The Deepest Darkest

Around the time of my earliest schooling, it’s just possible that TV failed me when it came to Africa. I figured that was where they made safari suits. And of course I knew that the Lion was such a serious and important king he could rule the jungle just by looking at it from the savannah where he spent most of his time sleeping. Well, TV was still playing a Looney Tunes version of Africa from the 1940s.

That was then though, right? Our understanding of Africa and the people who live there has progressed to become a full and complex understanding of the many facets of the continent that spawned humanity, surely?

There are two things that tell me otherwise. One is a nasty virus. One is a rebuilt country.

The Plague

The current Ebola outbreak in west Africa started with a source case in December 2013. It has taken 10 months, thousands dead, numerous alarms from MSF, a belated recognition from the WHO and a handful of infections outside of Africa for others to get interested. Interest has turned to hysteria all too readily.

Once you do notice that this Ebola thing is happening a bit of alarm is understandable. The thought of a contagion that assails those infected with a range of unpleasant symptoms including bleeding from all sorts of sites and a death rate beyond 60% does sound a little apocalyptic. Particularly when juxtaposed with photos of workers in personal protective equipment that are vaguely reminiscent of that E.T. movie all that time ago. Our local response seems to speak a lot about insularity though and an inability to imagine what it is like to really deal with such an outbreak.

‘Send Them To An Island’

When one state in Australia announced a single returned aid worker was being tested for Ebola because they had acted entirely appropriately in being monitored and reporting a mild fever there was a bit of a meltdown. It took only a couple of hours for people to start talking about enforced quarantine in isolation for weeks. A single case of something entirely different and everyone was building rhetorical neon signs saying “EBOLA IS HERE (actually probably not) DON’T PANIC ABOUT ALL THE WAYS IT WILL (not) KILL ALL OF US.”

It might be natural to respond to stories closer to home but no one seemed to stop and say “Wait, this is scary when there is one person with a fever and a remote chance of having Ebola. Imagine what it is like when everyone around you might be a disease carrier, large numbers of your community are dead amongst thousands of others and there isn’t really a health system to deal with it.”

So few seemed to consider that those in west Africa are just people with similar fears as us dealing with something overwhelming. Would you be able to justify the total hysteria here while offering subdued condolences to Africa? Could you possibly justify a pitifully limp response in offering aid? If you genuinely assessed this as a humanitarian crisis, you could not possibly stand by.

Effort is Not Impossible

After more than a month of evasion, the Australian government is apparently finally supporting personnel willing to go. MSF has been making it clear for a long time that money isn’t nearly as vital to containing the outbreak as personnel and infrastructure. The US have directly asked for people too. Containing Ebola requires an aim to manage 70% or more of cases in appropriate facilities. Prior to the outbreak Sierra Leone had 327 hospital beds in the country. Liberia had 61 doctors and 1000 nurses. Overtaxed health systems can’t deal with common ailments when dealing with such an outbreak.

Finally, well after the UK, US and even Cuba managed to send health professionals Australia is contributing to the best logical option – contain the disease in west Africa. If that doesn’t happen, the projections are alarming. Prior to this the government had promoted their $18 million contribution as meaningful. Or they had insisted the logistics of managing cases of infected health workers was an insurmountable obstacle. Is it really the case that they couldn’t have produced a solution with a bit of will if they really thought it mattered?

I don’t think so and Rwanda is the reason why.

This is a gratuitous shot of a baby mountain gorilla (because gorilla). [By Carine06 from UK (Baby mountain gorilla) [CC-BY-SA-2.0 (], via Wikimedia Commons

This is a gratuitous shot of a baby mountain gorilla (because gorilla). [By Carine06 from UK (Baby mountain gorilla) [CC-BY-SA-2.0 (, via Wikimedia Commons

Open Heart

In a little over a week I get the chance to join a team from Australia undertaking cardiac surgery in kids in Rwanda. It is a country that many people know more for the genocide of 1994 than the story of where it is now. Maybe 800,000 people were killed in 100 days (maybe more and that’s not to mention the massive refugee numbers leaving the country). Rwanda has rebuilt. 20 years later it is making good progress on many of the millennium development goals.

And despite the assumptions from everyone I mention it to that we’re accepting much higher risks of picking up Ebola, Rwanda is very different to west Africa because we’re actually talking about a big continent with lots of variety. Your GPS will tell you it’s quicker to drive to Madrid in Spain than over to Rwanda if you start in Liberia. There are around 55,000 health workers in Rwanda and a well developed health system. There is not much in the way of cardiac surgery for kids though.

At the end of November, a team of 34 health workers from Australia get to go and do some operations and provide some education. It should be an amazing experience in lots of ways but it’s the story of how it comes together that makes me think a government with all its resources and diplomacy could probably do a quicker job of helping African countries in need.

Almost everything for the trip comes from Australia (not the hospital so much, but everything else). Cardiac surgery requires people and quite a bit of gear. Monitors, needles, medicines, surgical equipment, intravenous fluids and even the machines to provide cardiopulmonary bypass during the operations. The equipment was packed a few weeks back and is already freighted. We’ll have coordinators, surgeons, anaesthetists, intensive care staff, ward staff with the bulk of the team being the rather vital nurses.

Some of the team has already gone to plan the operations. The rest of us head over in about a week. We start work the day after we fly in. It’s a big operation and requires a bit of coordination. Now there are some differences from an emergency response. OHI have been heading to Rwanda for 8 years now so relationships have been built. They get to plan over a little time.

However they don’t have a network of Australian Medical Assistance Teams or the military or huge international networks though. They have these people. If you check carefully, you’ll notice that not all of those people are actually working on this trip either. So they have a handful of regular staff who only need one table at the cafe, and the volunteers who will go over. They store gear underneath some buildings at a hospital. They run programs in up to 13 countries each year.

So yes, I think the government could have made something happen if they wanted to. There are people who want to go. They just need support. Perhaps if we actually understood the many sides of Africa we’d realise it is not that deep or dark. There’s just a part of it that needs our urgent help.


Note: I’ll be trying to provide updates from Rwanda while we’re over there working as will OHI. The working hashtag for those on Twitter is apparently #ohi and you can follow the organisation’s Twitter account as well – @OpenHeartIntl. There’s also lots of information on the website at (and I should point out I am a volunteer on this trip, with no other official responsibilities and no pay). 

I should also note there has been some excellent coverage of those dealing with the outbreak in west Africa too. As an example you can look here and here








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