My time in Geneva was short. I saw the mountains flying in, but did not have much time to look up after that. I was rapidly re-immersed into the WHO culture and all of the activities around Ebola. Many old friends and colleagues are working on the outbreak and it was good to meet up with them again. They remain dedicated and resilient despite external as well as internal pressures.

Even though I have not yet landed in Sierra Leone I have a number of working hypotheses. Lois will recognize, but not agree with, this approach!

In West Africa, and beyond, the response to Ebola is not chaotic but is certainly very complex. My public health pragmatism with be essential. Countries outside those affected, the UN system, and international governmental and non-governmental organizations are engaging on their own terms. They all have mandates and are making choices as to how, when and where to be involved depending on their interests, expertise, and willingness to become embroiled in the response. This makes coordination and adherence to a strategic plan very difficult. Also, in an affected country it may be seemingly well directed at the national level, but it is not straightforward to translate programmatic decisions into local action where community buy-in may not be present. I will let you know how well this analysis holds up!

There is good news from some areas of Sierra Leone but then not so good news from newly affected districts. I will be responsible for rolling out Ebola Care Units throughout Sierra Leone. These will be community based and are sorely needed where there are no treatment centres and where communities need local facilities for isolation and basic care. The person whom I am taking over from leaves on Saturday, so that we will be talking a lot over the next couple of days. I will be based in Freetown but will undoubtedly be travelling all over.

The training in Geneva was very much about personal safety and security and I have had to add a large medical kit as well as a mosquito net to my luggage. That, as well as a few more bottles of hand sanitizer! So, I will be looking after myself.
More to come…