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Saving lives: the civil military response to the 2014 Ebola outbreak in West Africa

Kamradt-Scott, Adam, Harman, Sophie, Wenham, Clare and Smith III, Frank (2015) Saving lives: the civil military response to the 2014 Ebola outbreak in West Africa. . University of Sydney, School of Social and Political Sciences, Sydney, Australia. ISBN 9781742103624

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Abstract

The 2014 Ebola outbreak in Guinea, Liberia and Sierra Leone proved to be an exceptional outbreak that blurred the lines between health and humanitarian crises. In so doing, it highlighted numerous problems with regard to the coordination of humanitarian disasters that have public health implications of international consequence. The manner in which the international response to this crisis unfolded has in turn prompted a number of high-level intergovernmental reviews of the key actors, institutions and systems that we - as a global community - currently rely upon. At the time of writing, some of these reviews are yet to hand down their findings. This study, which was funded by the University of Sydney, provides a number of independent insights into the civil-military response and overall coordination of the Ebola outbreak in Liberia and Sierra Leone. It also offers recommendations to inform future research and response efforts. The domestic health systems of Liberia and Sierra Leone were ill-equipped to address the size and scale of the Ebola outbreak. Overwhelmed, rapid international assistance was needed to halt the spread of the virus and save lives. The international civilian response to this crisis was, however, widely perceived as slow and inadequate. While key institutions such as the World Health Organization (WHO) have been heavily criticized, the role of non-government organizations (NGOs) was also mixed. A small number of non-state actors and international NGOs (INGOs) such as Medicines Sans Frontiers (MSF) reacted swiftly to the outbreak, but the majority of other organizations found themselves unprepared for a crisis of this nature, withdrawing personnel and closing down operations. This raises serious concerns about the overall capacity of the existing humanitarian system and agencies to respond to health-related crises. Due to the inadequate civilian response, the 2014 Ebola outbreak also witnessed the deployment of thousands of military personnel to help contain the outbreak. The majority of respondents interviewed for this study were positive about the role of foreign military assistance (FMA), which was seen as a necessary last resort. In addition, Sierra Leoneans were generally positive about the role of domestic armed forces, which played a larger role in the Ebola response than their Liberian counterparts. However, several significant criticisms and concerns emerged as well. Foreign armed forces were perceived as risk averse and slow in constructing Ebola Treatment Units (ETUs). Criticism of domestic armed forces included the threat - and in some instances use of - violence and intimidation. Strong leadership from the President and the health sector in Liberia was recognised as key to the country’s effective response, whereas weak leadership and patronage within the health sector was seen to hurt the response in Sierra Leone. Limited trust in government undermined public health, inhibiting behavioural change and social awareness campaigns (particularly in Sierra Leone). These findings highlight that changes are warranted in how governments, international organisations, NGOs, civil society and even militaries approach health-related humanitarian crises in the future.

Item Type: Monograph (Report)
Official URL: https://sydney.edu.au
Additional Information: © 2015 The Authors
Divisions: LSE
Subjects: R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Sets: Research centres and groups > LSE Health and Social Care
Date Deposited: 19 Sep 2016 11:58
Last Modified: 15 Sep 2019 23:12
URI: http://eprints.lse.ac.uk/id/eprint/67781

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