prevent maternal and infant mortality.

She said with flights to Liberia down to two from a pre-Ebola total of 11, movement of personnel with expertise and equipment into the country is becoming increasingly difficult, stressing that until private air service returns, the government will require assistance with air bridges to respond to the crisis.

“It is important to note, Mr. President, that since the beginning of the outbreak, MSF now has over 400 beds of Ebola patients in the region and not a single staff – medical or support- has ever gotten infected in those centers. MSF has made their protocols and template available to the CDC, Save the Children, International Rescue Committee and International Medical Corps. But none of these private charities will be able to deploy on the scale and at the speed required to arrest the spread of the Ebola virus diseases (EVD)”, President Sirleaf further writes.

Recounting the devastating impact the virus has have on the entire country, President Sirleaf said already, the government’s limited resources have been stretched to breaking point and up to now only a private charity, Medecins Sans Frontiers (MSF), has responded robustly in all the affected countries in West Africa, but noted that they too have reached their limits therefore, pleading that, “Without more direct help from your government, we will lose this battle against Ebola”, while reporting that a WHO investigation conducted with other partners and the Ministry of Health and Social Welfare here projects thousands of new cases in the next three weeks.

President Sirleaf said the virus is spreading across Liberia at an exponential rate and her government is left with a limited time window to arrest it.

“Mr. President, well over 40% of total cases occurred in the last 18 days. Our message has gotten out and our citizens are self-reporting or bringing in their relatives. But our treatment centers are overwhelmed. MSF is now running a 160 bed-unit that will expand even further. This is the largest ever Ebola Treatment Unit in the history of the disease and even that is inadequate.

To break the chain of transmission, we need to isolate the sick from their families and communities, but this is impossible because there is nowhere to take them. We are been forced to turn back the sick. We are sending them home where they are a risk to their families and the communities. I am being honest with you when I say that at this rate, we will never break the transmission chain and the virus will overwhelm us”, the Liberian leader desperately pleaded.

She said what is even more heartbreaking is that the government is unable to reopen basic and secondary health  facilities because terrified  health workers,   who have watched colleagues die, are afraid to return to work, detailing that to date, about 153 health workers have become infected and 79 of them have died.

“There is now a recurrence of children dying of malaria because mothers could not find a health facility that would admit them. Diseases that were treated with relative ease pre-Ebola now take lives because of the pall that Ebola has cast over our health system. We need to provide up to 1500 beds in Ebola Treatment Units in Monrovia. We also need to create 10 additional sites in the outlying affected counties.

This is beyond anything we are able to address on our own. Unless we significantly increase our capacity to isolate infected persons – their families and communities remain vulnerable and the transmission chain remains unbroken.  With our own resources, we can only support and manage one (1) one-hundred bed treatment facility. Medecins Sans Frontiers will scale up to 400 beds, leaving a very significant gap.”

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