The three African states most affected by the current Ebola outbreak -- Sierra Leone, Liberia and Guinea -- each spend far less than $20 per person per year on public health programs provided by their governments. Add to that perhaps an equal or slightly greater amount spent by missionary groups, international aid agencies and the United Nations system and you can readily see how ill-equipped they are to cope with a major Ebola outbreak.
The media coverage has been slowly turning to scare stories about Ebola arriving here through infected travelers and how our own system could cope with such a happenstance. [One GOP member of the House of Representatives even mentioned Ebola possibly being carried here by Central American children!].
While brave teams of infectious disease specialists from Western countries prepare to mount rescue missions, local physicians and medical staff continue to flee their posts in hospitals with diagnosed Ebola patients -- not out of lack of commitment but out of justified fear that their facilities are unable to provide them with the advanced protective gear they need to survive providing treatment to Ebola victims. Traditional burial rituals in those countries, which include washing the dead body and laying on of hands, are causing great unrest in communities when hospitals resist giving them the body of an Ebola victim who has to be buried or cremated immediately.
In this context, what would constitute "Smart Aid"?
Ellen Johnson Sirleaf, the President of Liberia and an former World Bank executive with a Harvard University background; said it very well yesterday as she prepared to leave for an all-Africa summit hosted by President Obama in Washington, DC. To paraphrase her: "We need everything: qualified specialists and a great deal of immediate material aid: specially-equipped ambulances to safely transport sick patients; ancillary drugs (Ebola has no vaccine or curative medication but other locally-prevalent diseases like malaria and typhoid compromise immune systems and make surviving Ebola less likely); "barrier materials" like gloves, masks, special hospital gowns and "space suits" like we see on television from Ebola's Ground Zero; hygiene supplies like infection control cleaning materials used in our own hospitals; transportation services to get the supplies to the three countries; and, prevention programs in water, sanitation and hygiene in still-unaffected but vulnerable communities."
Unfortunately, the aid community has villains as well as heroes. The Internet makes it easy to propagate inflated claims after a disaster and collect vast sums of donations from well meaning people. In general, I advise looking at Charity Navigator for general financial information on each major charity; an aid group's own website if you take notice of one particular charity (but read their federal I-990 tax return looking at fundraising expenses, executive salaries, and funds actually spent on programs) and ask others with a philanthropic background for advice (like your local community foundation).
My own group, Operation USA, flew a cargo plane to Kikwit, Zaire (now The Congo) General Hospital in mid-1995 carrying protective gear and hygiene supplies to an earlier Ebola outbreak, which was contained after killing 245 out of 316 patients. Fortunately, the outbreak was so virulent that it "burned itself out" before it spread. (see www.opusa.org). We are now following President Sirleaf's admonition about sending material aid as we receive it from donor companies which make or sell appropriate materials.