Ebola: Obama autorisiert Einberufung von Reservisten und Nationalgarde

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Auf der Startseite des Internetauftritts des Weißen Hauses steht derzeit (am heutigen Donnerstag) eine Krise so sehr im Mittelpunkt, dass selbst über ein Foto mit US-Präsident Barack Obama ein Hinweis gelegt wird: Der Todeszug des Ebola-Virus ist für die USA derzeit offensichtlich das größte internationale wie innenpolitische Problem. Obama ging sogar so weit, am Donnerstagnachmittag (Ortszeit) per Erlass die Einberufung von Reservisten und der Nationalgarde für den Einsatz gegen Ebola in Westafrika anzuordnen:

ORDERING THE SELECTED RESERVE AND CERTAIN INDIVIDUAL READY RESERVE MEMBERS OF THE ARMED FORCES TO ACTIVE DUTY

By the authority vested in me as President by the Constitution and the laws of the United States of America, including sections 121 and 12304 of title 10, United States Code, I hereby determine that it is necessary to augment the active Armed Forces of the United States for the effective conduct of Operation United Assistance, which is providing support to civilian-led humanitarian assistance and consequence management support related to the Ebola virus disease outbreak in West Africa.

In furtherance of this operation, under the stated authority, I hereby authorize the Secretary of Defense, and the Secretary of Homeland Security with respect to the Coast Guard when it is not operating as a service in the Navy, under their respective jurisdictions, to order to active duty any units, and any individual members not assigned to a unit organized to serve as a unit of the Selected Reserve, or any member in the Individual Ready Reserve mobilization category and designated as essential under regulations prescribed by the Secretary concerned, and to terminate the service of those units and members ordered to active duty.

Nun sind die USA durch – teilweise ungeklärte – Ebola-Infektionen auch von medizinischem Personal im eigenen Land besonders betroffen und, so scheint es, teilweise am Rande der Panik. Allerdings nicht grundlos, wie die aktuellen Warnungen der Weltgesundheitsorganisation zeigen. Und die USA tun (unter anderem) das, was sie am schnellsten können: Militär in Marsch setzen. Bereits jetzt sind rund 4.000 US-Soldaten in Westafrika im Einsatz oder auf dem Weg dorthin, um Behandlungseinrichtungen aufzubauen oder Personal zu trainieren.

Großbritannien setzte ebenfalls Militär in Marsch, für die in London Operation Gritrock getaufte Mission. In Sierra Leona kam Sanitätspersonal der britischen Streitkräfte an:

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Ein Blick nach Deutschland: Bundeswehr und Rotes Kreuz erkunden derzeit noch die Lage; eine Luftbrücke ist praktisch eingerichtet (und leider ist das letzte Lageupdate Ebola auf der Webseite des Sanitätsdienstes vom 9. Oktober). Ein Vorbereitungskurs für Westafrika wurde gestartet;  in der nächsten Woche soll die Ausbildung der freiwilligen Helfer beginnen. Inzwischen gibt es wohl Klarheit über Transportisolatoren, mit denen infizierte Helfer nach Deutschland zurückgeholt werden sollen.

Ergänzend dazu von der New York Times: W.H.O. to Focus on Containing Ebola in Africa

Nachtrag fürs Archiv: Wenn ich diese Presskonferenz des Pentagon nachlese, scheint mir für die US-Truppen auch nicht so ganz klar, ob sie bei einer Infektion aus Westafrika evakuiert werden… (die entsprechende Passage habe ich hervorgehoben):

Department of Defense Press Briefing on Pentagon’s Response to the Ebola Outbreak
Presenters: Major General Darryl Williams, Joint Task Force Commander; Debra Malac, U.S. Ambassador to Liberia; Ben Hemingway, U.S. Agency for International Development Deputy Disaster Assistance Response Team Director
October 16, 2014

STAFF: This will be an on-the-record briefing. Obviously, they — nobody can see each other, so please, Number one, speak up a little bit. Number two, name and who you’re with so that they can get a visual. I’ve already described the set up here to them on the phone, so they’ve got a mental picture, hopefully. And with that, Ambassador Malac, can you hear us?

AMBASSADOR MALAC: Can, good afternoon.

STAFF: Ma’am, welcome. And I think we have a few opening comments, so over to — over to Liberia.

MAJOR GENERAL DARRYL WILLIAMS: Well, thanks, ladies and gentlemen.

I am Major General Darryl Williams and here along with me are the U.S. Ambassador to Liberia, Deborah Malac, and the Deputy DART team lead, Ben Hemingway from USAID.

I have a brief statement I would like to give before the monitor opens the floor for questions.

Joint Forces Command United Assistance and U.S. Africa Command supporting a comprehensive U.S. government effort led by the U.S. Agency of International Development here and to fight the outbreak of Ebola virus in Liberia.

AFRICOM established a joint force command headquarters to facilitate the coordination of all U.S. military forces support to USAID and other U.S. and international agencies in stopping the Ebola outbreak. We are currently overseeing the establishment of logistics nodes, the Monrovia medical unit, which is a 25 bed hospital, and up to one, seven, 17 Ebola Treatment Units, as well as the training of health care providers and other USAID requests, as approved by the secretary of defense.

We’ve made great progress since the president announced our participation in the whole of government effort here. The USAID-led mission here is gaining momentum every single day. We have added two military labs, and I can talk about that later if you want more information on those, to the already existent labs that are here, and they’re making a tremendous difference every single day. They are literally saving lives.

We’ve completed the vertical construction of the Monrovia medical unit, the 25 bed hospital for the treatment of health care workers. Soon, it will be staffed by medical professionals from the U.S. Public Health Service Commission Corps and fully operational.

We are moving forward on all fronts. Our service members are excited to be in here helping and working hard with their Liberian counterparts to help end this outbreak. This is not an easy or simple mission, but working with the Liberians under USAID and with the leadership of Ambassador Malac, I believe we are starting to make real progress.

At this time, I would be happy to take your questions.

STAFF: Thank you sir. Per our custom, we’ll start with our senior wire reporter, Tony Capaccio from Bloomberg.

Q: Sir, I had two questions. One, what provisions are being made in case U.S. troops are infected with the virus. Have designated — have hospitals been designated for their care? What’s — what is in place right now for that unfortunate — if that happens?

MAJ. GEN. WILLIAMS: Yeah, so we have protocols in place with the augment of both increased medical capability, we have the Special-Purpose MAGTF, which will be critical in helping soldiers, sailors, airmen, marines, civilians and others get out of here in a non-Ebola event, which would be very critical.

Now, if someone were to come through and unfortunately contract the disease, we have quarantine protocols that we would enact, OK? So, they would be quarantined and we would put on the appropriate gear to take care and stabilize that patient until we could arrange for transportation to move them back to a facility. That would not be done, here.

Q: Three, do you see any need for a contracting on private transport companies for aeromedical evacuation or shipping roll-on, roll-off containers to supplement the military’s logistics equipment at this point?

MAJ. GEN. WILLIAMS: Yeah, well they’re already — so, there already was a very vibrant and robust logistical architecture here. We are finding that out. One of my concerns — one of our concerns we — when we came in here was does the country of Liberia have the contracting capacity? And we are very happy with both the local contracting capacity that’s here, and we’re using a lot of that, leveraging that.

What am I talking about? Gravel, wood, nails, those sorts of things are critical to building these Ebola Treatment Units. So, we are bringing some capacity in, but most of that is found here in the local economy that were used to build our various projects.

Q: Spending millions of dollars of defense dollars or state dollars on private U.S. or foreign contractors coming in and providing transportation assistance or construction assistance?

MAJ. GEN. WILLIAMS: Say that again, please?

Q: You do or do not anticipate spending millions of dollars of U.S. money for private contractors from the United States or from Europe to complement your effort?

MAJ. GEN. WILLIAMS: We have a continuum of contractors here, as I mentioned. And we are using both — leveraging both the local contractors and also contractors from other places, as you just mentioned. So, it’s a continuum of contracts. There is no sole source that we’re using in terms of leveraging the contracting capability in this great country.

STAFF: Next question will be from CNN.

Q: Barbara Starr from CNN.

General Williams, go back on one thing, and then I have a couple of questions. On the evacuation capability of the special purpose MAGTF, are you saying that people who need to be evacuated because they may have been determined to be at risk are showing no symptoms or may have fallen into a risk category could be evacuated by the marines? That’s my first question.

MAJ. GEN. WILLIAMS: So, thanks ma’am. We would have. There would be multiple ways that we could evacuate. That could be possibly be one way that we would evacuate folks that had no known exposure or low risk and would not have Ebola — exhibit Ebola-like symptoms.

We measure, while we’re here — twice a day, are monitoring as required by the recent guidance that was put out while we’re here in Liberia. I — yesterday, I had my temperature taken, I think, eight times, before I got on and off aircraft, before I went in and out of the embassy, before I went out of my place where I’m staying.

As long as you exercise basic sanitation and cleanliness sort of protocols using the chlorine wash on your hands and your feet, get your temperature taken, limiting the exposure, the — no handshaking, those sorts of protocols, I think the risk is relatively low.

I’m not an epidemiologist, but it’s been shown that this disease is most manifest when handling bodily fluids — blood, other sorts of fluids, and there is no plan right now for U.S. soldiers, sailors, airmen and Marines to do that.

Now, the exception is the mobile labs that were here, and they are triple-protective.

The ambassador and myself went up to Bong County a day or two ago, and the mobile labs, the two that are here now — there are four more coming, one in Bong County, one in Island Clinic — the sailors that are in there performing the confirm-or-deny on the Ebola virus, they are wearing PPE, and they are testing for this virus.

The — the other soldiers, sailors, air, Marine are not coming into contact with specimens.

Q: What I guess I’m asking is if someone is asymptomatic at the moment but yet, you have determined either their PPE failed or for some reason, they came into contact, but they are currently asymptomatic, nonetheless, they need to be monitored and or evacuated out of the area, how are you getting them out, short of them being determined to have the virus?

MAJ. GEN. WILLIAMS: Yeah, so they — they currently would be quarantined and watched, and we would attend to them. The personnel that would attend to them would — would wear PPE.

And then they would be stabilized, and we would provide one of these contracting mechanisms that was mentioned earlier, would come in here and move them out to a medical facility.

Q: Very quickly, sir, given the fact that in the United States here over the last couple of days, the CDC guidelines seem to have potentially not worked as expected.

As you monitor that and you look at your own following of the CDC guidelines, are you looking — are any of you looking at changing anything or strengthening your own practices beyond the current state of the CDC guidelines?

MAJ. GEN. WILLIAMS: No, ma’am.

I’ll start, and offer the ambassador or Ben to — to weigh in on this, but I have great confidence in the CDC guidelines. I meet with the current lead here all the — daily, and — and I have great confidence and don’t plan on adjusting any of the current guidelines.

AMBASSADOR MALAC: This is Ambassador Malac. If I could just follow up on Major General Williams‘ comment related to the guidelines.

You know our staff here, which — our embassy has been open and operating in this Ebola environment for six months. We have been following very carefully the CDC guidance and advice from day one, and we have no — no need or feel any need to have to make a change or deviate from those guidelines that have been or very successful.

We have made sure that everyone on the staff, including our local employees, are well-versed in all of that information, and to this point, they are keeping us safe.

STAFF: Thank you, sir.

Q: Hi, General. This is Courtney Kube from NBC News.

I’m sorry, I’m still a little unclear on the procedures if some U.S. troops are exposed, not necessarily if they have Ebola, but if they’re exposed to it, especially if there’s a group of them.

The contracting mechanism that you mentioned, I’m assuming that’s a contracting flight that would then take them back to the United States. What medical facility or facilities have been identified? Would they go to a civilian facility or a military one?

And then since you brought up this Special-Purpose MAGTF, those Marines, I believe, will redeploy back to Moron.

Has there been agreement with the government there about procedures for when they get back, whether they want them quarantined or — considering they’re not going back to the United States immediately, is there any kind of agreement with the government?

MAJ. GEN. WILLIAMS: Well, I’ll start with the second one first.

I know that AFRICOM is currently working the procedures for those sorts of things. And we’re also working. As you know, the 101st, it will come on and take this mission and to its completion. General Volesky actually is en route this weekend, and we’ll change out next weekend — the following weekend.

And so we are also starting to work with — not just Spain, Moron, but also Italy and the other places where my current forces are coming from. We have folks that are here from Germany, from Italy, and all over. So, that’s being worked at higher levels to work those sorts of — to work those pieces.

And your first question again, ma’am?

Q: I’m still just a little unclear on the — the specific procedures for evacuating troops or specifically if there’s a group of troops that are exposed to Ebola, you know, when they’ll be quarantined in Liberia but then, if a contracted aircraft that brings them back to the U.S., I’m assuming. And where will they go? Military facility? Civilian?

MAJ. GEN. WILLIAMS: Well, I would start with that the ambassador just mentioned, there are non-government organizations, AID, CDC. I fell in — we fell in on a host of folks that have been living here for some time, and operating in this complex environment.

And so, if, god forbid, one of these soldiers, sailors, airmen, or marine contracted this disease, as I mention, they would be stabilized, they would be quarantined, we would go through the appropriate protocols. People would be attending to them in the appropriate PPE.

As of today, no one has shown those symptoms that I’ve had since I’ve been here. I’ve been here 30 days as of today. And so they would be quarantined and then we would synchronize and work those actions so they would go back to the appropriate medical facility.

Q: And has any U.S. military medical facility been identified as the one that would accept potential Ebola-exposed patients?

MAJ. GEN. WILLIAMS: Not to my knowledge, ma’am. I’d have to get back to you on that. I know that the joint surgeon, we’re in constant contact with not only the joint surgeon, but our own Army surgeon about the appropriate protocols.

I would envision that the — I’ve got a lot of time in Europe that Landstuhl would probably be activated, but I cannot comment on that fact. I know that here on the ground, I’m at the tactical level, my concerns would be about stabilizing the soldier, sailor, airman, or marine, making sure we use the appropriate PPE, and then we would work with the coordination and synchronization to get them to the appropriate medical facility, where they could get the treatment they needed.

Q: Thank you.

STAFF: You can go ahead, Kristina. Thanks.

Q: Hi, General. This is Kristina Wong from The Hill.

Some lawmakers back here are advocating for troops to directly treat Ebola patients. Does that idea have any merit, and do you foresee that happening in the future?

MAJ. GEN. WILLIAMS: That’s not currently in the Department of Defense portfolio to do that. As I mentioned, what we are currently adding and to help fill the gaps of USAID as the lead federal agency, are the mobile labs. That’s probably the closest it comes to the Ebola virus chain, as you will. We have two, three-man sailor teams that are, as I mentioned, Bong County and in Island Clinic who are making a big difference. They are handling specimens of — of people who have been inflicted with the Ebola virus.

And so, the medical treatment that you’re talking about, now currently we are not been asked to do it — the closest that comes to it is the public health command that I mentioned that’ll be in — that’ll be manning the 25 bed hospital. Those — the 65 doctor nurse team that will flow in here in the next week or so, and they will actually be involved in the care and feeding of health care workers who have been inflicted with the Ebola virus.

Q: So, that team of 65 doctors and nurses, are they U.S. personnel?

MAJ. GEN. WILLIAMS: Yes, ma’am. They are.

Q: And then lastly — secondly, progress on slowing the spread of Ebola, have you seen any progress in slowing the spread?

MAJ. GEN. WILLIAMS: So, not an epidemiologist, and if Ben wants to talk a little bit more about this. So, in the 30 days that I’ve been here, I’ve seen great momentum. What this requires, this disease requires a team of teams. The Department of Defense team, the Department of State team, the CDC, the U.N., the non-governmental organizations, Peace Corps, all those together are providing the momentum that we currently have.

I know I won’t speak for the ambassador, but she’ll tell you that you know, there has been some change, and a lot of the — a lot of the projections have been assuming no interventions, and a lot of interventions are happening on scale. AID has six streams that they track. And the ambassador runs a daily update.

And we get that progress of how we’re doing against it. And I will tell you that a lot of momentum has — is starting to occur, and I’m very optimistic about our ability as a team to get after this fight.

STAFF: Dan, we’ll go to you, then we’ll skip to this side of the room.

Q: If you could, again, maybe elaborate exactly on what you think the impact has been so far of your mission there on the overall effort to stem the outbreak and then, related to that, one of the explanations we heard at the beginning was that bringing in this logistical help of more NGOs and more organizations would be able to then move in, arrive, and help.

Are you seeing that? And perhaps USAID could — could address that.

MAJ. GEN. WILLIAMS: Yeah, and I’ll let them start that sir, thank you for your question.

BEN HEMINGWAY: Right. In line with the question regarding the trends, it’s difficult to make a concrete statement on the trends based on epidemiological data. When looking at trends, you have to look at it over several epidemiological weeks. And we’re constantly working to improve the surveillance on that data and monitoring any trends there.

What I can say is that the — the whole of government effort that the U.S. has brought has definitely been catalyzing in not only bringing the hope for improved efforts at breaking this chain of infection, but has really improved the — the momentum behind the international effort. We’ve worked with many international partners and in full support of the government of Liberia’s national strategy for the reduction of the Ebola outbreak.

And as mentioned, we’re putting together up to 17 Ebola Treatment Units, 65 community care centers. Two laboratories are already in place — four more on the way providing training for both local and international staff that will man these Ebola Treatment Centers, also, a significant logistics undertaking, both international and in-country.

We’ve also stood up 56 safe burial teams, which now provide access to safe burial country-wide. And this is in addition to all of our non-governmental organization partners, international organizations, and the efforts of the United Nations to support the efforts of the government of Liberia.

MAJ. GEN. WILLIAMS: The other thing I would add, sir, to kind of add on to what Ben’s excellent explanation, is you can’t — in this fight, leadership is very important. And the military is used to working in complex, ambiguous environments. And I will tell you here, the leadership expressed by the government of Liberia, the embassy here and others in AID and CDC cannot be underestimated.

I often hear from folks as the ambassador, myself, and AID confront this in the united front, that they say, „you give us hope.“ And the ambassador’s leadership, AID’s leadership, and now with the military here adding fuel to those gaps and trying to fill those unique, those gaps with our unique capabilities and logistics, as you mentioned, our engineering oversight.

The first week I was here, AFRICOM commander redirected a lot of the engineering effort from the east part of Africa over here. And there’s been C.B.s that have been providing over the shoulder expertise and stuff’s been going up in a vertical and horizontal way very, very quickly.

Lastly, I will talk about the Armed Forces of Liberia, who we have partnered with in what we’re calling Exercise United Shield. Brigadier General Ziankahn, who’s the commander of the Armed Forces of Liberia, we have partnered with them. And as you’ve been out with us yesterday, I invite you all to come out.

If he had been in Tubmanburg yesterday, and you would have seen all these sappers, these Liberian engineers up there constructing one of the ETUs, Ebola Treatment Units that Ben talked about. It was awesome. And so we have a lot of momentum started here.

Q: I have a follow up. Sorry sir. Sorry. Just a follow up.

Going back to your comments earlier about the hospital that’s now constructed. We had understood that U.S. personnel would be training health care workers. But it’s our — it sounds like what you’re saying is that U.S. personnel will be actually working with and treating health care workers there who may be in infected with the virus. Is that correct?

MAJ. GEN. WILLIAMS: Yeah. Both of your — both your comments are correct, sir.

So we have been asked by AID to help train the local — the healthcare workers here, up to 500 a week. We’ll do 200 here in and around Monrovia, and then we will have three teams that’ll be in and around the area.

So up to 500 healthcare workers we’ve been asked by AID to help in the overall training effort, not just — DOD is not shouldering all the training piece.

The U.S. Public Health Services are actually providing support to healthcare workers who — if they unfortunately are stricken with the disease. That’s what their purpose is, that 65. The 25-bed hospital, I hope we never have to put anybody in it, but that’s the purpose of the U.S. Public Health Services and — and their job here.

Q: 65 U.S. troops, sir?

AMBASSADOR MALAC: No.

MAJ. GEN. WILLIAMS: No. This is U.S. Public Health Services.

STAFF: We’ll go to Tony and then Jennifer and Maggie, and that’ll probably be it.

Q: Sir, Tony Bertuca from Inside the Pentagon.

My question goes to budgetary resources. The DOD portion of this is expected to last about six months.

I’m wondering if at this point, you could say that if that would be sufficient or if you expect to have to come back and get additional funding. I think it’s 725 million, the DOD portion right now?

MAJ. GEN. WILLIAMS: Yeah, so I believe we have the resources we need to fill the gaps that AID has asked us to fill with our unique capabilities, and that’s probably all I really want to say on that right now.

I know that the Department of Defense is committed to this, but we are one of many actors here. The ambassador talked about that.

There’ve been folks that have been pulling on this rope for some time, and we were brought in now to provide some — fill some of those unique gaps. You know, I’ll have — I’ll have helicopters here. I have some now. As I mentioned, the V-22s they’re providing.

What they’re principally doing — I think I didn’t answer this earlier, somebody asked me, but they are principally completing the fight surveys.

When you go to one Ebola treatment unit, you’ve been to one Ebola treatment unit. And so the ones in and around Monrovia are relatively flat. They’re in a built-up area. But when you go up north or southeast, you’re in the jungle.

And you have the AFL that’s helping us clear the sites for these. They’re in there with machetes hacking down the jungle, sided by the local — the local officials there.

So we’re not just coming in and dumping these units where we want; we’re working with the community and the districts, we’re working with the government of Liberia to site these where they need to be, and most importantly, they’re sited where the government of Liberia and AID tells us where they need to be sited.

So I’m comfortable where we are right now with resources. We’ll see this through. I think the fact that we’re bringing in one of our divisions, the 101st Airborne Division — Gary Volesky, I’ve known a very long time — he already has about 40 folks on the ground.

We’re doing the left seat-right seat piece. If nothing else, the last 12, 13 years have taught us how to do that, and he’ll fit right in and nest within the ambassador and AID in terms of the construct and the leadership that’s already extent.

Q: Sir, it’s Jennifer Griffin from Fox News.

If I could ask all three of you, what are the biggest challenges, the most urgent challenges you’re facing right now, the biggest problems you’re facing?

And also, do you believe that the U.S. should halt flights from Liberia and the affected areas?

There are neighboring African countries that have closed the borders to people crossing from Liberia. Why do you not think it’s a good idea to halt flights from West Africa?

MAJ. GEN. WILLIAMS: Yes, ma’am. I’ll start it off and hand it — I’ll do the first part and hand the rest to the board.

Challenges for the Department of Defense, it rains a lot here, and the infrastructure is challenging, which is why I’m bringing in lift to use the vertical component of this great country.

So where we’ve been asked to build these Ebola treatment units is going to require us to get them and resource them with — by — by using the — the water, the air, and so my biggest challenge right now is working through the environment.

Now, the ambassador tells me — she’s lived here longer than any of us — that the season’s about to change, and so we’re about to go into — Gary Volesky will come into different conditions. It’s — it’s — that’s been the most — we — I wouldn’t say we underestimated, but I — I think we didn’t realize how wet it would be here, and that’s become somewhat of a challenge.

I’ll let the ambassador handle the other two.

AMBASSADOR MALAC: Major General Williams has outlined some of the sort of physical challenges.

On top of this, I would certainly emphasize the issue of very poor infrastructure, and that, you can interpret in many, many different ways — physical infrastructure, human infrastructure, financial infrastructure, if you will.

This is a, you know, very poor country that’s only 11 years removed from a long and devastating civil war that really destroyed everything.

Some of that rebuilding has happened, but when you now have an epidemic like this Ebola epidemic that is affecting all parts of a country, it’s very difficult to access many of the parts of the — of the country in order to find out exactly what the disease is doing in some of these remote areas.

So we have that overall challenge of understanding how we can communicate with all parts of the country, at what level we need to communicate our messaging to Liberians — it varies greatly — and the complex nature of this epidemic in an urban area like Monrovia, which has never been seen before.

So we’re really looking at two separate kinds of epidemic: what happens in — in Monrovia, in a crowded, urban area, and what happens in a rural environment where you have a population that has very low literacy, in some cases, that is quite cut off from the rest of the country.

So the challenges are many, but that said, we are making progress on overcoming those challenges. Fortunately, the weather will soon be one of our least — least of our challenges, but we will continue to confront this inability — difficulty in getting out to the other parts of the city — other parts of country.

As for the issue of whether or not borders should be closed, I think President Obama and others have been very clear all along. Isolating these countries is not the way to address the epidemic. We need to be able to get people and resources and supplies in.

And, in fact, it has been quite challenging over the last several months, because there have been a reduction in commercial flights, because there is a reduction in shipping that comes into the country. Very difficult to get things like food as well as supplies in that are critically needed in order to help address this epidemic.

Q: Thank you.

MR. HEMINGWAY: I think it’s been said about the — the various challenges that we face in this response, and it’s certainly a response unlike any we’ve ever undertaken before.

But based on the range of activities and the leadership that has been brought to this response, certainly in part by the U.S. government, we’re certainly seeing a more effective and more responsive international effort.

And the challenges — working in — working amongst all of these deficiencies that exist in the basic health system and just the lack of knowledge of how to battle this disease, the challenge is really maintaining an effective and dynamic response against an often unseen adversary.

Q: Hi. It’s Maggie Ybarra, Washington Times.

General, yesterday, you said that you were hoping that international partners would contribute protective equipment and other supplies to the Ebola mission, and you said that the ETUs required seven personal protective equipped pieces per bed, per day.

I’d like to know why you need help in that area. I’m wondering does this indicate like a lack, you know — lack of access to a certain amount of supplies or supplies are too expensive.

And the next question is just for all three of you. Germany wants to assist with the Ebola mission, but my understanding is that the country would be unable to transport its infected people back to Germany.

Australian politicians have also indicated the same thing that they’d be willing to help, but they don’t have a transport plan.

Would the U.S. consider providing transportation to the international partners in order to kind of facilitate the process, the international health process, and is that a conversation that’s ongoing at this point?

MR. HEMINGWAY: Sure, I’ll speak to the — the personal protective equipment piece.

When treating Ebola, the specification or requirements for PPE is of the highest importance. Many of the infections, particularly amongst healthcare workers, is actually when they are taking off and putting on the PPE.

So while there are a range of personal protective equipment items available throughout the world, it’s important that we have the exact specifications required to safely provide care to Ebola patients.

And there certainly is a lot of discussion around how to improve the pipeline and supply of these materials, and there’s an international working group amongst many interested organizations and nations to insure that pipeline stays robust and adequate for the response.

AMBASSADOR MALAC: And if I may, on the issue of medical evacuation, obviously, this is an issue — a topic of — of great discussion for the last several months, not just since the arrival of the U.S. military here, as we, together, have sought to encourage international healthcare responders to come in and help to fight this disease.

I would point out that, in fact, Germany is bringing — is going to take over the operation of one of the Ebola treatment units within the next two to three weeks. It will be a combination of the German Red Cross as well as German military medical personnel who will be working together.

In fact, Germany has received, already, to date, three EVD-positive patients that have come from Liberia or Sierra Leone for treatment, so they are, in fact — they do, in fact, have the capacity in Germany to treat these patients.

But the discussion about — we obviously need a more robust and more organized and coordinated process, so it’s very clear what will happen in the event that someone is in need of a evacuation as a result of Ebola.

This is an ongoing conversation at the Capitol level. I know my colleagues in Washington are — are quite engaged with a number of countries to determine how best to manage that type of a system.

STAFF: They have noticed our very own stars and stripes.

Q: Hi, General. Jon Harper with Stars and Stripes.

Do you anticipate that you’re going to need more troops as this effort goes on, including National Guard or Reserve?

And also, what kind of force protection measures are in place for U.S. troops over will in Liberia?

MAJ. GEN. WILLIAMS: Yeah. So as you know, the president announced the troop level that we would need over here, and so as you know, for any of these kinds of contingencies, the commander on the ground will make recommendations up or down — up the chain of command if he or she needed more resources to accomplish the mission as we support AID and the government of Liberia.

So I’m comfortable with the current — what the secretary of defense has approved in terms of the forces that will flow in here over the next — I guess I should’ve mentioned some time ago, we’re about 500 now, a little over 500, in the joint operational area.

And that includes Senegal. I didn’t mention earlier, but we have a staging base in Senegal, and the idea behind that is — is to give us more agility as we move into theater and increase our ability to rapidly resupply and bring soldiers, sailors, airmen, Marine and equipment into Monrovia, which is the center of gravity and where AID has asked us to focus, which is why the commander’s here. But we will also have some capacity at Senegal to enable the onward with movement.

The force protection is what I talked about. Were you talking about force protection in terms of the Ebola or other types — or — yes, other types of force protection?

Q: Including if, you know, someone infected with Ebola tried to, you know, approach U.S. troops or if there was some other, you know, domestic unrest for both of those, really.

MAJ. GEN. WILLIAMS: Yes, sir.

So on the higher end in terms of the force protection piece; I’ve worked very closely with the — the government of Liberia and the ambassador. I feel very comfortable with the current ROE that’s in place.

As the commander on the ground, we have certain authorities to protect American service folks — soldiers, sailors, airmen, Marine and or United States equipment — and those are in place now, approved by the ambassador, approved by the government of Liberia. That’s sort of the high end.

But as I mentioned earlier, this is a permissive — very permissive environment. Liberians like Americans, and we’re liking Liberians. The Americans already here told us that, and so this is not Afghanistan or Iraq.

So we have — depending on where you are in the country of Liberia, we have different modulated ROE in terms of that sort of force protection.

With respect to the Ebola piece, it’s discipline.

Everyday in the morning with my breakfast, I take a malaria pill. That’s my biggest concern.

We don’t shake hands. I wash my hands a lot, OK, with chlorine. We step on chlorine.

We don’t shake hands. We keep our distance.

And as I mentioned before, soldiers, sailors, airmen and Marine are not in contact with folks inflicted with the Ebola virus. They just are not — they are and are not going to be, besides the folks I mentioned, the U.S. Public Health Services, if, God forbid, one of the healthcare workers came in contact with that.

And so that’s our — that’s our force protection for the Ebola piece. We feel comfortable.

I will tell you, when I came in here 30 days ago and I was flying in, I was calling and you know, talking to all my CDC friends and my AID friends and trying to find out exactly the kind of environment that we’re going to be operating in.

But if you’re here, sir, there’s vitality here. This country is not hunkered down from this dreadful disease. As I drive around and fly around with the ambassador and others, there’s vitality here. Folks are getting about — getting about their daily lives and are — and are very, very resilient.

So, I would not say there’s no risk. But there is risk that can be tampered down if you take the appropriate discipline and use the protocols that established by CDC.

STAFF: That’s it for questions. Ambassador Malac or Ben Hemingway or General Williams, do you have any closing comments you want to leave us with?

AMBASSADOR MALAC: I would just like to say that you know, we are — we appreciate all the assistance that the U.S. military is bringing to our — to the fight here, and that we are altogether working very, very strongly and very, very well together to support the plan. And we are going to get on top of this, however long it takes. We hope it’s going to be faster and sooner than anybody would like, but we think it will happen. It’s just a question of when.

MR. HEMINGWAY: And I would just like to add to the ambassador’s comments that the Department of Defense, and there are more than just soldiers, sailors, airmen, marine. There are also civilians over here. I have some on my staff that are — that are doing a fantastic job. We’re motivated. We’re part of a greater team. And we’re here to fill the gaps as AID identifies for us with the — with the government of Liberia.

So, we’re very glad. It’s a — it’s a very noble mission. And we’re proud to do it with our teammates, here.

STAFF: Thank you very much. Thanks guys.

(Foto oben: Screenshot Webseite whitehouse.gov; unten: Staff Sergeant Tom Robinson/Crown Copyright/MoD News License)