The slow international response to the West Africa Ebola outbreak created an avoidable tragedy that cost thousands of lives, a leading medical charity said on the one year anniversary of the first confirmed case.
The world's worst Ebola epidemic has killed over 10,200 people in the three most affected countries of Guinea, Liberia and Sierra Leone since March 2014 when it was first confirmed in the forest region of Guinea.
Medecins Sans Frontieres (MSF), which first raised the alarm over Ebola, said in a report that everyone from national governments to the World Health Organization (WHO) had created bottlenecks that prevented the epidemic being quickly snuffed out.
"The Ebola outbreak has often been described as a perfect storm: a cross-border epidemic in countries with weak public health systems that had never seen Ebola before," Christopher Stokes, MSF's general director, said in the report.
"Yet this is too convenient an explanation. For the Ebola outbreak to spiral this far out of control required many institutions to fail. And they did, with tragic and avoidable consequences."
In a scathing report titled "Pushed to the limit and beyond", MSF said its warnings in June that the epidemic was out of control and that it could not respond on its own were dismissed as alarmist.
Guinea and Sierra Leone downplayed the epidemic and accused MSF of spreading fear and panic. In June, the Sierra Leone government told the WHO to report only lab-confirmed deaths - falsely reducing the death toll, the report said.
Kenema hospital in the southeast, where some of the first cases were reported in Sierra Leone, also withheld crucial epidemiological data preventing MSF from identifying affected villages and responding, the report said.
"The Ministry of Health and the partners of Kenema hospital refused to share data or lists of contacts with us, so we were working in the dark while cases kept coming in," MSF's emergency coordinator in Sierra Leone, Anja Wolz, said in the report.
Liberia was transparent and asked for help almost on a daily basis. MSF, which reported this to the WHO in June, said the outbreak could have been halted if immediate action was taken, but these warnings were again ignored.
"INDESCRIBABLE HORROR"
When MSF first declared there was an unprecedented Ebola outbreak at the end of March, the WHO rejected the assessment. It finally declared a public health emergency on August 8, prompting a belated international response.
MSF branded the response a "global coalition for inaction" and said by the end of August, it had to turn away patients in Liberia leaving many to die in their homes or on the streets.
"We had to make horrendous decisions about who we could let into the centre," said MSF coordinator Rosa Crestani, who worked at the organisation's Ebola centre in Monrovia, which could only be opened for 30 minutes a day because of the demand for beds.
"We could only offer very basic palliative care and there were so many patients and so few staff that the staff had on average only one minute per patient. It was an indescribable horror."
The number of Ebola cases dropped dramatically over the new year in Sierra Leone, Liberia and Guinea. The presidents of all three countries announced a target to reach zero Ebola by mid-April.
However, Guinea recently reported a doubling of cases in a month, Sierra Leone has a whole neighbourhood under quarantine and Liberia announced on Friday its first new case 16 days after its last Ebola patient was released.
The Ebola outbreak is not over until there are zero cases in the region for 42 days.
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