Ebola crisis: UN envoy rejects criticism of agency's response

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Media captionUN Ebola co-ordinator David Nabarro: "We are putting in place the foundations of a very powerful response"

The UN's special envoy for Ebola has defended efforts to fight the virus in West Africa after leading aid agency MSF said they had had no real impact.

David Nabarro told the BBC that plans were on course to provide 4,000 beds for Ebola patients by next month, compared with 300 at the end of August.

MSF coordinator Christopher Stokes says the virus is still out of control.

A damning internal report from the UN's own health agency, the World Health Organization (WHO), has also emerged.

The WHO report found that it had failed to respond in time to a "perfect storm", according to the document reported by the Associated Press news agency.

Sources close to the WHO also told Bloomberg news agency of multiple failures in the outbreak's early stages.

In the worst affected countries - Liberia, Guinea and Sierra Leone - the Ebola virus has now killed 4,546 people with cases of infection numbering 9,191, according to the latest WHO figures.

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Image caption The World Health Organization is ramping up efforts to stop Ebola from spreading elsewhere in Africa

'Very powerful response'

The BBC's international development correspondent, Mark Doyle, asked Mr Nabarro to respond to the MSF (Medecins Sans Frontieres) allegation that all of the recent international pledges of help and deployments of staff had not yet had any impact on the epidemic.

Mr Nabarro said he had seen a big increase in the international response over the past two months:

"I am absolutely certain that when we look at the history, that this effort that has been put in place will have been shown to have had an impact, though I will accept that we probably won't see a reduction in the outbreak curve until the end of the year.

"We are putting in place the foundations of a very powerful response."

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Media captionChristopher Stokes of MSF: "[The crisis] has never been under control"

Earlier, MSF's Christopher Stokes told our correspondent that it was "ridiculous" that his volunteers were still bearing the brunt of the care.

MSF, he said, was still running the majority of Ebola treatment facilities across the region, responsible for 700 of the 1,000 or so beds in place.

Recent high-profile offers of help from the international community such as a British Army field hospital being built in Sierra Leone would not have any significant impact for a month or six weeks, Mr Stokes said.

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Media caption"I've lost five members of my family"

The internal WHO report seen by AP states: "Nearly everyone involved in the outbreak response failed to see some fairly plain writing on the wall. A perfect storm was brewing, ready to burst open in full force."

It says that experts should have realised that traditional methods of containing infectious disease would not work in a region with porous borders and poor health systems.

Issues highlighted by the unnamed WHO sources who spoke to Bloomberg include

  • Delays in WHO experts in the field sending reports to headquarters in Geneva
  • Bureaucratic hurdles preventing $500,000 (£311,000) reaching the response effort in Guinea
  • Virus contact tracers (tasked with identifying people who may have come into contact with sufferers) refusing to work out of concern they would not get paid

How not to catch Ebola:

  • Avoid direct contact with sick patients as the virus is spread through contaminated body fluids
  • 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

Ebola basics: What you need to know

How Ebola attacks

What virus has hit - in maps

Uncertainty over figures

  • 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.