quarta-feira, 17 de dezembro de 2014

Médecins sans Frontières: Ebola, Syria and imposed on terrorists

They risk their lives to go to places where reigns the despair, either to fight Ebola, is to help in a time of war-Syria, Iraq, Nigeria, Central African Republic, Ukraine, are some examples. Doctors without borders working in the front line. To address the most pressing situations nowadays, Isabelle Kumar spoke with the President of the Organization, Joanne Liu.

Joanne Liu: I believe that ' satisfactory ' is a word too generous. What I would stress is that people have heard our message and they have taken some measures. What is needed now is a flexible response and moldable, because many of the resources that were mobilized to meet the needs of yesterday, not today. Things have changed, we have to adapt. He doesn't have to build those big centers of 100 or 200 beds to isolate patients. But small centres are needed in rural areas. That's the challenge.

IK: you were on the ground. What was it like to see the reality of the Ebola virus that closely?

JL: are images that I will never forget. On the last visit that I performed, I went through a ward where there were 7 patients â€" three of them were at an advanced stage, had lost consciousness, bleeding from the mouth, had blood in my stool. We were very concerned about his situation. The most distressing, the harder it was to see them delivered themselves, no family around, we only special facts take care of them. I always say that no human being should die alone.

IK: how many more people may die until the situation changes? There are more than 6,000 fatalities, thousands are infected. How far are we going to get?

JL: it is very difficult to make an estimate. There were many who tried to make predictions: in the most serious scenario in 2015 would have 1 million and 400 thousand cases. I don't think that's going to achieve that ratio. But the essential message that we must pass is that, although the number of cases have slowed down in some areas, we cannot claim victory. We may have won small battles, but we didn't win the war against the Ebola virus.

IK: they're testing new treatments in their clinics. How's it going? When can we see the results?

JL: If all goes well, this month we're starting two tests with antiviral medications in patients infected in two of our centres in West Africa. This will last a few weeks. In principle, in the first quarter of 2015 we will have the first results.

IK: as regards vaccines â€" there are also tests taking place in the United States-, considers that are the best resource to combat illness or technically there are other containment solutions on the ground?

JL: in the future, what can stop the chain of transmission of the Ebola virus to large scale is a vaccine. And we hope that it becomes a resource as soon as possible.

IK: as early as possible can be when?

JL: we hope to have a vaccine available in 2015 for the most urgent cases in West Africa.

IK: we asked our online community to participate in this interview, sending us questions via social networks. One of them reads as follows: "are receiving the necessary support (already answered in this part) and what is the country that gives aid in combating Ebola?"

JL: The United States have been very involved in Liberia and have supported some centers. If we compare with the promises made in September by President Obama, things are still falling short. But there is a mobilization and commitment. We are asking for flexibility to all those who have received American financing, because they are no longer required 17 centres with a capacity of 100 beds. What is needed are, maybe, 25 smaller centres in rural areas. We have to adapt the resources tailored to the needs.

IK: what will be the impact of this virus in the long term? There are schools that are closed, there are serious economic repercussions and. ..

JL: it will take years to overcome this situation. There are losses in terms of lives, there are losses in terms of infrastructure. In fact, it is very difficult to ascertain the extent of the impact. We are beginning to see positive results on the ground, but it is essential to focus not only on the energy answers for tomorrow, without bridging the glaring needs of this.

IK: This was one of the biggest emergencies in which they were involved, but doctors without borders working in 67 countries. There are teams in Syria, for example. It has been particularly difficult, especially since President Bashar al-Assad doesn't let teams operate. However, they have managed to intervene in rebel areas. What have you seen in these areas?

JL: right now, the reports are very scarce because our presence is very limited. And this is very frustrating because we know that Syria represents one of the biggest humanitarian crises of today. For us, it's a priority, but we're not being able to give a response to the measure of the situation. Is a very sad reality.

IK: why don't they let teams come in?

JL: the point is that we can't get a security guarantee to protect a team on the ground.

IK: your organization faces, sometimes, moral dilemmas. It is well known that, in the past, doctors without borders had to pay a tax to the Al-Qaeda in order to operate on the ground. How do you evaluate this type of situations?

JL: the reality is that, wherever we work, we have to pay a tax. If we are to cooperate with a Government and we have to import material, such as antiretroviral drugs in an African country, no tax exemption. There's always things to pay. May be the Government in power or to another type of authority. This is the reality on the ground.

IK: to what extent is difficult to evaluate the right one or the wrong one, when we know that probably this money they pay will not be applied in the best way ...

JL: we always do an assessment of the type of action that we intend to take and the impact that will have. When we think the impact is considerable and there are lives to save, we negotiate with the parties on the ground.

IK: another surfer asks, "How did you get to conflict zones."

JL: First tried to understand the geopolitical situation. Then, when we move to the ground â€" I've done exploratory missions-what we do is go talk to everybody to explain who we are, to try to get security guarantees for the mobilisation of the teams. Make sure that the work that we perform will have an impact and respond to specific needs on the ground. This is more or less the process.

IK: also work in Europe, in Ukraine, for example. What impact has had on your speech the Government's decision to discontinue the official medical services in Eastern Ukraine?

JL: Since the Government's decision, since the beginning of the conflict in may, we have provided assistance in various infrastructures on both sides. To a large extent, we have been acting in the area of mental health. One of the facts with which we came across was finding a population too traumatized by the unfolding events, by the attacks.

IK: If you could convey a message to President Poroshenko, what would it be?

JL: He has to authorise the entry of medical assistance and facilitate all bureaucratic procedures which are necessary ...

IK: ... because it affects your work?

JL: A little, Yes.

IK: the responsibility of your work is huge. We have another participant asks: "what was the most difficult problem they faced and how did you solve it?".

JL: the hardest part is when, in some regions, we do not have the acceptance of the population. Sometimes, in West Africa, people don't realize what we're doing there and they're afraid. At some point, kept us physically because they said it was us who were spreading the Ebola virus. And it is difficult to manage because it takes time to be accepted. But in a situation such as the Ebola virus, a disease that has a mortality rate of 50%, we must act quickly, we cannot afford to wait. The acceptance of the community is essential to the success of our work.

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