As RFA Argus sails South I think a few thoughts on Ebola are due.
Fresh from lecturing the world about the generational threat posed by ISIS (followed by limited resources and even less resolve) David Cameron finds himself pontificating on the generational threat from Ebola.
He then went on to lecture other world leaders about ponying up resources.
He also made the claim that the UK was leading the way, expect that came as a surprise to the 500 or so US personnel in Liberia that are being ramped up to 4,000, but hey.
Am not normally a fan of Simon Jenkins in the Guardian but in a piece published today he is bang on the money in his criticism of the language used;
We have lost control of the language of proportion
Simon Jenkins makes the point that crying wolf and an uncontrollable use of dramatic adjectives means a rise in cynicism about what may well actually be a generational threat.
I would recommend the article, the only one I have found that actually expresses some degree of uncertainty whilst recognising the potential of Ebola.
Having said that, a precautionary stance would seem prudent and whilst local authorities, large corporations, the NHS and any organisations are busy dusting off their pandemic plans, stocking up with Tyvek suits the MoD is contributing with a wide ranging response, targeted at the infection hot spot of Sierra Leone.
The story so far
This infographic (without double decker buses unfortunately) gives a good overview of resources no deployed.
Much of the recent focus has been on the deployment this morning of RFA Argus but we should not forget the many personnel (MoD and DFiD) that have been in Sierra Leone for many weeks and months.
In fact, the UK’s military presence in Sierra Leone goes back many years, the International Military Advisory Training Team Sierra Leone (IMATT SL) has been in place since 2000 to support the Republic of Sierra Leone Armed Forces (RSLAF) transition from civil war.
Following an improvement in the security situation, a reduction of funding and focus on Somalia the British led (but international) IMATT SL gave way to International Security Advisory Team Sierra Leone (ISAT) in March 2013. ISAT has a broader security remit that includes policing and prisons for example.
IMATT and ISAT has been a quiet success, an advert for upstream engagement if there ever was one, RSLAF personnel have even contributed to UN missions, although after one of their number was tested positive for Ebola their status is in some doubt.
Whilst IMATT SL and ISAT are mainly a training and mentoring organisation they can request additional support, a typical example being the well drillers of 521 Specialist Team Royal Engineers (STRE) deployed in 2013 to install wells and pumps at 11 RSLAF bases.
In May this year, with the international focus on sexual violence summits, the Foreign and Commonwealth Office issued a travel advisory covering an outbreak of Ebola in Guinea. By June, DFiD had confirmed their 2012/13 expenditure for Sierra Leone stood at £68.6m. The Project List for the country can be found at this link.
Of the 96 projects listed, only one, GB-1-204838, is Ebola related.
Emergency support to response to the Ebola Virus Disease in Sierra Leone 2014, Budget £5m
At the end of June, the travel advisory had changed but was still advising that most visits would be incident free. This had changed dramatically by the beginning of August with a state of emergency being declared in Sierra Leone, suspension of British Airways flights and the first COBRA meeting in the UK
The Foreign Secretary chaired a further meeting of COBR this morning to discuss Ebola and the current situation in Sierra Leone, Liberia and Guinea. Ministers and officials from across Whitehall and other relevant organisations attended.
The meeting discussed efforts to limit the spread of the infection across affected countries, which has included DFID’s work to fill critical gaps in the front-line response in those countries and working with the World Health Organisation (WHO) to train health workers and increase supplies. A further £3m would now be provided to strengthen health systems in Sierra Leone and Liberia and support the WHO, UNICEF and the International Rescue Committee in limiting Ebola’s spread, taking the total UK contribution to £5m.
#medical advice remains that the risk to the UK is very low. The UK has an established, well-tested system to deal with any known or suspected imported case of this disease. As part of that, precautionary planning measures are being kept up-to-date and the UK’s Public Health authorities are working closely with clinicians, border staff and other agencies to ensure they are prepared to deal with any eventuality.
The UK will continue to monitor the situation closely.
The mid August infographic showed the UK’s resource commitment
Since this first response the UK has slowly ratcheted up the resources provided to combat Ebola in Sierra Leone, by the beginning of September that £2m had grown to £25m.
One of the first projects was the building of a 62 bed Ebola treatment centre in Kerry Town, by personnel from the Royal Engineers (first in, last out, as ever), RSLAF engineers and locally employed civilians.
In mid September, an announcement confirmed the 62 bed centre would be joined by over 650 additional treatment beds spread across a number of locations. DFiD also funded a Red Cross training facility.
The RAF flew in a number of personnel, stores and equipment.
It was time for a new graphic
Then there was a quick interlude, a donor conference in London and the inevitable hash tag!
More flights followed, bringing in personnel and supplies like generators, ambulances and building materials.
At this point, there were about 40 military personnel in Sierra Leone, mostly engineers, logisticians and medical planners, getting things ready for the initial deployment by 22 Field Hospital, part of 2 Medical Brigade.
It was also announced that RFA Argus would deploy with a number of helicopters and additional personnel.
The Operation also had a name, OP GRITROCK.
Back in the UK, 22 Field Hospital had created a mockup treatment centre at the Army Medical Services establishment in Strensall (York garrison) and were involved with planning and additional training
The Commanding Officer of 22 Field Hospital, Lieutenant Colonel Alison McCourt explained to the media
This unit has been the ‘Vanguard’ medical regiment for the past 20 months which means we are on high readiness to deploy at short notice to anywhere in the world – although this is a bit different and provides us with a challenge we are perfectly suited to this kind of task.
Joining 22 Field Hospital are medical personnel from the Royal Air Force and Royal Navy.
More exercises and preparations were carried out.
In the images above the protective masks are from 3M in County Durham. The 3M Aura Particulate Respirator 9322+is designed and made in the UK, the Northeast factory making about a million face masks every year.
A few days later, another aid flight arrived.
On October 14, the Deputy head of the British Joint Inter Agency Task Force, Brigadier Steven McMahon CBE, Minister of Defense the Honourable Major (Ret)Alfred Paolo Conteh and Lieutenant Colonel Abubakarr Sidique Bah, the Commanding Officer of the Engineering Regiment of the RSLAF, visited the by now well under construction treatment centre at Kerry Town, Waterloo, Western Rural District.
Reported in ‘Awareness Times’
Minister Paolo Conteh said the Kerry Town project was commenced by the Sierra Leone government but is now fully sponsored by the British Government and military personnel from both the RSLAF and the U.K. Military were on the site to provide support. He expressed gratitude to the U K Government for helping Sierra Leone in this fight as he acknowledged that more troops will soon arrive from the UK..
Minister Conteh said the centre will be a 100-bed Ebola facility and later be converted into a Multi-Purpose Medical Centre which will continue to serve the nation long after Ebola would have been eradicated.
The Defense Minister in his conclusion said that according to the engineers on the site, the centre will be completed by the 27th October 2014.
And ‘Awoko’, the Brigadier said;
The most important thing is for every Sierra Leonean to follow the strict prevention code laid down by the health authorities. but it is you the Sierra Leoneans that can eradicate the virus or prolong the time.
The Kerry Town site is being run by Save the Children UK with support from the British military, RSLAF and other NGO’s. This site will be joined by five others (Moyamba, Makeni, Port Loko, Hastings and a site Southeast of Freetown between Sussex and Tokeh) with a similar range of facilities, 80 beds for patients and 20 for infected health workers, these will be operated solely by UK medics.
Lt. Col. Abu Bakarr Sidique Bah is the CO of the RSLAF Engineers being supported by UK forces.
The deadline for all six sites to be complete is the 27th of October.
Heading the Joint Inter Agency Task Force is a civil servant from DfID, David Browne.
After completing their extensive preparations the lead elements of 22 Field Hospital departed the UK for Sierra Leone on the 17th of October
As the Army arrived, the Navy departed!
The Royal Navy website describes RFA Argus;
The principal role of RFA Argus is to serve as a Primary Casualty Receiving Ship (PCRS). She has a fully equipped 100-bed medical complex on board, which can be uniquely tailored to deliver cutting-edge treatment afloat.
RFA Argus is a stalwart of the RFA fleet, I had a look at her in the Atlantic Conveyor post from a few years ago, she has a fascinating history.
Contender Bezant was one of the many civilian ships utilised in support of the Task Force to retake the Falklands Islands after invasion by Argentina in 1982, used as an aircraft transport, ferrying helicopters and harriers on her deck.
Read more about STUFT at the fantastic site of Nick Messenger, click here
Following purchase by the MoD in 1985 for £13million she was converted to an aviation training ship at the shipyard of Harland & Wolff, Belfast, with the addition of extended accommodation, a flight deck, aircraft lifts and naval radar and communications suites. A Primary Casualty Receiving Facility was added before Argus was sent to participate in the 1991 Gulf War. Another role of RFA Argus is that of RORO vehicle transport with vehicles carried in the hangar and on the flight deck, a role she performed in support of United Nations operations in the former Yugoslavia.
During the 2003 invasion of Iraq, Argus was again present in the Persian Gulf as an offshore hospital for coalition troops, earning the nickname “BUPA Baghdad”.
In 2010 she had a £37m refit
Although many might think the 100 bed medical complex will be used for treating Ebola patients, this is not the case, the medical facilities will only be used for injuries and non Ebola illness. If any personnel contract Ebola they will be treated ashore.
The ship provide transport and storage facilities, supporting 3 Merlin HM2 Helicopters, 2 LCVP Mk5 landing craft, various items of load handling plant, 55 vehicles and a couple of Offshore Raiding Craft. 300 pallets of stores have also been loaded.
Deployment of up to 6 months is anticipated and the various news releases have stressed the stringent infection control procedures that will be implemented.
No deployment of this kind would be complete without the obligatory ISO container!
RFA Argus is now on her way.
The 750 or so personnel will conduct a number of activities, #logistics support, force protection, medical training and medical support for the NGO’s and Sierra Leone Government.
Personnel from Royal Scots Borderers 1st Battalion (1 Scots) form part of the force, joining Royal Marines, Royal Engineers, Royal Logistic Corps, Royal Army Medical Corps, , Royal Signals, Royal Electrical Mechanical Engineers, Royal Navy, Fleet Air Arm, Royal Fleet Auxiliary, DFiD civil servants, personnel from the National Health Service and various NGO’s.
It is a multi-organisation deployment.
There is an obvious need for force protection and evacuation measures for deployed personnel, if the pandemic leads to the break down of law and order or ‘mob rules’ apply the British personnel could find themselves under threat.
Whilst the British Armed Forces, NGO’s and DFiD are getting stuck in, the militaries of the EU are currently reviewing how they can help, that’s comforting to know!
In the finest traditions of the armed services, those involved will do a great job.
I think all that is left is good luck and come home safe.