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Dr Graham Easton reports on the Ebola Epidemic for the BBC World Service

Senior GP Teaching Fellow Dr Graham Easton from the Department of Public Health and Primary Care recently visited Ghana on behalf of the BBC World Service to host a radio debate on whether failed health systems in Africa make global epidemics - such as the recent Ebola outbreak - inevitable.

The debate explored why the Ebola outbreak was able to spread so widely, and looked at broader lessons about containing local epidemics in today’s globalised world. The expert panel included the Liberian ambassador to the UK [formerly to Ghana], the World Health Organisation’s representative in Ghana, the Operations Director of Medicins Sans Frontieres, and the Communications Minister for Ghana, as well as about a hundred other invited guests from Ghana and the worst-affected countries. As well as co-hosting the debate with BBC Africa presenter Akwasi Sarpong,

Graham was interviewed about Ebola on local radio stations, BBC partner stations across Africa, and contributed to a live special edition of Focus on Africa from the University of Ghana Medical School in Accra. Graham gave a presentation about his trip to the department on 15th October, covering both the medical and media perspectives from his experience. He highlighted how the scale of the epidemic seemed to have caught everyone by surprise.

While fragile health systems certainly played a part, particularly after years of conflict in the worst-hit countries, a delayed response, lack of first-hand experience of Ebola in West Africa, several countries affected at once and spread to urban areas had made matters worse. There was much debate about the value of “lockdowns” and enforced quarantines – despite official reservations from the WHO, Sierra Leone and Liberia both felt they had played an important role in surveying the outbreak and stemming its spread. There was frustration and anger over a lack of basic equipment and resources, from Personal Protective Equipment to running water, soap and disinfectant. Isolation beds and trained personnel are still woefully lacking.

There was also a strong message from those on the frontline that appropriate, culturally sensitive communication was crucial to building trust and persuading people to seek medical help. Although vaccines and experimental medicines were mentioned, it was clear that these were not yet realistic solutions; the focus has to be on getting the public health basics right. The impression was that the international response had been too little too late, and the projections for the epidemic were gloomy unless the response was scaled up significantly and rapidly.

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