Dáil Éireann Debate, Thursday - 22 January 2015
10. Deputy Maureen O'Sullivan asked the Minister for Foreign Affairs and Trade Ireland's contribution in respect of the Ebola crisis; his views on concerns relating to low survival rates in the management centres; and if enough is being done to ensure better survival rates. [2539/15]
View answerThis is to ask the Minister about Ireland's contribution with regard to the Ebola crisis, about the low survival rates in the centres and whether he believes enough is being done to ensure better survival rates.
Ireland is playing a strong role in the international response to the Ebola crisis through the work on the ground of its embassy in Sierra Leone - it is one of very few countries that have such a bilateral relationship with that country in particular - and through its significant financial support. In 2014 alone, the Government provided more than €18 million directly and through non-governmental organisations, NGOs, to the most affected countries in that region. This included approximately €10 million through its annual development programmes in its partner countries, namely, Sierra Leone and Liberia, which have a particular focus on strengthening the national health systems. Moreover, the Government has provided more than €5.6 million specifically for Ebola treatment facilities and for work on contact-tracing, community mobilisation and child nutrition programmes. The Government intends to continue this strong focus in 2015.
While there appears to have been a welcome slow-down in the incidence of cases of Ebola in recent weeks, there are fluctuations from country to country. It is therefore essential that the international community maintains its resolve to defeat the epidemic and not lose the momentum of its response. The World Health Organization, WHO, reports that fatality rates for hospitalised patients in the most affected countries are between 57% and 60%, which still is too high. However, deaths outside treatment centres are significantly under-reported, making it difficult to provide a completely accurate case fatality rate for the outbreak as a whole. Now that Ebola transmission rates are dropping slightly and pressure on beds is reducing, more suspected Ebola cases will go directly to treatment centres rather than transiting through holding centres while awaiting test results. This will allow more patients to receive the highest quality of care at an earlier stage and that will lead to improved outcomes.
One must distinguish between treatment centres and management centres. There is a low survival rate, I believe it is 30%, among those who go into what are known as and must be called management centres. The fear is that not enough is being done and the point has been made by various medical people that were Ebola to be present in a western developed country, there would be much greater emphasis on its treatment. Members can see, for example, the amount of effort that goes into the treatment of individuals who return from countries such as Sierra Leone or Liberia. One must draw the point that Ebola is an illness of poverty that comes about because of inequality in society. Unless this is considered as part of the overall picture, the statistics will continue to be extremely bad. I met recently Ireland's ambassador to Sierra Leone and I acknowledge completely that in a sense, her life is on the line, as well as her total commitment. I had the opportunity with the Joint Committee on Foreign Affairs and Trade to visit Sierra Leone two and a half years ago but another aspect of this problem concerns the breakdown in society and the lack of socialisation. We visited St. Joseph’s School for the Hearing Impaired run by Sr. Mary and to think that school had to be stopped and those children now have been left without any support. While I acknowledge that some kind of outreach is going on there, I refer to the social impact and do not believe we are concentrating enough on survival and getting through it. Moreover, one must distinguish between treatment centres and management centres. Another issue concerns burials and the manner in which they are a major cause of contamination.
Through the Chair, I wholeheartedly agree with everything Deputy Maureen O'Sullivan has said. In fairness to the Irish response, it has been extremely influential in influencing the United Nations response. There is a United Nations mission on the ground - I was present in Freetown on the very weekend it arrived - and because of the presence of our ambassador and team on the ground, as well as Irish NGOs being on the ground in Sierra Leone and Liberia, we were able to influence the global response to the crisis. However, for our part and in respect of our response as a nation, it was early and effective. While I agree absolutely with Deputy O'Sullivan when she states there are more fundamental problems, the Government has an embassy and accreditation there by virtue of the fact that Sierra Leone is third from last on the human development index. This signifies Ireland's commitment to those countries on the very issues such as education, maternal health, nutrition, gender and so on. When I visited, I spoke to the President and the Ministers for social welfare, education and health on those very issues because the Government believes strongly that there must be action on them and that Ireland has a role to play in assisting countries such as Sierra Leone in that respect.
Briefly, one other aspect on aid is the need for it to go to established community organisations that are run by the people of Sierra Leone because they are located within their communities. Sometimes, an NGO can be a little bit removed and it is important that aid should go to those community groups, which are established and are out in the field. They know their communities and in particular, they know how to communicate with those communities on the best way to deal with the illness, as well as on the best way to handle burials and on how dangerous it is to continue people's usual practices for dealing with those who have passed away.
To their credit, the Irish NGOs are working directly with people and seek to empower people on the very dynamics about which the Deputy has spoken. While I acknowledge the Deputy is not necessarily making this point, Ireland does not take a patronising or patriarchal view in this regard. We help people to empower people to build up capacity in order that they can do it themselves. However, the immediacy of the Ebola crisis has caused the Government to shift the focus towards directing funding towards that crisis per se by directing funding to things like call centres, community mobilisation and psychosocial issues. However, once the Ebola crisis is over, the work to which the Deputy refers will continue apace and the Government's commitment to that region of west Africa is as strong as it ever has been.
As we were late starting, there are a couple of minutes of the allocated time remaining. With Deputy Terence Flanagan's agreement I will ask the Minister, Deputy Charles Flanagan, to reply first to his question and I will then allow him a brief supplementary question.
