The Ebola isolation unit is dismantled at the Connaught hospital, Freetown. Photograph: Jo Dunlop/King’s Health Partnership
A Ugandan epidemiologist arrived to lead the response for WHO and drew up a plan, costing $286,000, which included 16 cars for a surveillance team. He reckoned this would be enough to kill the outbreak.
He got $86,000 and one car. “It was not nearly enough,” Walsh said.
She had been sitting in the WHO offices at the beginning of the outbreak in June 2014 pleading with the organisation to tell her how Irish Aid and other donors could help. Had she known she could have “quickly have produced far more”, she believes she could have helped stop Ebola in its tracks.
Perhaps the biggest mismatch was Kerry Town, an ambitious British hospital designed and conceived in London, which took months to open. When it did it was so constrained by its own protocols that it treated relatively few patients. In all, it is estimated to have cost DfID around £80m.
As one local doctor told the authors: “They wanted to get everything perfect before they started receiving patients,” while other clinics were having to turn away patients, who were likely to go on to die as well as infect others.
Walsh, however, is clear in the book that the UK ultimately played a critical role. “No matter what criticisms I and others had of some of the ways the UK operated during the response, there was absolutely no doubt in my mind that they had turned the response around and invested enormous resources which had been central to getting to zero.”
There are many heroes in the book – not least the 221 local health workers who died – and Foday Sahr, now the surgeon general of the Sierra Leonean army, who ran one of the military’s Ebola units. But of organisations, it is the Sierra Leonean army that Johnson and Walsh single out for praise. “A week after the government-run Hastings Ebola treatment unit had opened, they had 120 beds compared with the four they had managed in Kerry Town,” wrote Johnson.
If there was one overall message the authors said they wanted to impart, it is is that international agencies must “work with communities – not do something to them”.
The book, published on Monday, is a compelling full of compassion, grief, ingenuity and stories of courage and unstinting commitment of local nurses, cleaners and others who remain unsung heroes of Ebola. But it is also full of tales of denial, extraordinary lapses in leadership and awkward truths that will make uncomfortable reading for many, locally and internationally.
- Getting to Zero is published by Zed Books. All proceeds are going to Sierra Leonean charities for health workers and St Joseph’s School for the Hearing Impaired, Makeni