Search The Archives

Friday, October 31, 2014



The following is a portion of the State Department Daily Briefing held on October 31, 2014.  From the onset of the briefing, questions were raised regarding the stance of Turkey specifically;  Turkey has been accused of being to "permeable" to "foreign-fighters" as well as being too demanding of their request for a "buffer zone."  The United States also is not agreeing to Turkey's request to make direct attacks on the Assad regime, and non-ISIS related targets.  This is causing some stressors on the relationship and coalition between the U.S. and Turkey, although on-the-record, the State Department is stating that relations are strong and no contentions exists.  

France is the other country that appears to be falling out of line with the U.S. on a few issues, not the least of which is the potential delivery of two warships to Russia.  Russia is expecting the delivery of the two ships as ordered, and from reports we have read, they are still being built, however, it is not clear whether or not France will go through with the delivery of them as planned.  France also seems to be aligning itself more with Turkey's stance regarding Syria / Assad, at least behind-the-scenes.  Time will tell how this plays out.  in the meantime, here is the section of the briefing we found to indicate some wavering of alliances:

QUESTION: Thank you. I saw right before we came out the statement about executions in Anbar and wanted to talk a little bit about ISIL, both in Iraq and in Syria. One, what was your reaction to the new reports about the foreign fighter flow coming into Syria and Iraq, that the airstrikes have not seemed to stop these – this flow? And then also, I’m wondering if you saw the reports that some of the Peshmerga who went into Kobani over the last day or two have come out, and they’re saying that Turkey isn’t supporting them – if you have a reaction to that.

MS. PSAKI: Sure. Let me take the first one. As you know, cracking down on foreign fighters is one of the most important components of our effort to degrade and defeat ISIL. It’s one of the five elements of the coalition and something that we are working with every member of the coalition on. Over the past year, the Department of State has led interagency delegations to Western Europe, the Balkans, North Africa, and the Gulf to press for greater cooperation on – both bilaterally and regionally – on information sharing, border security, law enforcement, capacity building, and countering violent extremism. This engagement has directly resulted in steps such as stronger counterterrorism laws and arrests through the Balkans region, increased security cooperation in North Africa, terrorist financing reforms in the Gulf, and closer cooperations with Western European counterparts.

But we know that this is a long-term effort. Obviously, there are new laws and new steps that have put in place, but it’s going to continue to take some time. It’s positive that a number of countries in the region have taken steps to put new laws on the books, to take additional steps at their borders, and we’re going to continue to work with them, because we feel this is such a strong and important priority.

QUESTION: Do you have any explanation for why it’s starting to ramp up again now? There is some linkage to the airstrikes, the point being that the airstrikes hadn’t stopped this. I’m wondering if the airstrikes may have actually caused – been kind of a rallying cry for more to go, if there’s any analysis on that.

MS. PSAKI: I don’t think that’s our analysis. And I don’t think, as far as I read the story, that’s what the story said, but that’s not our analysis. Obviously, what I was getting at here is that there has been additional steps and additional actions by countries in the region to do more to crack down on foreign fighters. And we know that there have been – there has been a history where that has not been the case. That’s a positive step. Does that mean it’s resolved? Obviously, it’s not resolved. But we don’t have a new assessment of the numbers. I expect that’s something we may have soon.

QUESTION: Just to follow up on Lara’s question on the foreign fighters, you know the majority of these fighters come through Turkey. Why do you think the Turks are not really cracking down on foreign fighters? They have always – I mean, this is not something that has happened overnight. This is something chronic. It’s been going on for three and a half years.

MS. PSAKI: Well, Said, I’m not sure there’s evidence – or factual evidence to back that specifically up. I will say that this is one of the topics of discussion that the Secretary has had with his Turkish counterparts, that General Allen and Ambassador McGurk has discussed with them. Turkey has taken additional steps to crack down on foreign fighters. They have made a number of arrests over the course of the last several months. Is there more that needs to be done? Absolutely there’s more that needs to be done. And that’s part of the discussion that we’ll continue to have.

QUESTION: Do you think that Turkey has been looking the other way while these foreign fighters are going in?

MS. PSAKI: I think the fact that they have taken additional steps recently is evidence that they’re beginning to do more.

QUESTION: Like what? What are these steps?

MS. PSAKI: They’ve put laws on the books. They’ve made some arrests. They’ve done more on their borders.

QUESTION: But the border remains quite porous, in fact. And in fact, a lot of people go through – slip through that border.

MS. PSAKI: Well, there – I just said there are additional steps they’ve taken. I pointed you to those. And obviously there’s more that needs to be done.

QUESTION: Do you believe that Turkey has its own agenda in this scheme, in this big – in the scheme of things, I should say?

MS. PSAKI: We continue to believe that Turkey is not just a NATO ally, but they’re an important partner in this coalition. They’ve taken a range of steps. We’ll continue to discuss with them what more they can do.

QUESTION: Can you speak to my --
MS. PSAKI: Oh, sorry. What was your second question again?
QUESTION: -- second question about Kobani? It was about the Peshmerga fighters who went into Kobani and who have come out. They’re saying that Turkey isn’t supporting them.

MS. PSAKI: Well, I know that there have been ongoing discussions on the ground between – that involve Turkey, of course, about moving the Peshmerga through. I remind you that Turkey is the one – is the country that said that they would be comfortable with having them come through, and they’ve actively talked about facilitating that. As – I think our last assessment of this – sorry, let me just pull this up. One moment.

QUESTION: Do you have any understanding of why – what’s your understanding of why the Peshmerga have come back out?

MS. PSAKI: I don’t have an independent analysis for you. I think we’ve seen that there has been some progress over the past couple of days in terms of who’s traveling in and out. I would point you to them for more specifics on that.
Do we have any more on this topic?
MS. PSAKI: Go ahead.

QUESTION: The French president has said today that he supports the conditions that the Turkish President Erdogan puts to join the coalition. How do you view this statement?

MS. PSAKI: I – can you give a little more context for what he means specifically by that?
QUESTION: We know that the Turkish president asked for the creation of a buffer zone and --
MS. PSAKI: And did the French president say specifically that he wants a buffer zone?
QUESTION: He said that he supports the conditions --
MS. PSAKI: And he said that in the past, too. I’m not sure that’s new.
QUESTION: No, he said it today, with the --
MS. PSAKI: Sure. I know, but I’m just getting that – the fact that France has said that they would support that in the past.
QUESTION: But he said that in the --

MS. PSAKI: Our position hasn’t changed on that. Turkey and France are important partners in the coalition. We continue to discuss with them, as we do with all of our partners, what ideas they may have about how to address the threat of ISIL. That’s an ongoing discussion.

QUESTION: But you disagree with the both of them?

MS. PSAKI: I think you’re familiar with our position.

QUESTION: But the conditions also that Turkey put down calls also for the removal of Assad and actually targeting Syrian forces and air assets, or air defense assets, and so on. So it’s a whole – it’s a package deal. It’s not just one thing.

MS. PSAKI: Well, Said, I think I’d point to the fact that Turkey has already made a range of contributions in all of the lines of effort. The United States and Turkey have a shared interest in defeating ISIL, seeing a political transition in Syria, and bringing stability to Iraq. Turkey also plays an important role in supporting international peace in many parts of the world. We’re working with them on all those objectives. Obviously, we don’t agree on every component, but they remain an important partner and we have the same – many of the same objectives we want to achieve.
Go ahead in the back.

QUESTION: Yes, please. Regarding the foreign fighters in ISIL, from your answer it’s not clear enough that – are you – are you agreeing or not agreeing with what was mentioned today in The Washington Post that their number is increasing or not? I mean, this is like a reality or just news story?

MS. PSAKI: Well, I don’t have an assessment from the United States Government on numbers. We’ve given numbers in the past that obviously comes out of other agencies. What I was pointing to is the fact that there are a range of steps that we have worked on diplomatically with a number of these countries on cracking down on foreign fighters, whether it’s putting new laws on the books, whether it’s doing more to crack down on borders. That’s one of the primary topics of discussion as it relates to the coalition.

QUESTION: The reason that I’m asking because at the beginning of the year it was mentioned the number of around five or six thousand, and then by July it reached more than 15,000 people from 80 countries. And when you say additional steps were taken by countries who are really concerned about or they have – they are concerned about the foreign fighters, do you have any assessment of these additional steps block some people from entering there, or it’s just like additional steps on the paper?

MS. PSAKI: Well, one, I’d say first on your first part, we have talked before in the past publicly about our assessment that ISIL can muster between 20,000 and 31,500 fighters across Iraq and Syria. That’s based on a review of all intelligence reports from May to August. And we saw an increase over the previous assessment, which is consistent with what we’ve been saying, which is that they grew in strength and numbers over the course of the early period of this year. We’ve seen specific impacts and countries – we’re working on an Iraq first strategy, which is something we’ve consistently talked about. We’ve seen the Iraqi Security Forces strengthen in some areas. We’ve seen efforts to try to take back some parts of territories. But this is going to be a long process, so I just don’t have a new assessment for you.

QUESTION: The other thing which is like always when this story or this issue is raised is based on the – one of the front line or the lines that you are fighting, which is propaganda war or what we can say deviating people from being misled by the ISIL message. Do you still believe there is a link between these two thing, I mean that the war of the – let’s say the war of ideas has to be done in order to stop these people from going there?

MS. PSAKI: Absolutely. The question of what is attracting individuals to join ISIL, to travel across borders is one that is key to us addressing the threat. And that’s why we’ve spent time and energy and the – of high-level State Department officials, including Under Secretary Stengel, to try to coordinate efforts to combat that.

QUESTION: I’m not trying to make the assessment of what you are doing of war of ideas, but generally people are linking between the increasing of the number and the Administration or generally the coalition failure in doing this war, I mean, properly or efficiently. Do you agree with that assessment?

MS. PSAKI: I would not. I think that there is a recognition that more needs to be done to take on ISIL messaging and that they have been effective in using online tools to recruit and to provide often misleading information out there. This is something – it’s not that the United States is the sole – will not be the sole owner of this. We will work with many countries in the region who have more impactful voices in the region to do that.



This undated photo shows US Marine Sgt. Andrew Tahmooressi.
U.S. Marine Sgt. Andrew Tahmooressi, jailed more than 200 days in Mexico, was freed by a  judge Friday and immediately returned to the U.S., his family said.
Tahmooressi, 26, who served two tours of duty in Afghanistan, had been held since March 31, when he said he mistakenly crossed into Mexico with three legally-purchased and registered guns in his truck.
A court-appointed psychiatrist confirmed that Tahmooressi has Post-Traumatic Stress Disorder.
Family spokesman Jonathan Franks said the judge released him from the Tijuana jail without making a determination on the charge against him.
His family released a statement Friday night saying, "It is with an overwhelming and humbling feeling of relief that we confirm that Andrew was released today after spending 214 days in a Mexican jail. He is back on American soil and will shortly resume treatment for both his pre-existing combat related PTSD and the residual effects of months of incarceration – which has taken a toll on him far worse than his two tours in Afghanistan."
The Florida man said he got lost on a California freeway ramp that sent him across the border with no way to turn back. His long detention brought calls for his freedom from U.S. politicians, veterans groups and social media campaigns.
In Mexico, possession of weapons restricted for use by the Army is a federal crime, and the country has been tightening up its border checks to stop the flow of US weapons that have been used by drug cartels.
Tahmooressi reportedly had three weapons, all registered in the U.S., including a .45 caliber pistol, a 12-gauge shotgun and an AR-15 rifle.
Tahmooressi’s lawyers have maintained the weapons in the truck were there because he had recently moved from Florida to San Diego, and had all of his possessions, including the legally-purchased weapons, in his vehicle when he was stopped at the border.
Members of Congress were quick to react to the news of the release.
Rep. Ed Royce, R-Calif, chairman of the House Foreign Affairs Committee, immediately issued a statement saying, “I am elated that Sgt. Tahmooressi has been ordered released from jail in Mexico. This is great, but overdue, news. I am pleased that both Attorney General Jesús Murillo Karam and the judge on the case recognize that Sgt. Tahmooressi did not intend to violate Mexican law, and that his combat-related PTSD should be treated by specialists in the United States.”
In Florida, Democratic Rep. Debbie Wasserman Schultz, who represents the district where Tahmooressi’s’ mother, Jill, lives, said in a statement, “I am thrilled that Sergeant Tahmooressi has been released from prison in Mexico. We have waited long enough. As a mother, my heart is with Jill Tahmooressi tonight and I can only imagine the many emotions she must be experiencing, namely the relief in knowing her son is coming home and that they will soon be reunited without prison bars, without handlers and without unnecessary travel.”
Rep. Matt Salmon, R-Ariz., chairman of the Subcommittee on the Western Hemisphere, said, “I am truly overjoyed to hear the news that our Marine Sgt. Tahmooressi is finally coming home to America. During my last visit with Andrew in a Mexican prison, I told him the next time I saw him would be during his release to America; I am grateful that I will be able to keep that promise and be with him and (his mother) Mrs. Tahmooressi as he returns to the United States tonight.”


FORT KENT — A judge issued a new ruling Friday that removes some of the restrictions placed on Kaci Hickox, the nurse whom the state has been trying to quarantine since she returned to Maine this week after caring for Ebola patients in Sierra Leone.
In a news conference held outside her house at 2 p.m., Hickox said the favorable decision is just the beginning of an ongoing discussion about Ebola. She thanked the support she had gotten from her community, across Maine and internationally.

“I know as a global community, we can end Ebola,” she said.

Gov. Paul LePage issued a statement earlier saying the judge’s ruling is unfortunate, but that the state would abide by it.

“As governor, I have done everything I can to protect the health and safety of Mainers,” LePage said, reiterating his criticism of Hickox for not cooperating with restrictions placed on her by state officials.

Hickox did take issue with one statement by the state’s top health official, that her roommate had contracted Ebola. She said that was incorrect, but did not elaborate.
David Soley, a partner in the Maine law firm Bernstein Shur, which is representing Hickox, said Chief District Court Judge Charles LaVerdiere issued a moving oral decision that sets conditions for Hickox that she has intended to follow all along.

The new restrictions call for direct active monitoring of her condition, coordination of travel with public officials and a requirement that the state be alerted as soon as Hickox develops symptoms, Soley said. It does not prevent her from leaving her house or being in contact with other people.

In his ruling, the judge said Hickox and all health care workers fighting the disease deserve gratitude.

“We would not be here today unless (Hickox) generously, kindly and with compassion lent her skills to aid,comfort, and care for individuals stricken with a terrible disease,” LaVerdiere said in his decision.

He said Hickox should understand that “the court is fully aware of the misconceptions, misinformation, bad science and bad information being spread from shore to shore in our country with respect to Ebola. The court is fully aware that people are acting out of fear and that this fear is not entirely rational.”

“However, whether that fear is rational or not, it is present and it is real,” he said. “(Hickox’s) actions at this point, as a health care professional, need to demonstrate her full understanding of human nature and the real fear that exists. She should guide herself accordingly.”

LaVerdiere noted in his decision that it has critical implication for Hickox’s freedom “as guaranteed by the U.S. and Maine Constitutions as well as the public’s right to be protected from the potential severe harm posed by transmission of this devastating disease.”

He said he issued his temporary order Thursday maintaining the status quo so he could review in detail the arguments posed by both sides.

LaVerdiere said the restrictions he authorized are “necessary to protect other individuals from the dangers of infection.” The state was unable to prove that the limits it proposed on Hickox’s movements were necessary to prevent the spread of the disease.

If she begins to show symptoms, then she will need to be isolated, he said.

The judge’s decision was made public because Hickox waived her right to confidentiality.
A little more than an hour after the decision was issued, a Maine State Police trooper who had been stationed outside Hickox’s home left.

After a campaign stop in Yarmouth on Friday, LePage expressed disappointment with the judge’s ruling.

“We don’t know what we don’t know about Ebola,” LePage said. “And I’m concerned, but (the judge) ruled, and as a governor I took an oath to honor the rulings of the court and the laws, and I’m going to do that.”

LePage also took a jab at Hickox.

“This has been one of the disappointments so far, she has violated every promise she’s made so far, so I can’t trust her,” LePage said. “I don’t trust her. And I don’t trust that we know enough about this disease to be so callous.”

The new rules will be in place until a full hearing on the state’s petition, which is scheduled for Tuesday – Election Day.

“The judge issued a very beautiful and moving order in the case. I listened with tears in my eyes,” Soley said.

The judge on Thursday had issued a temporary order directing Hickox to follow a series of restrictions that mirrored recommendations from the U.S. Centers for Disease Control guidelines for patients with “some risk” of Ebola.

Hickox’s lawyers agreed on Thursday that she would abide by the restrictions and stay in her home until at least Friday morning or when the court issued another decision prior to the hearing. LaVerdiere made his subsequent ruling before noon Friday.
Hickox is pleased with the developments, Soley said.


Remarks by Ambassador Samantha Power, U.S. Permanent Representative to the United Nations, at the German Marshall Fund on the International Response to the Ebola Crisis 

Samantha Power
U.S. Permanent Representative to the United Nations 
Brussels, Belgium
October 30, 2014

On September 18th, six weeks ago today, the United Nations Security Council held its first-ever emergency meeting on a health crisis. A Liberian man named Jackson Naimah spoke to the Council via video link from Liberia. Jackson works for Médecins Sans Frontières, and is a team leader in one of MSF’s Ebola treatment centers in Monrovia. He told the Council that he had lost a niece and a cousin to the virus – both of them nurses infected at work. He said that, as he was speaking to us, sick people were outside the gates of the MSF clinic, begging to be let in and treated. MSF had to turn them away, because they had no more beds. Jackson said, “I feel that the future of my country is hanging in the balance. If the international community does not stand up, we will be wiped out.”

You all are familiar with the statistics of what Ebola has done to Liberia, Guinea, and Sierra Leone. More 10,000 people infected. More than 5,000 people killed, nearly 250 of them health professionals. More than 4,000 children orphaned.

Given these stark facts, I’m especially grateful to you all for coming today. The size of the crowd here is a testament to the growing concern around the world about Ebola.

Having just returned from travelling (sic) to Guinea, Sierra Leone, and Liberia, I have two simple messages for you today. First, the international community is not yet doing enough to stem the tide of the epidemic, causing devastating heartbreak to countless families and allowing a global threat to metastasize. Second, based on what I saw this week, the contributions that have been made by the United States and many of the countries represented here today have begun to save lives and offer the first tangible signs that this virus can and will be beaten.

We stand at a historic juncture. We face the greatest public health crisis ever. And we each have the opportunity to work together in support of the brave and determined people of the region to bend the chilling curve of Ebola’s spread and to end the devastation and suffering that it has wrought. To beat this virus and to produce the seismic shift upon which the lives of an entire generation in West Africa depend, we each have to dig deeper, and we each must conquer the fears that this epidemic has generated.

First, the bad news: Everywhere we travelled in the three West African countries affected by Ebola, we saw or heard about alarming gaps in our collective response, and the overwhelming devastation Ebola continues to inflict on the communities who are often just getting back on their feet after years of conflict and repression.

Aid workers in Guinea told us that rural villages just a dozen kilometers away from where the outbreak began have still never heard of Ebola. Outside the capital, even basic supplies like buckets and chlorine are hard to find. Contact tracing teams – the local investigators who track the outbreak’s spread – often lack the money to buy fuel for their motorcycles, and they’re not paid their salaries on time. Burial teams that may have received some protective equipment don’t have enough to go around.

Across the region, in a matter of months, Ebola has reversed years of hard-earned development progress in the affected countries. Since the outbreak began, the number of births in Liberia attended by a medical professional has fallen by roughly 30%, and maternal mortality is rising fast. A new World Bank report concludes that if the response continues apace, the losses to Guinea, Liberia, and Sierra Leone will top some $359 million just by the end of this year and the effects of the isolation the countries are now facing could take years to counteract.

The health profession – never very substantial in the region – has been decimated. Doctors and nurses who didn’t have the proper training to stay safe have been killed in droves by the virus. As the historian Thucydides wrote of the plague in Athens: “They died themselves the most thickly, as they visited the sick the most often.” One victim was Dr. Sheik Umar Khan, age 39, a world-renowned epidemiologist known for reaching into his own pocket to buy medicine and food for his poor patients. He was one of more than 30 health professionals killed by Ebola who worked in the same hospital. Imagine.

A huge number of infections are caused by elaborate burial rituals that become deadly when a deceased person is covered in Ebola. As the epidemic spread these last months, infected bodies have been left to rot in the street for days, because families feared that neighbors would stigmatize them for having a relative die of Ebola, because the burial teams were so overwhelmed by the demand that they could not respond to all the calls to collect the bodies, because team members lacked protective gear required to safely remove remains, or simply because the burial workers didn’t have vehicles or the fuel they needed to power them.

Notwithstanding these grim facts, some in the international community have not yet shouldered their share of the response burden. Some may tell themselves that we have waited too long, the virus has spread too far and too wide in the affected countries, and that it is safer to hang back and hope for the best. Others who read news reports of other countries’ activities, are wrongly reassured by the belief that others – whether NGOs, a handful of wealthy governments, or pharmaceutical companies – will do the job.

NGOs are already giving their all to this response. Of the dozens of NGO representatives I met on my trip, every single one was drawing upon his or her expertise to help with the Ebola response, from the education program officer now providing psychological treatment for children orphaned by the virus; to the media trainers who used to work on other things now collaborating with local radio stations to share Ebola survivor stories to try to deal with the stigma. Were it not for the efforts of these organizations, the outbreak would be much, much worse. But they are maxed out. They cannot fill all the remaining gaps without more support.

Of course, certain governments have a greater capacity to contribute than others, and that capacity brings with it a greater responsibility. President Obama fully understands this. Under his leadership, the United States has already provided more than $360 million to fight the outbreak in West Africa, and announced our intention to devote more than $1 billion to the whole-of-government Ebola response effort. We have deployed more than 250 civilian, medical, healthcare, and disaster response experts from multiple U.S. government departments and agencies. We’re committed to sending as many as 3,200 U.S. military forces to the region, more than 1,000 of whom are already on the ground.

I was privileged to meet with some of these service members this week and I can tell you that they are already hard at work. These forces are supporting the U.S. effort to construct and support up to 17 Ebola Treatment Units, establish a regional training hub where we will train up to 500 local health care workers and providers each week, and they’re providing crucial airlift and logistic support to other responders. I also visited the U.S.-built hospital for foreign and Liberian healthcare workers and responders which will be operational early next month and staffed by the U.S. Public Health Service, whose officers are already on the ground training in other ETUs around Monrovia.

Six days ago, European Union members announced a campaign to rally 1 billion euros in support to pay for the Ebola response, including the construction of facilities to care for patients. Countries have already pledged some 600 million euros in support, a promising sign of the commitment of EU member states. EU members have also come together to offer critical medical, air, evacuation support to international health care workers who contract Ebola, a vital assurance to those working on the frontlines (sic) to end the outbreak that they will not be left behind. Other countries have stepped up in ways large and small. Having slayed the Ebola demon in its own country, the Nigerian government recently announced it would send some 600 health care workers to the affected countries. Cuba, a country of just 11 million people, has already sent over 250 health care workers, and 200 more are on the way.

This is a crisis that is so vast, with needs so great, with potential consequences so dire, that no country can afford to stand on the sidelines. A few are doing a lot. But a lot are doing very little, or nothing at all. It is well past time to join what is a historic, groundbreaking, lifesaving mission – a noble mission.

We need more doctors and more nurses. More beds and more treatment facilities. More personal protective equipment. More burial teams and more ambulances. More cell phones. More SIM cards. More motorbikes and trucks and helicopters. More plastic gloves, more bleach and more thermometers. And the list goes on and on.

And even if we are able to build a bed for every infected person, and even if we can eventually ensure every one of those individuals gets the quality care needed to have a fighting chance of survival, that still will not be enough. We need to move beyond treating the sick to preventing new infections – in the affected countries, in neighboring countries, and in nations around the world. We have been playing defense with Ebola. Now we also need to go on offense. To do that, we need more contact tracing teams, who can reach more communities with greater speed. We need more accurate, real-time data collection, which can be shared across borders; not only for tracking the virus’ spread, but also to anticipate and preempt its next moves. And we need more effective public awareness campaigns, hyper-targeted to the most marginalized populations, which are often the most vulnerable.

Every single one of these gaps must be filled. The longer we wait to fill them, the longer the virus will replicate and the more that it will kill. In addition to gaps, we have other concerns. There is a risk we will fall back on business-as-usual and process-heavy solutions, which locate decision-making in far-away capitals, rather than empowering people on the ground to adapt their tactics to what is happening day-to-day.

Too often, we have seen, the international community provides resources that cannot easily be re-purposed rather than providing resources that are flexible, and which governments and humanitarian groups can adapt to the evolving crisis on the ground. We tend to plot out static, long-term plans to respond to the outbreak, and then stick to them, rather than developing fluid structures that can move with the virus, a virus whose movement is difficult to predict.

There is a risk, too, that we will spend billions of dollars vanquishing the virus but leave behind little more than broken healthcare systems, fragile infrastructures, and the memory of a remarkable anti-Ebola surge that then receded. Instead, we must ensure that at every opportunity we help create and deepen local capacity through partnership with governments, with teachers, with local institutions and local NGOs. So my first point is that we need to do much, much more.

My second message, however, is one of profound hope. I did not go to Guinea, Sierra Leone, and Liberia expecting to find much cause for hope at this point. But today, the affected countries are, in fact, in a very different place than they were six weeks ago. I came away more convinced than ever that if we rally the right response, together, we can stop Ebola.

In Guinea, we saw the power of religious leaders coming together to use their pulpits not only to share religious doctrine, but also to share public health information. Under Grand Imam Camara’s leadership, the Imams of Guinea have clearly communicated that a safe burial can be consistent with a religious burial. In our meeting with the Grand Imam in Conakry’s Grand Mosque, he unequivocally told us that “religion cannot stop science.” The Grand Imam has asked the leaders of the 12,000 mosques across the country to amplify these messages and to encourage their congregations to cooperate with local and foreign health workers.

In Sierra Leone, we saw first-hand how a surge of international aid and coordinated leadership can produce dramatic results in just a matter of days. A week before we visited, President Koroma had set a goal to retrieve victims’ bodies and give them a dignified burial in Freetown within 24 hours of their being reported. This is a crucial way to help slow Ebola’s spread, because traditional burial rituals have been a major cause of new infections.

On Tuesday, we visited Freetown’s new Ebola response call center. A robust public information campaign had spread the word among the city’s residents to call “117” when a person was suspected of having Ebola, or when a sick person had died. The message was getting through. On the wall of the call center was a map of Freetown. Sierra Leonean volunteers were using red pins to mark the locations where bodies had been reported. When a team retrieved and buried a body, the red pin was replaced with a blue one. A week earlier, the Sierra Leoneans told us, only 30% of bodies were being collected and buried safely within 24 hours. By the time we visited – in no small part due to the infusion of British military and civilian experts and other international partners – 98% of reported bodies were being buried within 24 hours. On the map, we saw a single red pin surrounded by a sea of blue pins. Swiftly modeling this in all of Sierra Leone’s 12 districts is critical.

In Liberia, the U.S. military forces deployed by President Obama are on the ground, working side-by-side with a team of some 50 experts from the Centers for Disease Control who have been deployed since March. USAID, the U.S. Public Health Service Commissioned Corps, and the Liberian government are part of this collective effort and their impact has been striking. We flew to Bong County, where we visited a remote U.S. Navy Ebola testing lab. Before the lab was up and running just two weeks ago, Liberians in the area waited at least five days for Ebola test results to come back from labs in Monrovia, and samples were often lost in transit. While people waited to hear results, they were often quarantined with other Ebola patients, increasing the risk that those who did not have the virus, who were waiting to get a test result back, would contract it while waiting. Now the results take three to five hours, freeing up beds and allowing those infected to be swiftly isolated so they do not pass along the infection and so they can begin treatment earlier, which can dramatically, of course, increase the rate of survival.

Armed with the knowledge of how to stop the spread of the virus, many Liberian communities are leading grassroots prevention efforts. One community in Montserrado County created a local committee to go house-to-house, separating infected individuals into buffered zones. Now people who have been exposed to the virus and are at risk of infection are isolated until 21 days pass. Their system draws on knowledge of older generations in the community, who had been taught a similar approach for containing smallpox decades earlier. As President Johnson Sirleaf said to me of the community-based response: “If communities work, it works.”

I mentioned Jackson Naimah and his powerful presentation at the UN Security Council in September. Well, I caught up with Jackson during my stop in Liberia and heard how the MSF clinic where he works no longer has to turn people away, because they now have enough beds. I asked him what kept him up at night and to my surprise, he told me that he was worried about how his society would deal with the lasting damage caused by Ebola after the epidemic had been brought to an end. A month ago, it wasn’t clear how we could bend the curve at all. And now, notwithstanding the very, very steep mountain yet to be climbed, some are able to imagine what their societies will look like after we not only bend the curve, but end the curve.

We know exactly what must be done to bring this outbreak under control. We just have to marshal the will to do it. And for anyone who doubts whether we can do it, consider the following:
There were more than 20 outbreaks of Ebola before this one – all of which began in underdeveloped countries. We contained every single one of them.

Nigeria and Senegal both registered cases during the current outbreak, with Nigeria identifying more than 20 cases in two distinct regions. Both countries were able to track down and contain those infected with the virus, and both have since been declared Ebola-free.

Individual towns and districts in the affected countries have also shown they can contain the virus. Leaders in the Télimélé district, in the northwest of Guinea, started preparing for Ebola shortly after the outbreak started. When the first cases surfaced there in May, the response was immediate. Community leaders, including local religious leaders and griots, disseminated a clear message that the only way a person could survive Ebola was to seek medical treatment immediately. Trusted local health workers fanned out to local communities to raise awareness about the virus and to instruct how to prevent infections. Médecins Sans Frontières set up an isolation wing in a local health center to treat the sick. And a 14-person contact tracing team traversed the district on motorbikes, tracking down some 250 people who had interacted with the infected people. Twenty-six infected individuals were tracked down, 16 of whom survived. The 62% survival rate in Télimélé’s outbreak was more than double the average in the rest of Guinea, because the community recognized Ebola early and knew how to respond. No new cases have been reported in the district since that first outbreak.
There is one grave threat that endangers our ability to build on the momentum of the last few weeks to actually stop the spread of this deadly disease. That grave threat is fear. Ebola has no greater friend than fear. The virus thrives on it.

We see fear in the affected countries. It is a fear that drove the residents of the West Point neighborhood of Monrovia to overrun a building housing Ebola victims. Members of the community had set aside space to move men and women with Ebola out of their homes, to protect their loved ones. But fearing the possibility that gathering the sick together in one space would make the virus more likely to spread, a mob drove out the patients and ransacked the facility.

It is fear that leads community members to stigmatize survivors of the virus, or the relatives of those who have died, or even the health professionals and other people aiding in the response. A 24-year-old survivor in Guinea told me she had lived three lives: her life before Ebola; her life in the hell of her infection; and her life since recovering. She said the stigma she has suffered since beating Ebola has made her current life the hardest. The stigma had so affected her that she said she was amazed by President Obama’s embrace of Nina Pham, the Texas nurse who was just cured of Ebola. When I went to give this young woman survivor a hug goodbye, though, she demurred and offered a fist bump. She did not seem yet to fully trust that she was cured or to recognize that she had done nothing wrong – only the virus had.

It is fear that has caused some of those who develop a fever or other symptoms not to come forward to seek help, putting themselves and the people around them at greater risk. Fear that going to seek care will make them sicker, or that seeking help will alienate them from their communities.
We also see fear in countries like my own, whose active participation is critically important to bringing this outbreak under control. All over the world, governments and our fellow citizens are afraid that if we send doctors or nurses or soldiers or engineers or other volunteers to the affected countries, we will put our own communities at risk.

The fear is understandable. Many of our countries, like those most affected, are dealing with Ebola for the first time, and it is a dangerous and terrifying virus.

Leaders have a responsibility to listen to the fears coming from the public, and to try to understand them. And we also have a profound responsibility to enact public policies that keep our own citizens safe. And as President Obama has repeatedly said, the best way to keep Americans safe – or citizens of any of our countries – is to stop the outbreak at its source.

When isolated incidents happen, they grab headlines, and the facts and the science tend to recede into the background. Two days before I left New York for Guinea, an American doctor named Craig Spencer – who had recently returned to New York after a tour helping those sickened from Ebola in Guinea – came down with the virus. My five-year-old son Declan begged me not to travel to what he called the place where there is “bola.” It took the calming words of my mother, a physician, to reassure my little boy that the virus is not airborne and that the protocols to stay safe are extremely reliable, as the presence of many, many thousands of visitors to West Africa who have not contracted the virus attests.

We cannot eradicate fear altogether. But we can educate ourselves and our communities about when fears are legitimate, and when they are unfounded or counterproductive. Local community and religious leaders can help provide a bridge of trust between humanitarian workers and the villages they come to help. Public campaigns can inform communities that Ebola survivors pose no risk to their neighbors – as President Obama has done with his hug of Nurse Pham. Leaders can send a clear and consistent message to their citizens that the best way to beat Ebola is to seek medical help immediately, as Islamic clerics in Guinea have been doing in their sermons.

We have to bring the same empirical approach and measured judgment to evaluating risk in our own communities and countries. So while statistics on infections in West Africa are frightening, we must educate our own societies about the breaches in safety measures that gave rise to these infections, as well as to the vast differences between the capacity and preparedness of our health systems and those in West Africa.

In the United States, we are doing that by reminding the public that only two people so far have contracted Ebola on our soil: two nurses who treated a patient who contracted it in West Africa. And today, both of those nurses are disease-free. Of the seven Americans treated for Ebola so far, all were detected early and have survived. So has the nurse who was infected treating a patient in Spain.
Prior to the outbreak, Liberia had approximately 50 doctors for the entire country of 4.3 million people. That’s around one doctor for every 100,000 people. Sierra Leone had two doctors for every 100,000 people. The United Kingdom, by contrast, has 279 doctors per 100,000 people. France has 318. Germany: 380. The hospital where the American doctor infected with Ebola is being treated in New York has 1,200 physicians on staff – more than 24 times the number of doctors in all of pre-Ebola Liberia.

These numbers not only tell us why we are much more prepared to prevent outbreaks in the United States, the United Kingdom, France, Germany, Belgium, and so many other countries. They also underscore why it is so important that the volunteer health care workers brave and altruistic enough to serve in West Africa be encouraged to go and be shown respect upon return.

But instead of knocking down the obstacles standing in the way of their service, some are choosing to put them up. These kinds of restrictions could dissuade hundreds, if not thousands, of skilled volunteers from helping stop Ebola’s spread – which is in the national interest of every one of our countries. And they place an additional burden on people who, at significant risk to themselves, volunteer to help sick people in countries that are not their own, far away from their own families and loved ones. These volunteers are heroes to the people they help and they are heroes to our own countries. They should be treated like heroes when they return.

After this trip, I understand the fear on a personal level, as well. Meeting with Ebola survivors or health professionals who had treated patients, I’d sometimes hear that little voice in the back of my head asking: What if the science is wrong? We all hear those voices of fear in our heads. That is what makes us human. The challenge, especially for leaders, is not to let them rule us. Like all of our fears, we must confront them. And when science warrants it, when the facts warrant it, we must overcome them. The science is right and the risks can be managed. As the late, great, UN diplomat and humanitarian Sergio Vieira de Mello used to say, “Fear is a bad advisor.”

In moments of fear, we must force ourselves to think of the men, women, and children on the front lines of this conflict – whether they are the volunteers from our countries, or the countless Guineans, Sierra Leoneans, and Liberians fighting for their lives, their families and their future – our shared future. As a young man from Sierra Leone told me, when I asked why he had volunteered to work in an Ebola treatment unit, he said, “If we leave our brothers and sisters to die, who knows, it might be us next. It is a point of duty.”

That duty is a duty we all share. We must ask ourselves: twenty years from now, when we look back on this historic crossroads, will we want to say we left this fight to the people of the affected countries? Will we want to say we did not act because we thought others would win the fight without our help? Will we want to admit that fear held us back? If we will not want to give these answers when we are asked in twenty years – and make no mistake, we will all be asked – we have to do more.

We talk a great deal about the numbers with respect to the crisis: numbers of new infections, numbers of deaths, numbers of bodies collected. Let me close by telling you about what lies behind the numbers.

One family, six members: a father, a mother, an uncle, and three children. The father, Alexander James, was a health promotion officer with MSF in Liberia. His job was to travel around the country, teaching communities how to avoid infection, and what to do if they got sick.

First, on September 21st, Alexander’s wife became infected and died. They had been together for 23 years. He said, “She was the only one who understood me very well. I felt like I’d lost my whole memory.” Days later, Alexander’s brother, who had taken care of his wife, became infected and died, too. Then Alexander’s two younger daughters both died. Alexander said, “I was breaking in my mind.”

Out of six, there were only two: Alexander and his sixteen-year-old son, Kollie. Then Kollie became sick as well. Alexander brought him to a clinic. They were separated by a fence. Alexander went to speak to his son. They could not touch. I cannot tell you how many times I was told in my trip what an inhumane virus Ebola is; how, in cultures known for their warmth, it preys on the simplest acts of affection. An embrace. Holding hands. The wiping of tears from a child’s face. Ebola punishes us when we cannot repress these impulses. So, father Alexander was forced to speak across a fence to his son Kollie.

Alexander said, “Son, you’re the only hope I got. You have to take courage.”
His son responded, “Papa, I understand. I will do it. I will not die. I am going to survive and I will make you proud.”

From the other side of the fence, Kollie was given treatment and fought for his life, while his father waited. And then, slowly, he began to recover. As the days passed, he gained strength. And eventually, a test came back showing that he was Ebola free. He was allowed to walk out of the clinic and hug his father.

Kollie was the 1,000th person to be cured in an MSF clinic. A family of six, reduced to two and almost to one.

In The Plague, Albert Camus wrote, “It could be said that once the faintest stirring of hope became possible, the dominion of plague was ended.”

We have so many reasons to have hope in our capacity to curb Ebola’s devastating spread. We find hope in every survivor, like Kollie, who has fought the virus and won. We find hope in every volunteer in West Africa who, out of a sense of duty, is working to serve his or her country and community. We find hope in the brave doctors and nurses from our own countries, who – driven by a sense of common humanity and common security – leave behind their loved ones to help people from other nations in their time of greatest need. And we find hope in every person who survives, every family that is untouched by the disease, every community that successfully eliminates Ebola. We cannot let our fears stand in the way of these hopes.


October 31, 2014

Ambassador Samantha Power returns to the United States from her trip to Ebola-infected regions of West Africa and meetings in the EU earlier this week.  Ambassador Power met in Brussels, Belgium and delivered remarks which are presented at this LINK.

However, we want to share the images Amb. Power posted up on her Twitter account on 10/31/2014 as she returned to the US.  The images don't seem to coincide with the official stance of the CDC in terms of "personal protective" measures and equipment, and I will explain why below the images.

While many Americans are confused about what appropriate "Ebola Precautions" actually are, these images only reinforce that even those who are performing screenings don't have a firm grasp of what protective measures are necessary.  Let me explain:

  1. Notice in the first image, the gentleman in black is wearing gloves while taking Ambassador Power's temperature.  The use of gloves, while taking a non-invasive (forehead) temperature, is not necessary if we go along with the CDC guidelines.  REASON:  There is no need for actual contact with a person getting a forehead temperature reading.  According to the CDC, Ebola can ONLY be contracted by an open wound, or contact with infected bodily fluids.  The use of a thermal scanner / thermometer does not present a contact risk, as the person taking the temperature never touches the person getting scanned.  If there is no skin contact, then why would we need to wear Nitryl / Latex gloves?  If there is no risk of Ebola transmission without contact of a "Symptomatic" patient (i.e. a person who is visibly sick, WITH A FEVER, and the other symptoms of vomiting, diarrhea, headache, etc) then why is there a need for gloves on a non-invasive temperature scan?  RED FLAG #1.
  2. Notice on the first image, that the gentleman taking the forehead temperature scan is also wearing a "surgical" style mask.   This demonstrates an error in protocol or a misunderstanding of the current protocols because surgical style masks do not offer protection against airborne or droplets.  If the person taking Amb. Power's temperature was concerned about droplets or airborne transmission, then a NIOSH approved N95 Respirator is the MINIMUM level of mask required.  It appears in the second image, that the CBP officer doing the intake questions for Ms. Power is wearing an N95 particulate mask;  however, there shouldn't be a need for him to be wearing one, as Ebola, according to the CDC, is NOT airborne, and is not able to be transmitted without contact.  Additionally, the CBP officer is greater than 3-feet away from Amb. Power, and therefore, should not be at risk due to "distance" according to the CDC guidelines.  Technically, there should be no reason for the wearing of an N95 mask at all, unless Amb. Power was SYMPTOMATIC WITH FEVER... in which case, she should be in immediate Quarantine.  Given she is met with Reuters at 9AM this morning, I will assume that she had no fever, nor had symptoms.  Therefore, the use of an N95 mask by the officer, or the woman sitting approximately 6 feet to the left of Ambassador Power is not needed.  WHY IS THE WOMAN TO HER LEFT wearing one anyway?  It seems to me, there IS a concern about airborne transmission based on these images.  RED FLAG #2.
  3. In the second image, the CBP officer is utilizing either Nitryl or Latex gloves while writing, holding a clipboard, etc.  There is no purpose for the use of gloves at all for non-patient care activities.  In fact, this likely INCREASES the risk of disease transmission should he continue to wear the gloves.  The reason being is that the officer will have a false sense of security due to wearing a glove-barrier, and may not wash his hands as frequently or appropriately, or will likely cross-contaminate other objects if he touches an item that is potentially infectious.  Studies have shown that in EMS workers who continuously wear gloves doing non-patient care activities that infectious disease transmission increases.  It is a bad practice to engage in, and unless the CBP officer was going to have direct-contact with Ambassador Power, there is no reason at all to be wearing gloves.  RED FLAG #3



This summer, when the U.S. Coast Guard cutter Bertholf was monitoring shipping traffic along the desolate tundra coast, its radar displays were often brightly lighted with mysterious targets.

There were oil drilling rigs, research vessels, fuel barges, small cruise ships. A few were sailboats that had ventured through the Northwest Passage above Canada. On a single day in August, 95 ships were detected between Prudhoe Bay and Wainwright off America’s least defended coastline, and for some of them, Coast Guard officials had no idea what the vessels were carrying or who was on them.
“There’s probably 1,500 people out there,” Rear Adm. Thomas P. Ostebo, commander of the Coast Guard’s 17th District in Alaska, said at a recent conference of Arctic policymakers near Anchorage. “It’s kind of spinning a little bit out of control.”
The rapid melting of the polar ice cap is turning the once ice-clogged waters off northern Alaska into a navigable ocean, and the rush to grab the region’s abundant oil and mineral resources by way of new shipping lanes is posing safety and security concerns for Coast Guard patrols.
What happens if a cruise ship gets stranded in stray ice? Or if a sailing vessel capsizes off an uninhabited coast?
“Yesterday, we saw three sailing vessels in 24 hours,” said the Bertholf’s commander, Capt. Thomas E. Crabbs.
The Coast Guard this summer ran Arctic Shield, the most extensive patrol operation it has ever mounted in the Arctic. It set up a temporary operating base and remote communications station at Barrow.
A fleet of cutters, buoy tenders, helicopters and boarding vessels deployed across the Beaufort, Chukchi and Bering seas to oversee new offshore oil drilling operations offers search-and-rescue if needed and provides notice to burgeoning ship traffic that the U.S. is monitoring its northernmost border.
The rush for riches as Russia, Norway and Canada vie with the U.S. for the Arctic’s mineral resources, and the possibility that drug dealers, arms merchants and terrorists could begin to explore transport routes near America’s largest oil fields have prompted the U.S. military to begin planning for a future in the Arctic much more substantial than it had envisioned.
The U.S. Naval War College last year conducted war games simulating the sinking of a ship carrying weapons of mass destruction from North Africa to Asia across the top of Canada and Alaska.
The Air Force has been practicing how to make food and survival gear drops to survivors of a large plane crash in the unbelievably remote Brooks Range, north of Fairbanks.
The North American Aerospace Defense Command, known as NORAD, already has gone beyond drills: F-15 fighters have been launched on interceptions at least 50 times during the last five years in response to Russian long-range bombers — not previously seen here since the Cold War — which have been provocatively skirting the edges of U.S. airspace.
Through it all, U.S. security forces are battling historically sketchy radio communications, vicious storms, shifting ice floes and huge distances from base: Coast Guard cutters must sail 1,200 miles south just to take on food and refuel.
Oversight of Alaskan Command was transferred to U.S. Northern Command this week, according to a statement released by Alaskan Command on Wednesday.
Secretary of Defense Chuck Hagel approved the move Monday, reassigning control of ALCOM from U.S. Pacific Command, which is headquartered in Hawaii.
NORTHCOM is the combatant command responsible for North America and the Arctic, and the shift is expected to better align ALCOM with its emphasis on cold-weather training and missions, the statement said.
The move is not expected to have an effect on ALCOM’s force size or budget.
The realignment is “a more cohesive approach” to defending North America, according to Gen. Charles Jacoby, who commands both NORTHCOM and the U.S.-Canada North American Aerospace Defense Command, or NORAD.
"This is an important step in integrating our defenses across North America,” Jacoby said in the statement. “It places our nation in a better position to plan and execute homeland defense and civil support missions in Alaska, and reflects the growing strategic value of the Arctic to our nation’s defense.”


National Nurses United

RN Ebola Strike and National Day of Action – November 12

From California to Maine, registered nurses plan to make their voices heard louder on Nov. 12 with a National Day of Action for Ebola Safety Standards.

This comes after hospitals across the country refuse to set proper safety protocols and training with optimal personal protective equipment.

Please sign petition: Tell President Obama and Congress to mandate hospitals protect nurses and healthcare workers.

A centerpiece to the actions will be a two-day strike by 18,000 RNs and nurse practitioners at 66 Kaiser Permanente hospitals and clinics who have pressed the giant HMO for improved standards for weeks. Kaiser officials have repeatedly dismissed the nurses’ concerns.
NNU Co-President Deborah Burger, NNU Executive Director RoseAnn DeMoro and NNU Vice-President Zenei Cortez, who is also chair of the Kaiser RN bargaining team
“Kaiser has shown a complete disregard for the safety of nurses and patients in the face of a disease that the World Health Organization calls the ‘most severe acute health emergency in modern times’,” said Deborah Burger, RN, co-president of NNU and a Kaiser nurse. “We will not be silent while Kaiser puts all of us, our families, and our communities, at risk.”

Another strike will take place at Providence Hospital in Washington, DC, affecting 400 RNs.

“We’re striking to protect ourselves and our patients,” said Providence RN, Rose Farhoudi.
In addition, Ebola safety actions are tentatively set for Augusta, Ga., Bar Harbor, Me., Boston, Chicago, Durham, N.C., Houston, Kansas City, Las Vegas, Lansing, Mi., Massilon, Oh., Miami, St. Louis, St. Paul, Mn., St. Petersburg, Fl., and Washington DC, as well as a number of other California locations.
The list of actions will continue to grow, as nurses are contacting NNU across the country.
Nurses are demanding that all U.S. hospitals follow the precautionary principle in safety measures for Ebola, which holds that absent scientific consensus that a particular risk is not harmful, especially one that can have catastrophic consequences, the highest level of safeguards must be adopted.

That means nurses and other caregivers who interact with Ebola patients are provided the optimal personal protective equipment, including full-body hazmat suits that are body fluid, blood and virus impervious.
  • Meet American Society for Testing and Materials F1670 standard for blood penetration
  • Meet F1671 standard for viral penetration
  • National Institute for Occupational Safety and Health-approved powered air purifying respirators with an assigned protection factor of at least 50, with full hood
  • Leave no skin exposed or unprotected
  • Hands-on interactive training on proper donning and doffing HazMat suits
 NNU has also repeatedly called on the White House and Congress to direct all hospitals to meet these standards.
“We know from years of experience that these hospitals will meet the cheapest standards, not the most effective precautions. And now we are done talking and ready to act,” said NNU Executive Director RoseAnn DeMoro.