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TEDx Talks
Published: 2014-12-30
Source: https://www.youtube.com/watch?v=ZChEFOGSn8Q
when I was asked to invite your brother to give this talk a couple of months ago we discussed a number of titles with the organizers and a lot of different titles for kicked around were discussed but nobody suggested this one that you see here today and the reason for that was two months ago Ebola was escalating exponentially and spreading over wider geographic areas than we had
ever seen and the world was terrified concerned and alarmed by this disease it way we've not seen in recent history but today I can stand here and I can talk to you about beating a bowler because of people whom you've never heard of people like Peter claimants a Liberian doctor who's working in low for county a place that many of you have never heard of probably
in Liberia the reason that low for county is so important because about five months ago when it was ed the epidemic was just starting to escalate no for county was right at the center of the epicenter of this epidemic at that time MSF into treatment center there and they were seeing dozens of patients every single day and these patients these communities were becoming more and more
terrified as time went by with this disease and what it was doing to their families to their communities to their children to their relatives and so Peter Clemens was charged with driving that twelve hour long rough road from Monrovia the capital up to Norfolk County try and help bring control to the escalating epidemic there and what Peter found when he arrived was a terror though I
just mentioned to you so he sat down with the local chiefs and he listened and what he heard was heart breaking he heard about the devastation and the desperation people affected by this disease he heard the heartbreaking stories about not just the damage that a bullet did to people but what did to families and what it did to communities and he listened to the chiefs the
local chief there and what they told him they said when our children are sick when our children are dying we can't hold them at a time when we want to be close to them when our relatives die we can't take care of them as our tradition demands were not allowed to wash the bodies to bury them the way our communities and our rituals demand and for
this reason they were deeply disturbed deeply alarmed and the entire epidemic was unraveling in front of them people were turning on the healthcare workers who aid com the heroes he come to try and help save and the community to help work with the community and they were unable to access them and what happened then was Peter explained to the leaders the leaders listen to turn the
tables and Peter explained what a boulder was he explained what the disease was he explained what it did to their communities and he explained that the bowler threatened everything that made us human a building means you can't hold your children the way you would in this situation you can't bury your dad the way that you would you have to trust these people in the space suits
to do that for you and ladies and gentlemen happened then was rather extraordinary the community health workers Peter they sat down together and they put together a new plan for controlling a bona in that local county and the reason that this is such an important story ladies and gentlemen is because today this county which is right at the center of this epidemic you've been watching you've
been seeing on the newspapers you've been %HESITATION you've been seeing on the television screens today no for accounting is nearly eight weeks without seeing a single case of a bowline now this doesn't mean this doesn't mean that the job is done obviously the still a huge risk that there be additional cases there but what it does teach us is that Ebola can be be that's the
key thing even on the scale even with the rapid kind of growth that we saw in this environment here we now know Ebola can be beat when communities come together with health care workers work together that's when this disease can be stopped but how did a bold and up in Norfolk County in the first place well for that we have to go back twelve months to
the start of this epidemic it is many of you know this virus went undetected you faded %HESITATION detection for three or four months when it began that's because this is not a disease of West Africa to disease of central Africa half a continent away people hadn't seen the disease before health workers hadn't seen ZZ before they didn't know what they were dealing with and make it
even more complicated the virus itself was causing a symptom is a type of that presentation that wasn't classical of the disease so people didn't even recognize the disease people who knew Ebola for that reason it evaded a detection for some time but contrary to public belief sometimes these days once the virus was detected there was a rapid surgeon of support imagechef rapidly set up a %HESITATION
in a bowl treatment center as many of you know in the area the World Health Organization and the partners that it works with deplored and eventually hundreds of people over the next two months to be able to help track the virus a problem ladies and gentlemen is by then this virus well known now as a bowler had spread too far it had already outstripped what was
one of the largest responses that had been mounted so far too in a bowler outbreak by the middle of the year not just a Guinea but now Sierra Leone and Liberia were also infected and the virus was spreading geographically the numbers were increasing and at this time not only were hundreds of people infected and dying of the disease but as importantly the frontline responders to people
who had gone to try and help the people of the year the health care workers the other responders were also sick and dying by the dozens the presence of these countries recognize emergencies a match right around that time they've agreed on common action in the put together an emergency joint operation center and concrete to try and at work together to finish this disease and get it
stopped to implement the strategies we talked about but what happened then was something we had never seen before with the Boland what happened then was the virus or some sick with the virus boarded an airplane flew to another country and for the first time we saw in another distant country the virus pop up again and this time it was in Nigeria in the teeming metropolis of
legos twenty one million people now the virus was in that environment and as you can anticipate there was international alarm international concern on the scale that we hadn't seen in recent years because by a disease like this the World Health Organization I mediate we called together an expert panel looked at the situation declared an international emergency and in doing so the expectation would be that there
be a huge outpouring of international assistance to help these countries which were in so much trouble and concern at that time but what we saw was something very different there was some great response a number of countries came to assist many many NGOs and others as you now but at the same time the opposite happened in many places alarm grew alarm escalated and very soon these
countries found themselves not receiving the support they needed but increasingly isolated what we saw with commercial airlines started flying into these countries and people who hadn't even been exposed to the virus were no longer allowed to travel this because not only problems obviously for the countries themselves but also for the response those organizations that were trying to bring people in to try and help and respond
to the outbreak they could not get people on airplanes he couldn't get it into the countries to be able to respond and that situation ladies and gentleman a virus like Ebola takes advantage and what we saw then was something also we hadn't seen before not only did this virus continue in the places where there's already become infected but then it started to escalate and we saw
the case numbers that you see here something we've never seen before on such a scale an exponential increase of a bowl of cases not just in these countries %HESITATION or the areas already infected in these countries but also spreading further and deeper into these countries ladies and gentleman this was one of the most concerning international %HESITATION emergencies and public health we've ever seen and what happened
in these countries and many of you saw again on the televisions read about in the newspapers we saw the health system start to collapse under the weight of this epidemic we saw the schools begin to close markets no longer started that no longer functions away that they should in these countries we saw the miss the misinformation the misperceptions started to spread even faster through the communities
which became even more alarmed about the situation they started to recoil from those people that you saw on the space suits as they call them who had come to help them and then the situation deteriorated even further the countries had to declare a state of emergency large populations needed to be quarantined in some areas and then riots broke out it was a very very terrifying situation
and the world many people began to ask can we ever stop a bolo when it starts to spread like there's they started to ask how well do we really know this virus the reality is we don't know about it extremely well it's a relatively modern disease in terms of what we know about it we've known to disease only for forty years since I first popped up
in central Africa in nineteen seventy six but despite that we do know many things we know that this virus probably survives in the type of data we know that it probably enters a human that population when we come in contact with a wild animal that has been infected with the virus probably sickened by it and then we know that the virus spreads from person to person
through contaminated body fluids and as you've all seen we know the horrific disease at it then causes in humans where we see this disease caused severe fevers diarrhea vomiting and then unfortunately and seventy percent of the cases are profit more deaths this is a very dangerous debilitating and deadly disease but despite the fact that we've not known this disease for a particularly long time that we
don't know everything about it we do know how to stop this disease this for things that are critical to stopping the bowler first and foremost the communities have got to understand this disease they've got to understand how it spreads and how to stop it and then we've got to be able to have systems that can find every single case every contacted those cases and begin to
track the transmission chain so that you can stop transmission we have to have treatment centers specialized Botha treatment centers where the workers can be protected as they try to provide support to these that to the people who are infected so that they might survive the disease and then for those who do die we have to ensure there is a safe but at the same time dignified
burial process so that there is no spread at that time as well so we do know how to stop a bowler and the strategies work ladies and gentlemen the virus was stopped in Nigeria by these four strategies and the people who limiting them obviously it was stopped in Senegal where it had spread and also in the other countries that were affected by this virus in this
outbreak so there's no question that these strategies actually work the big question ladies and gentleman was whether the strategies could work on this scale in this situation with so many countries affected with the kind of exponential growth that you saw that was a big question that we were facing just two or three months ago today we know the answer to that question and we know that
answer because of the extraordinary work of incredible group of NGOs of governments of local leaders of UN agencies and many humanitarian and other organizations that came and joined the fight trying to stop a boulder in West Africa but what had to be done there was slightly different these countries took those strategies IG showed you the communities of the and gate community engagement the Yankees final contact
tracing etcetera and they turn them on their head through so much disease they approach to differently what they decided to do was they would first try and slow down this epidemic by these rapidly building as many beds as possible so that they in specialized treatment centers so that they could control that they could prevent the disease from spreading from those who are infected they would rapidly
build out many many burial team so that they could safely deal with that with that they were trying to slow this outbreak to see if we could actually then be controlled using the classic approach of case finding in contact tracing and when I went to West Africa and about three months ago when I was there what I saw was extraordinary I saw presidents opening emergency operation
centers themselves against Ebola so that they could personally coordinate and oversee and champion the surge of international support to try and stop this disease we saw militaries from within those countries and from far beyond coming in to help the deal the boulder treatment centers that could you be used to isolate those who were sick we saw the red cross movement working with its partner agencies on
the ground there to help train the community so that they could actually safely buried their dead in a dignified manner themselves and we saw the UN agencies the world food program build a tremendous air bridge that could get responders to every single corner of these countries rapidly to be able to implement the strategies that we just talked about what we saw ladies and gentleman which is
probably most impressive was this incredible work by the governments by the leaders in these countries with the communities to try and shore people understood this disease understood the extraordinary things they would have to do to try and stop a bowler and as a result ladies and gentlemen we saw something that we did not know only two or three months earlier whether or not it would be
possible what we saw was what you see now in this graph when we took stock on the first of December what we saw was we could ban that curve so to speak change this exponential growth and bring some hope of back to the ability to troll this outbreak and for this reason ladies gentlemen there's absolutely no question now that we can catch up with these outbreak
in West Africa and we can beat a bowl that the big question though is that many people are asking even when they saw this curve they said well hang on it that's great you can slow it down but can you actually drive it down to zero no we already answered that question it right back at the beginning of this talk when I spoke about %HESITATION loath
accounting in that in the %HESITATION in Liberia we told you the story how both account do you got to a situation where they have not seen a bowl of for eight weeks but the similar stories from the other countries as well from get hit you in the beginning the first area where the first case was actually had diagnosed we seem very very few cases in the
last couple of %HESITATION in the last couple of months and here in Canada in Sierra Leone another area in the at the center we have not seen the virus for more than a couple of weeks way too early to declare victory obviously but evidence ladies and gentleman not only can the response catch up to the disease but this disease can be driven to zero the challenge