Ebola epidemic 'could lead to failed states', warns WHO

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Media caption"Most people in Liberia do not believe the virus is real"

The Ebola epidemic threatens the "very survival" of societies and could lead to failed states, the World Health Organization (WHO) has warned.

The outbreak, which has killed some 4,000 people in West Africa, has led to a "crisis for international peace and security", WHO head Margaret Chan said.

She also warned of the cost of panic "spreading faster than the virus".

Meanwhile, medics have largely ignored a strike call in Liberia, the centre of the deadliest-ever Ebola outbreak.

Nurses and medical assistants had been urged to strike over danger money and conditions. However, most were working as normal on Monday, the BBC's Jonathan Paye-Layleh in Monrovia said.

Image copyright EPA
Image caption More than 4,000 people have died during the Ebola outbreak

A union official said the government had coerced workers - but the government said it had simply asked them to be reasonable.

In a speech delivered on her behalf at a conference in the Philippines, Ms Chan said Ebola was a historic risk.

"I have never seen a health event threaten the very survival of societies and governments in already very poor countries," she said. "I have never seen an infectious disease contribute so strongly to potential state failure."

She warned of the economic impact of "rumours and panic spreading faster than the virus", citing a World Bank estimate that 90% of the cost of the outbreak would arise from "irrational attempts of the public to avoid infection".

Ms Chan also criticised pharmaceutical firms for not focusing on Ebola, condemning a "profit-driven industry [that] does not invest in products for markets that cannot pay".

At the scene: Mark Doyle, BBC international development correspondent, Accra, Ghana

In a corner of a UN compound at Accra airport, the UN's newest agency is having its first warehouse put up.

In a nearby office block, a multinational team of UN workers are finding desks and setting up phone lines for the regional headquarters of the UN Mission for Ebola Emergency Response (UNMEER). The operation is so new that pieces of paper Sellotaped to walls and doors serve as nameplates.

But the question on many minds is why it has taken the UN so long to set up UNMEER. Medical aid agencies working on the front lines in the fight against Ebola, such as Medecins Sans Frontieres, have been sounding the alarm since the beginning of the year.

But UNMEER officials say they didn't realise until recently that the disease was out of control.

Image copyright AFP
Image caption Health care workers are most at risk of infection

The latest outbreak has killed at least 4,033 people in Liberia, Sierra Leone, Guinea and Nigeria since it was identified in March.

Health workers are among those most at risk of catching the disease. Ninety-five have died from the virus in Liberia.

Liberia's National Health Workers Association had called for a strike to demand an increase in the fee paid to those treating Ebola cases.

The union is seeking a risk fee of $700 (£434) a month. It is currently less than $500, on top of basic salaries of between $200 and $300.

The association also wants more protective equipment and insurance for workers.

Ebola deaths: Confirmed, probable and suspected

Source: WHO

Note: figures have occasionally been revised down as suspected or probable cases are found to be unrelated to Ebola. They do not include one death in the US recorded on 8 October.

How not to catch Ebola:

  • Avoid direct contact with sick patients
  • Wear goggles to protect eyes
  • Clothing and clinical waste should be incinerated and any medical equipment that needs to be kept should be decontaminated
  • People who recover from Ebola should abstain from sex or use condoms for three months

Why Ebola is so dangerous

How Ebola attacks

Ebola: Mapping the outbreak

On Monday, the association's secretary-general, George Williams, said the government had put some health workers under "duress" and persuaded them to work.

The government says the scale of the epidemic means it now cannot afford the risk fee originally agreed. It warned that a strike could also harm patients.

Information Minister Lewis Brown said the government had asked health workers to be reasonable. "We are working with them the best way we possibly can," he said.

Six months after the epidemic began in West Africa, there are still only about a quarter of the treatment beds required to tackle it.

Food is now in short supply as markets are disrupted in some parts of Liberia, Sierra Leone and Guinea.

In other developments:

  • A regional UN co-ordination centre to fight Ebola is being set up in Ghana
  • The archbishop of Guinean capital Conakry has issued guidelines aimed at checking the spread of Ebola in churches
  • The American cameraman who contracted Ebola while in Liberia has tweeted that he is "feeling like I'm on the road to good health"

  • Protective Ebola suit

  • Surgical cap


    The cap forms part of a protective hood covering the head and neck. It offers medical workers an added layer of protection, ensuring that they cannot touch any part of their face whilst in the treatment centre.

  • Goggles


    Goggles, or eye visors, are used to provide cover to the eyes, protecting them from splashes. The goggles are sprayed with an anti-fogging solution before being worn. On October 21, the US Centers for Disease Control and Prevention (CDC) announced stringent new guidelines for healthcare personnel who may be dealing with Ebola patients. In the new guidelines, health workers are advised to use a single use disposable full face shield as goggles may not provide complete skin coverage.

  • Medical mask


    Covers the mouth to protect from sprays of blood or body fluids from patients. When wearing a respirator, the medical worker must tear this outer mask to allow the respirator through.

  • Respirator


    A respirator is worn to protect the wearer from a patient's coughs. According to guidelines from the medical charity Medecins Sans Frontieres (MSF), the respirator should be put on second, right after donning the overalls.

  • Medical Scrubs


    A surgical scrub suit, durable hospital clothing that absorbs liquid and is easily cleaned, is worn as a baselayer underneath the overalls. It is normally tucked into rubber boots to ensure no skin is exposed.

  • Overalls


    The overalls are placed on top of the scrubs. These suits are similar to hazardous material (hazmat) suits worn in toxic environments. The team member supervising the process should check that the equipment is not damaged.

  • Double gloves


    A minimum two sets of gloves are required, covering the suit cuff. When putting on the gloves, care must be taken to ensure that no skin is exposed and that they are worn in such a way that any fluid on the sleeve will run off the suit and glove. Medical workers must change gloves between patients, performing thorough hand hygiene before donning a new pair. Heavy duty gloves are used whenever workers need to handle infectious waste.

  • Apron


    A waterproof apron is placed on top of the overalls as a final layer of protective clothing.

  • Boots


    Ebola health workers typically wear rubber boots, with the scrubs tucked into the footwear. If boots are unavailable, workers must wear closed, puncture and fluid-resistant shoes.

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