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  • ’Israeli fire at Gaza border protests causing wounds not seen since 2014 war’

    Some 1,700 wounded within month ■ Doctors say wounds ’devastating,’ most will result in disabilities ■ WHO: Lack of medical equipment endangering wounded

    Amira Hass Apr 22, 2018

    https://www.haaretz.com/middle-east-news/palestinians/.premium-gaza-doctors-injuries-in-border-protests-worst-since-2014-war-1.60

    The live-fire wounds suffered by more than 1,700 Palestinians in the Gaza Strip over the past month have been unusually severe, Palestinian and foreign doctors say.
    To really understand Israel and the Palestinians - subscribe to Haaretz
    Since the series of demonstrations known as the March of Return began on March 30, Israeli soldiers have killed 37 Palestinians and wounded about 5,000, of whom 36 percent were wounded by live bullets.

    Haaretz
    Doctors at Gaza’s Shifa Hospital said they haven’t seen such severe wounds since Israel’s Operation Protective Edge in Gaza in 2014. The aid group Medecins Sans Frontieres said its medical teams have given postoperative care to people “with devastating injuries of an unusual severity, which are extremely complex to treat. The injuries sustained by patients will leave most with serious, long-term physical disabilities.”
    Since April 1, MSF has given postoperative care to 500 people with bullet wounds, mostly in the lower extremities. Most were young men, but some were women or children.
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    “MSF medical teams note the injuries include an extreme level of destruction to bones and soft tissue, and large exit wounds that can be the size of a fist,” the group said in a report on April 19.
    It quoted Marie-Elisabeth Ingres, MSF’s head of mission in Palestine, as saying, “Half of the more than 500 patients we have admitted in our clinics have injuries where the bullet has literally destroyed tissue after having pulverized the bone. These patients will need to have very complex surgical operations and most of them will have disabilities for life.”
    The report concluded: “Apart from regular nursing care, patients will often need additional surgery, and undergo a very long process of physiotherapy and rehabilitation. A lot of patients will keep functional deficiencies for the rest of their life. Some patients may yet need amputation if not provided with sufficient care in Gaza and if they don’t manage to get the necessary authorization to be treated outside of the strip.”

    The London-based group Medical Aid for Palestinians echoed MSF’s findings. It quoted a Shifa surgeon as saying, “The bullets used are causing injuries local medics say they have not seen since 2014. The entrance wound is small. The exit wound is devastating, causing gross comminution of bone and destruction of soft tissue.”
    The group’s April 20 report also said that Gaza surgeons had performed 17 amputations – 13 legs and four arms. In addition, a boy shot by Israeli soldiers on April 17 had his left leg amputated in Ramallah. His parents said he was playing soccer near the Israel-Gaza border fence east of the Al-Bureij refugee camp.
    Both aid groups repeatedly used the same word to describe the bullet wounds – “destruction.”
    To cope with the flood of patients, both official and private medical institutions in Gaza have beefed up their presence near the demonstrations that are taking place along the Gaza-Israel border.
    The Palestinian Health Ministry set up five field clinics near the protests in order to stabilize patients before they reach the hospital. Each clinic has three beds plus several mattresses, and is staffed by up to 10 doctors and 15 nurses, plus volunteers.
    In addition, the Palestinian Red Crescent has set up five emergency treatment stations. MSF has brought in surgical teams that work alongside Gazan teams at the Shifa and Al-Aqsa hospitals.
    Yet the World Health Organization says the lack of medication and nonreusable medical supplies like bandages is undermining the ability to give patients proper care. The Palestinian Health Ministry urgently needs stocks of 75 essential drugs and 190 types of nonreusable medical supplies.
    The WHO also criticized Israel for harming medical personnel, saying 48 medical staffers have been wounded by Israeli fire while trying to evacuate the wounded. At least three were hit live bullets. In addition, 13 ambulances were hit by live bullets or tear gas grenades.
    Between March 30 and Thursday, 1,539 Gazans were wounded by live bullets and around 500 by sponge-tipped bullets, according to the Palestinian Health Ministry. Of the victims, 62.3 percent were hit in the lower body, 16 percent in the upper body, 8.2 percent in the head or neck, 4.8 percent in the stomach and four percent in the chest. In addition, 4.7 percent had multiple injuries.
    On Friday, the ministry said 729 Palestinians were wounded by Israeli bullets or riot-control equipment, of whom 305 required hospital treatment. Of the latter, 156 were hit by live bullets.
    Fifteen of the 305 hospitalized patients were women, it added, while 45 were children. Altogether, 500 minors have been wounded by Israeli fire since March 30.

  • Si j’ai bien compris, aujourd’hui l’UE discute de la possibilité de détruire les bateaux de #passeurs en Méditerranée pour prévenir les naufrages (sic). Je vais utiliser le tag #destruction_de_bateaux, à moins que quelqu’un n’ait une meilleure idée...
    Mediterranean migrants are not slaves – do not pervert history to justify military action

    EU leaders have accepted that using force will kill adults and children boarding boats in Libya. This is no high-minded crusade


    http://www.theguardian.com/commentisfree/2015/may/17/mediterranean-migrants-slaves-history-military-action-eu-leaders-libya
    #destruction #bateaux #Méditerranée #stratégie #EU #Europe #asile #migration #réfugiés #naufrage

  • Alors que les États-Unis envoient 3000 militaires en Afrique de l’Ouest, une compilation d’articles sur #Ebola et la réponse internationale

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    What We’re Afraid to Say About Ebola - NYTimes.com
    http://www.nytimes.com/2014/09/12/opinion/what-were-afraid-to-say-about-ebola.html

    The Ebola epidemic in West Africa has the potential to alter history as much as any plague has ever done. (...)

    There are two possible future chapters to this story that should keep us up at night.

    The first possibility is that the Ebola virus spreads from West Africa to megacities in other regions of the developing world. (...) What happens when an infected person yet to become ill travels by plane to Lagos, Nairobi, Kinshasa or Mogadishu — or even Karachi, Jakarta, Mexico City or Dhaka?

    The second possibility is one that virologists are loath to discuss openly but are definitely considering in private: that an Ebola virus could mutate to become transmissible through the air.

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    The Mathematics of Ebola Trigger Stark Warnings: Act Now or Regret It | WIRED
    http://www.wired.com/2014/09/r0-ebola

    I’ve spent enough time around public health people, in the US and in the field, to understand that they prefer to express themselves conservatively. So when they indulge in apocalyptic language, it is unusual, and notable.

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    BBC News - Ebola outbreak ’threatens Liberia’s national existence’
    http://www.bbc.com/news/world-africa-29136594

    [Defence minister] Brownie Samukai Samukai warned on Tuesday that the disease was “devouring everything in its path” in Liberia.

    The country’s weak health system was already overwhelmed by the number of cases, he said.

    Mr Samukai told UN Security Council members that Liberia lacked “infrastructure, logistical capacity, professional expertise and financial resources to effectively address this disease”.

    “Liberia is facing a serious threat to its national existence. The deadly Ebola virus has caused a disruption of the normal functioning of our state,” he said.

    Separately on Tuesday, the UN’s envoy in Liberia said that at least 160 Liberian health workers had contracted the disease and half of them had died.❞

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    ‘Ebola’ Draining Economy - Min. Konneh - The New Dawn Liberia | Truly Independent
    http://www.thenewdawnliberia.com/index.php?option=com_content&view=article&id=12673:ebola-draining

    According to him, some concession companies have already scaled down operations, as expatriates depart the country for fear of contracting the Ebola virus. He said productivity in the various sectors of the economy was adversely affected, resulting in lower revenue performance, and increased expenditure demands, threatening the post- conflict recovery process of sustainable, inclusive and proper growth.

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    Poor will die of hunger, not just Ebola, say Sierra Leoneans
    http://www.trust.org/item/20140915104032-w7rs4?

    FREETOWN: Supplies of food are running so low in Sierra Leone that residents fear many could die of hunger if the Ebola virus is not contained soon, reports humanitarian organisation Plan International.

    Freetown residents say food prices are soaring out of control due to the lack of cross-border trade.

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    Ebola’s Hard Lessons | The CSIS Global Health Policy Center
    http://www.smartglobalhealth.org/blog/entry/Ebolas-Hard-Lessons

    In the acid words of one observer, Ebola is to WHO what Katrina was to FEMA in 2005. MSF is at its limits and cannot possibly continue to shoulder the lion’s share of responsibilities. In the meantime, staff on the ground are becoming steadily more vulnerable – to infection and to violence – requiring greater investments to ensure their protection.

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    The Ebola War
    http://haicontroversies.blogspot.ca/2014/09/the-ebola-war.html

    Although there are clearly downsides, experts from Peter Piot to MSF leaders to Mike Osterholm are calling for military involvement. 

    The need for such involvement is based simply on the scale of this disaster—WHO, CDC, non-governmental groups like MSF, no group has anything close to the logistical capability of the military to quickly deploy personnel and supplies almost anywhere in the world. If, as MSF suggests, military assets are “not…used for quarantine, containment, or crowd control measures”, which have backfired (particularly in Liberia), such a response could help bring essential capacity where it is needed most. The chart below provides a comparison of the total budgets for the US military, CDC, WHO and MSF.

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    Ebola outbreak an avoidable tragedy, say UK MPs | Global development | theguardian.com
    http://www.theguardian.com/global-development/2014/sep/12/ebola-outbreak-avoidable-tragedy-uk-ministers-mps

    “The devastating ongoing Ebola epidemic in west Africa has served to emphasise the importance of establishing strong health systems,” it said. “The apparent hesitancy and lack of coordination in the international response suggest that the global health system and emergency plans have failed.”

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    Ebola – the World’s Katrina | Molecules to Medicine, Scientific American Blog Network
    http://blogs.scientificamerican.com/molecules-to-medicine/2014/09/09/ebola-the-worlds-katrina

    the world’s response has been incomprehensibly and seemingly irresponsibly slow. Why is this the case? Likely because of disparities in the power and wealth of people affected by the epidemic.

    The Washington Post has a good backgrounder, “The long and ugly tradition of treating Africa as a dirty, diseased place,⁠” by professors Laura Seay and Kim Yi Dionne. They note the racism of the European colonizers, and how that led to “othering” of Africans, attributing inherent flaws to the people and their societies rather than to cultural differences, without any true basis or understanding. And they cite the “persistent association of immigrants and disease in American society.”

    The impact of such “othering” was first really brought home to me in a provocative lecture by Eileen Stillwaggon in 2006, at a Global Network for Neglected Tropical Diseases⁠ conference. She spoke of the perception that AIDS was more prevalent in Africa because of different sexual mores⁠—hypersexuality⁠ and promiscuity. Then she ripped this apart with eye-opening evidence of the links between helminth (worm) infections, schistosomiasis, malaria, and AIDS, effectively demonstrating that the parasitic infections strongly increase the susceptibility to HIV, explaining the difference in HIV rates between Africa and industrialized countries.

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    Ebola highlights slow progress in war on tropical diseases | Reuters
    http://www.reuters.com/article/2014/09/11/us-health-ebola-neglected-analysis-idUSKBN0H60TA20140911

    [until this crisis] the absence of economic incentives for drugmakers to develop and supply medicines for neglected tropical diseases (NTDs) has long been highlighted by health campaigners, but it rarely gets on to the political radar in the West. (...)

    It is not that scientists don’t have ideas for new drugs and vaccines but, until now, they have lacked the industry buy-in needed to take experimental products through the costly late stages of clinical development.

    BIOWEAPON FEARS IN WEST

    Significantly, much of the funding for Ebola has been driven not by concerns about sporadic outbreaks in Africa but by a biodefence strategy in the United States and other countries fearful of the potential to weaponize the virus.

    • M’enfin, si les États-Unis envoient des militaires quand Cuba envoie des médecins, c’est qu’ils y ont des intérêts précis à défendre ! Comme la présence de firmes américaines par exemple. Pétrole, plantations commerciales... faudrait voir à ne pas faire obstacle au business. C’est du #pur_cynisme

    • réponse à l’article d’Osterholm par Vincent Racaniello (qui au passage cite l’intérêt des expériences de Ron Fouchier) :

      What we are not afraid to say about Ebola virus
      http://www.virology.ws/2014/09/18/what-we-are-not-afraid-to-say-about-ebola-virus

      More problematic is Osterholm’s assumption that mutation of Ebola virus will give rise to viruses that can transmit via the airborne route:

      If certain mutations occurred, it would mean that just breathing would put one at risk of contracting Ebola. Infections could spread quickly to every part of the globe, as the H1N1 influenza virus did in 2009, after its birth in Mexico.

      The key phrase here is ‘certain mutations’. We simply don’t know how many mutations, in which viral genes, would be necessary to enable airborne transmission of Ebola virus, or if such mutations would even be compatible with the ability of the virus to propagate. (...)

      The other important message from the Fouchier-Kawaoka ferret experiments is that the H5N1 virus that could transmit through the air had lost its ability to kill. The message is clear: gain of function (airborne transmission) is accompanied by loss of function (virulence).

    • édito du Guardian :

      The Guardian view on using the American military to contain the Ebola epidemic in Liberia | Editorial | Comment is free | The Guardian
      http://www.theguardian.com/commentisfree/2014/sep/17/guardian-view-american-military-ebola-epidemic-liberia

      President Barack Obama’s decision to despatch a force with a strong military component to contain the Ebola epidemic in Liberia is to be welcomed. This is one of those cases where American boots on the ground will be an unalloyed good.

      (...) But there are lessons – about readiness, about the proper funding and staffing of the World Health Organisation, and about the need to work on cures for diseases ignored in the past because there were no easy profits to be made by the pharmaceutical industry – and they must be learned.

  • Ebola : We Could Have Stopped This - by Laurie Garrett
    http://www.foreignpolicy.com/articles/2014/09/05/we_could_have_stopped_this_ebola_virus_world_health_organization

    Public health officials knew Ebola was coming. They know how to defeat it. But they’re blowing it anyway.

    La réponse est très loin du compte :

    To understand the scale of response the world must mount in order to stop Ebola’s march across Africa (and perhaps other continents), the world community needs to immediately consider the humanitarian efforts following the 2004 tsunami and its devastation of Aceh, Indonesia.

    L’OMS est en vrac :

    the sole major international responder, Doctors Without Borders (MSF), pleaded for help and warned repeatedly that the virus was spreading out of control. The WHO was all but AWOL, its miniscule epidemic-response department slashed to smithereens by three years of budget cuts, monitoring the epidemic’s relentless growth but taking little real action.

    et ça fait des années qu’elle est maltraitée et instrumentalisée :

    The neglectful status of the WHO was, horribly, by design. Its governing body, the World Health Assembly (WHA), in which nearly every nation on Earth is a voting member, has declined to increase country WHO dues for more than a quarter-century. Worse, following the 2008 financial crisis, most of the extrabudgetary special support that the WHO relied upon — funds from rich countries that more than doubled the agency’s financing — disappeared as once-wealthy governments turned away from philanthropy

    le facteur épidémique (R0) s’accroît :

    Today in Liberia, the virus is spreading so rapidly that no RO has been computed. Back in the spring, however, when matters were conceivably controllable, Liberia’s then-small rural outbreak was 1.59.

    Les stats sous-évaluent la réalité :

    WHO’s official case reports, which solely reflect lab-confirmed patients that have sought care in medical facilities, under-represents the true toll by at least half

    Le reste de l’article est un appel à l’armée américaine qui est la seule (selon l’auteure) à pouvoir intervenir à cette échelle de besoins et de manière décisive :

    Washington officials say off the record that options for U.S. military assistance are under consideration, and may be announced in a few days.

    Mais ça va pas être facile :

    Ebola responses in Liberia, Sierra Leone, Guinea, and possibly Nigeria each need a “national force/brigade that tells people, ’this is what you do and what you do not,’ and that does surveillance — this brigade has to have the trust of the people.”

    #santé #intervention #OMS #ebola #MSF #armée

    • [2 septembre] le discours de Joanne Liu, la présidente internationale de MSF aux Nations unies :

      MSF International President United Nations Special Briefing on Ebola | Médecins Sans Frontières (MSF) International
      http://www.msf.org/article/msf-international-president-united-nations-special-briefing-ebola

      To curb the epidemic, it is imperative that States immediately deploy civilian and military assets with expertise in biohazard containment. I call upon you to dispatch your disaster response teams, backed by the full weight of your logistical capabilities. This should be done in close collaboration with the affected countries.

      Without this deployment, we will never get the epidemic under control.

      The following must be prioritized:

      – Scaling up isolation centers;
      – Deploying mobile laboratories to improve diagnostic capabilities;
      – Establishing dedicated air bridges to move personnel and equipment to and within West Africa;
      – Building a regional network of field hospitals to treat suspected or infected medical personnel.

    • Can The U.S. Military Turn The Tide In The Ebola Outbreak? : Goats and Soda : NPR
      http://www.npr.org/blogs/goatsandsoda/2014/09/11/347666891/can-the-u-s-military-turn-the-tide-in-the-ebola-outbreak

      the Pentagon’s commitment seems modest in the wake of Obama’s comments. It plans to supply Liberia with a 25-bed field hospital — but no medical staff. (...)

      “Our deployable medical capabilities are generally trauma medicine, treating people who suffer wounds in combat and things of that nature,” says Michael Lumpkin, the assistant secretary of defense in charge of Ebola response. “That’s not necessarily what they’re dealing with there.”

      And a large number of troops are dispatched, that could make things worse. (...)

      Foreign troops would not be there to enforce quarantines. But just their presence has the potential to destabilize, says Julie Fischer, a public health expert at George Washington University.

    • [Peter Piot,] Scientist who identified Ebola virus calls for ’quasi-military intervention’ | Society | The Guardian
      http://www.theguardian.com/society/2014/sep/11/scientist-identified-ebola-quasi-military-intervention-peter-piot

      The microbiologist who helped identify the Ebola virus in 1976 has urged David Cameron to support a “quasi-military intervention” to stop the current epidemic, which is spreading unchecked in west Africa.

      Professor Peter Piot, the director of the London School of Hygiene and Tropical Medicine, said the outbreak was now so bad that a UN peacekeeping force ought to be mobilised in Sierra Leone and Liberia with huge donations of beds, ambulances and trucks as well as an army of clinicians, doctors and nurses.

  • UN anti-cholera plan in Haiti ’failing’ - BBC News
    http://www.bbc.co.uk/news/world-latin-america-22703387

    “There have been grand plans - a 10-year $2.2bn project,” Duncan McClean, a senior manager for MSF, told the BBC.

    But the UN plan had not been implemented, he added.

    “I travel regularly to Haiti; the impact on the ground today is almost non-existent.”

    #nations-unies #Haïti #cholera #santé