Category Archives: MED

Freaking out over the disease that’s “coming for us”? Watch this!

 

 

 

 

 

 

 

 

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U.S. Embassy Dakar Issues Security Message on Ebola Virus Disease (EVD) in Senegal

– Domani Spero

 

Today, the U.S. Embassy in Dakar issued a security message to U.S. citizens in Senegal concerning the country’s first confirmed case of Ebola Virus Disease (EVD):

On August 29, the Senegalese Minister of Health and Social Action (MOH) announced the country’s first confirmed case of EVD.  At a press conference, the MOH reported that Guinean authorities reached out to Senegalese authorities to advise them about a young Guinean student who is confirmed to have the virus.  The student is currently placed in isolation at a local hospital and is in stable condition.  At this time, there are no other confirmed cases in Senegal. The Department of State is working with the government of Senegal, the World Health Organization (WHO), and the Centers for Disease Control and Prevention (CDC) to monitor the situation.

 

On August 21, the government of Senegal has closed its borders with Guinea. It has also closed air and sea borders for aircraft and ships from Guinea, Sierra Leone, and Liberia.

The State Department has previously issued travel warnings for two countries in the region - Liberia and Sierra Leone- and warned U.S. citizens against non-essential travel to these countries. Due to the lack of available medical resources in these countries and limited availability of medical evacuation options, the U.S. Department of State ordered the departure of family members residing with Embassy staff in Monrovia and in Freetown. (see U.S. Embassy Sierra Leone Now on Ordered Departure for Family Members #Ebola and U.S. Embassy Liberia Now on Ordered Departure For Family Members, New Travel Warning Issued).

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State Dept Issues Travel Alert on Ebola-Related Screening and Travel Restrictions in West Africa

– Domani Spero

 

On August 28, the State Department issued a Travel Alert for screening and restrictions related to the Ebola outbreak in parts of West Africa:

The Department of State alerts U.S. citizens to screening procedures, travel restrictions, and reduced aviation transportation options in response to the outbreak of Ebola Virus Disease in Guinea, Liberia, Nigeria, and Sierra Leone.   This Travel Alert will expire on February 27, 2015.

Due to an outbreak of Ebola Virus Disease (EVD) in the West African nations of Liberia, Guinea, and Sierra Leone, the Centers for Disease Control and Prevention (CDC) issued  Level 3 Travel Warnings for those three countries advising against non-essential travel and provided guidance to reduce the potential for spread of EVD.  The CDC also issued a Level 2 Travel Alert for Nigeria to notify travelers of the Ebola outbreak in that country.  The Bureau of Consular Affairs’ website prominently features an Ebola Fact Sheet and links to the CDC Health Travel Warnings, Travel Alert, and general guidance about Ebola.

The World Health Organization (WHO) and CDC have also published and provided interim guidance to public health authorities, airlines, and other partners in West Africa for evaluating risk of exposure of persons coming from countries affected by EVD.  Measures can include screening, medical evaluation, movement restrictions up to 21 days, and infection control precautions.  Travelers who exhibit symptoms indicative of possible Ebola infection may be prevented from boarding and restricted from traveling for the 21-day period.  Please note neither the Department of State’s Bureau of Consular Affairs nor the U.S. Embassy have authority over quarantine issues and cannot prevent a U.S. citizen from being quarantined should local health authorities require it.  For questions about quarantine, please visit the CDC website that addresses quarantine and isolation issues.

The cost for a medical evacuation is very expensive.  We encourage U.S. citizens travelling to Ebola-affected countries to purchase travel insurance that includes medical evacuation for Ebola Virus Disease (EVD).  Policy holders should confirm the availability of medical care and evacuation services at their travel destinations prior to travel.

Some local, regional, and international air carriers have curtailed or temporarily suspended service to or from Ebola-affected countries.  U.S. citizens planning travel to or from these countries, in accordance with the CDC Health Travel Warnings and Health Travel Alert, should contact their airline to verify seat availability, confirm departure schedules, inquire about screening procedures, and be aware of other airline options.

The Department is aware that some countries have put in place procedures relating to the travel of individuals from the affected countries, including complete travel bans.  Changes to existing procedures may occur with little or no notice.  Please consult your airline or the embassy of your destination country for additional information.

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According to the WHO’s Outbreak News, the total number of probable and confirmed cases in the current outbreak of Ebola virus disease (EVD) as reported by the respective Ministries of Health of Guinea, Liberia, Nigeria, and Sierra Leone is 3069, with 1552 deaths.  The World Health Organization reports that the outbreak continues to accelerate with more than 40% of the total number of cases occurring within the past 21 days.  The overall case fatality rate is 52%.

A separate outbreak of Ebola virus disease not related to the four-country outbreak was laboratory-confirmed on  August 26 by the Democratic Republic of Congo (DRC). The DRC’s index case was a pregnant woman from a village who butchered a bush animal that had been killed and given to her by her husband. From July 28- August 18, 2014, a total of 24 suspected cases of haemorrhagic fever, including 13 deaths, have been identified in that outbreak.

As of this writing, Senegal also confirmed its first case of Ebola related to the four-country outbreak in West Africa.

 

 

 

 

 

 

 

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U.S. Embassy Sierra Leone Now on Ordered Departure for Family Members #Ebola

– Domani Spero

 

On August 14, the State Department  announced the ordered departure of family members not employed at U.S. Embassy Freetown from Sierra Leone. This follows the ordered departure of family members from U.S. Embassy Liberia on August 7. No Travel Warning has yet been issued for Sierra Leone as of this writing but we expect one coming out soon. Below is the statement of the U.S. Embassy Freetown ordered departure:

At the recommendation of the U.S. Embassy in Sierra Leone, the State Department today ordered the departure from Freetown of all eligible family members (EFMs) not employed by post. The Embassy recommended this step out of an abundance of caution, following the determination by the Department’s Medical Office that there is a lack of options for routine health care services at major medical facilities due to the Ebola outbreak.

We are reconfiguring the Embassy staff to be more responsive to the current situation. Our entire effort is currently focused on assisting U.S. citizens in the country, the Government of Sierra Leone, international health organizations, local non-governmental organizations (NGOs), and the Sierra Leonean people to deal with this unprecedented Ebola outbreak.

We remain deeply committed to supporting Sierra Leone and regional and international efforts to strengthen the capacity of the country’s health care infrastructure and system — specifically, the capacity to contain and control the transmission of the Ebola virus, and deliver health care.

According to the World Health Organization, a total of 128 new cases of Ebola virus disease (EVD) (laboratory-confirmed, probable, and suspect cases) as well as 56 deaths were reported from Guinea, Liberia, Nigeria, and Sierra Leone between August 10-11, 2014. See the disease update from the WHO:

via WHO

via WHO

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U.S. Embassy Liberia Now on Ordered Departure For Family Members, New Travel Warning Issued

– Domani Spero

 

On August 7, the State Department ordered the departure of all family members not employed at the U.S. Embassy in Monrovia, Liberia.  The new Travel Warning issued today says that the U.S. government employees in Liberia will remain on active duty at the Embassy and additional staff are being deployed to assist the Government of Liberia in addressing the Ebola Virus Disease outbreak.  This follows the departure of  the U.S. Peace Corps from Liberia on July 30 as a result of the current outbreak of Ebola Virus Disease in the region. Yesterday, the CDC also issued a Level 3 warning urging all US residents to avoid nonessential travel to Sierra Leone, Guinea, and Liberia.  

Full State Department statement below:

At the recommendation of the U.S. Embassy in Liberia, the State Department today ordered the departure from Monrovia of all eligible family members (EFMs) not employed by post in the coming days. The Embassy recommended this step out of an abundance of caution, following the determination by the Department’s Medical Office that there is a lack of options for routine health care services at major medical facilities due to the Ebola outbreak. We are reconfiguring the Embassy staff to be more responsive to the current situation. Our entire effort is currently focused on assisting U.S. citizens in the country, the Government of Liberia, international health organizations, local non-governmental organizations (NGOs), and the Liberian people to deal with this unprecedented Ebola outbreak.

We remain deeply committed to supporting Liberia and regional and international efforts to strengthen the capacity of the Liberian health care infrastructure and system – specifically, their capacity to contain and control the transmission of the Ebola virus, and deliver health care. Additional staff from various government agencies including 12 disease prevention specialists from the Centers for Disease Control and Prevention and a 13-member Disaster Assistance Response Team from USAID are deploying to Liberia to assist the Liberian Government in addressing the Ebola outbreak.

A new Travel Warning for Liberia also came out today indicating that the ordered departure of USG family members will begin tomorrow, August 8. The new warning also advised travelers that some airlines have discontinued service and flights to Liberia and that air carriers chartered by medical evacuation insurance companies may not be able to provide timely services in Liberia or the region. Excerpt below:

In May 2014, a case of Ebola Virus Disease (EVD) was confirmed in Liberia, marking the first case in a second wave of the EVD outbreak. Since then, EVD has continued to spread and intensify. The latest wave of the outbreak has overwhelmed Liberia’s health system and most health facilities lack sufficient staff or resources to address the continuing transmission of EVD.  Options for obtaining routine medical care are severely limited.  For more information concerning EVD, please visit the Centers for Disease Control and Prevention website.  Please direct inquiries regarding U.S. citizens in Liberia to EbolaEmergencyUSC@state.gov. Callers in the United States and Canada may dial the toll free number 1-888-407-4747.  Callers outside the United States and Canada may dial 1-202-501-4444.

If you arrive in Liberia and subsequently need routine or emergency medical care, you should expect limited, if any, options.  Travelers are advised that air carriers chartered by medical evacuation insurance companies may not be able to provide timely services in Liberia or the region.  Policyholders should confirm the availability of medical evacuation services prior to travel.  While commercial flights are still available from Monrovia, some airlines have discontinued service and flights may become more difficult to obtain.  If you plan to visit Liberia despite this warning, you should purchase travel insurance that includes medical evacuation, and confirm that the coverage applies to the circumstances in Liberia.

According to USAID , the deployed staff came from the Agency’s Office of U.S. Foreign Disaster Assistance (OFDA)  and will be overseeing critical areas of the response, such as planning, operations, logistics in coordination with other federal agencies, including the U.S. Departments of Defense and Health and Human Services. Members of the Centers for Disease Control and Prevention (CDC) are also on the DART to lead on public health and medical response activities.

USAID has already provided $2.1 million to the UN World Health Organization and UNICEF for the deployment of more than 30 technical experts and other Ebola response efforts.

Two days ago, USAID also announced an additional $5 million in assistance to help ramp up the international community’s Ebola response efforts. This new funding will support outreach campaigns via radio, text messages, and through local media as well as the expansion of Ebola outbreak programs the Agency is already supporting in Guinea, Sierra Leone, and Liberia. These programs help trace people who may be infected with the disease, as well as provide health clinics and households with hygiene kits, soap, bleach, gloves, masks, and other supplies to help prevent the spread of disease.

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U.S. Embassy Bolivia: A Post Far From Heaven, Read the Fine Details in the Classified OIG Annex!

– Domani Spero

 

Which regional bureau recalled one post’s top two officials prior to the arrival of the OIG inspectors?
Burn Bag, March 23, 2014

 

According to the OIG report on the US Embassy in La Paz, Bolivia released on July 17, just before the OIG inspection conducted in February and March 2014, the State Department “recalled the chargé and the political/economic section chief who served as acting DCM from August 2012 to September 2013 and took steps to mitigate some of the embassy’s leadership problems.”

How do you recall the embassy’s top two officials? Very quietly, presumably.  There were no public announcements or statements.  There have been some pretty awful embassies with leadership problems but we have seldom heard the recall of both the number #1 and #2 at the same time. So, what happened?

This OIG report has a classified annex which includes supplemental narrative and recommendations.  This is not the first time that a report has a classified annex but this is one of the few we can recall since the OIG stopped issuing the Inspector’s Evaluation Reports for senior embassy officials.  So now, all the bad stuff is just dumped in the classified annex of the report where the OIG says that “Portions of context, leadership, resource management, Equal Employment Opportunity, and quality of life in the annex should be read in conjunction with this report.” We have no access to the annex and of course, only State Department insiders who theoretically, have a “need to know” can access the classified material.

via US Embassy La Paz/FB

via US Embassy La Paz/FB

Here is what the publicly available, sanitized report on US Embassy Bolivia says on Leadership:

The former chargé interacted with senior government officials more often and more effectively than the hostile environment might have suggested. He expanded his personal engagement with the local media. He negotiated an unexpected $2.4-million reimbursement of value-added taxes. Also, he initiated development of an updated mission vision that called for expanded outreach to the Bolivian people and greater focus on cultural programs and English-language training.

Despite these and other successes, nearly all American staff members told the OIG team that they did not understand mission priorities or their part in achieving goals. The OIG team frequently heard staff tell of instructions given one day only to have the former front office forget or reverse them the next. Skepticism about public diplomacy programming one month could be replaced by front office enthusiasm for a cultural project the next. Reporting officers, already in a difficult environment for contact development and reporting, stated that the front office did little to direct reporting or provide training and mentoring. Embassy staff members told the OIG team they wanted clear and steady guidance from the front office but did not receive it.

Is that not enough to get two senior officials recalled?

On Resource Management:

Although the 2013 annual chief of mission statement of assurances identified no significant management control deficiencies, many of the vulnerabilities discussed in this report would have been apparent if embassy leadership had conducted a thorough review of management controls prior to submitting the chief of mission statement.

On Equal Employment Opportunity:

Within the past year, the EEO counselors handled more than 10 inquiries, many involving gender bias or sexual harassment.

On Quality of Life:

The Health Unit  ” handled eight medical evacuations of U.S. personnel within the past year and provides ongoing support to mission personnel for altitude-related ailments.”

 

Well, what do you think?  The report’s key judgments, are pretty well, bland; no one ran off to a new job in Tripoli or Sana’a. And man, whose fault was it that La Paz was assigned a cadre of inexperienced officers?

  • Embassy La Paz lacked the strong, consistent leadership and the sustained attention from Washington that it needed to manage a complicated bilateral relationship and had a relatively inexperienced officer cadre and a locally employed staff emerging from a reduction in force.
  • The embassy registered several impressive successes despite a drastic reduction in programs and work force in response to the Bolivian Government’s expulsion of the U.S. Agency for International Development and the Department of State’s decision to end all U.S. counternarcotics programs.
  • The embassy needs a clearly defined mission strategy.
  • The management section has a number of potential management control vulnerabilities related to record keeping and funds control. It is still coping with 2013’s major reduction in force of locally employed staff and an almost 50-percent reduction in the embassy’s services budget.

According to the OIG report, as of January 2014, the embassy had a total staff of 310, slightly more than one-third of 2008 numbers. The U.S. Embassy in La Paz has not been a typical embassy operation since 2008. In September that year, Bolivia expelled Ambassador Philip S. Goldberg (now ambassador to the Philippines). Shortly thereafter, the Drug Enforcement Administration and the Peace Corps suspended their operations in the country. In May 2013, Bolivia expelled USAID and the USG subsequently also shut down all International Narcotics and Law Enforcement (INL) programs in the country.   The OIG inspectors conclude that the US-Bolivia relationship is “unlikely to normalize soon.” Below are some additional details extracted from the publicly available report:

La Paz, A Post Far From Heaven

  • The Bureau of Western Hemisphere Affairs (WHA) paid sporadic attention to embassy operations.
  • Since 2008, WHA used a series of deputy chiefs of mission (DCM) as chargé d’affaires and after July 2012 detailed section heads (first from the political/economic section, then from public affairs, and just before the inspection from the management section) to serve as acting DCM for extended periods. The Department also decided not to assign a permanent office management specialist for the chief of mission, and the front office relied on office management specialists from other sections for months at a time. [...] The effects of these stopgap measures were threefold. First, they required officers to serve as acting DCM for extended periods without appropriate training. Second, they took seasoned leaders out of embassy sections, leaving those sections in the hands of usually capable—but inexperienced—deputies. The deputies rose to the challenge, but they did not receive adequate guidance or leadership from their former supervisors. Productivity and morale suffered.

Love Letters Written, Never Sent

  • The political/economic section staff is frustrated and discouraged, primarily because of lack of front office policy direction, as well as poor communication, organization, and training within the section. Given the deteriorating political environment and unclear policy guidance from both the front office and the Department, the section had an opportunity to devise and drive a revised policy and action agenda, but did not do so. [...] The OIG team reviewed a number of substantive and useful report drafts prepared by officers and local employees that were never sent, usually because the former section chief dismissed them without working with the drafter to improve the texts. This wasted effort caused significant staff frustration.

Tearing Your Hair, Learning on the Job

  • The public affairs section does not have enough experienced grants officers. Only one person in the section, a FAST officer, had a grants warrant as of February 2014. From June through August 2013, in the absence of any public affairs section grants officer, two political/economic FAST officers signed about 100 public diplomacy grants, about which they knew little.

Not Leading By Example – Managing From Desk Via Email

  • The consular section is a small operation, processing fewer than 20,000 nonimmigrant visas, approximately 800 immigrant visas, and about 1,600 passport applications in 2013. The section chief manages from her desk and via email. This remote management style is not appropriate for the size of the operation and has a negative impact on section morale and operations.
  • The consular section chief only adjudicates high-profile or referral visa cases. Recent guidance in 13 STATE 153746 reminded consular managers that they are expected to do some interviewing themselves. The section chief’s lack of hands-on participation contributes to longer hours that the more junior employees have to spend interviewing, and remoteness from actual processing undermines her credibility as an expert. It also reduces the opportunities for management to train new personnel and to identify potential interview technique and workflow efficiencies.
  • Neither the former chargé d’affaires nor the former acting DCM reviewed the 65 cases that the consular chief handled in the past year. Failure to review the required 10 percent of visa approvals and 20 percent of refusals, per 9 FAM 41.113 PN 17 and 9 FAM 41.121 N2.3-7, leads to lack of consistency in visa issuance and refusal. Adjudication reviews are also a vital management control to prevent malfeasance.

FSN Evaluations and Health Plans

  • The human resources office memo also listed 11 locally employed staff whose performance evaluations were between 21 and 242 days late. Locally employed staff members cannot qualify for in-grade salary increases if their performance reviews are not current.
  • Although the embassy participates in the local social security retirement plan, it does not participate in the local social security health program. Instead, the embassy provides a private health plan for locally employed staff. When locally employed staff members retire, most of the social security health plans are unwilling to accept them because they have not been longstanding contributors. The retirees are left with diminished health insurance coverage for their retirement years.

Allowances Paid on Outdated Info

  • The Department of State Standardized Regulation 072.12 requires that the hardship differential report, consumables allowance report, and cost-of-living survey be submitted every 2 years. All these reports are late. The embassy is paying allowances based on outdated information.

Power Outages with No Fully Functional UPS. For 3 Years!

  • The embassy’s centralized uninterruptible power system is in disrepair and has not been fully functional for the past 3 years. As a result, the chancery building experiences frequent power outages caused by the instability of the local power infrastructure. The power outages have caused permanent damage to the server room and disrupted the network infrastructure.

 

Just before the inspection, the WHA bureau and the Bureau of Human Resources apparently agreed that, because a permanent ambassador is not likely in the foreseeable future, the Department would assign a permanent chargé d’affaires and a permanent DCM in La Paz. It only took them about five years to make up their minds.

Peter Brennan was appointed chargé d’affaires of the U.S. Embassy in La Paz in June 2014. Prior to his appointment in Bolivia, he was Minister-Counselor for Communications and Public Affairs at the U.S. Embassy in Islamabad, Pakistan.  It does not look like post now has a permanent DCM as Public Affairs Officer, Aruna Amirthanayagam, who was acting chargé is now Acting DCM.

The inspection took place in Washington, DC, between January 6 and February 4, 2014, and in La Paz, Bolivia, between March 5 and 20, 2014. Ambassador Gene Christy (team leader), Thomas Allsbury, Laurent Charbonnet, Eric Chavera, Leo Hession, Tracey Keiter, Keith Powell, Ashea Riley, Richard Sypher, Alexandra Vega, Roman Zawada, and Barbara Zigli conducted the inspection.

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Related item:

-07/31/14   Inspection of Embassy La Paz, Bolivia (ISP-I-14-16A)  [595 Kb]  Posted on July 17, 2014

 

 

 

 

 

 

 

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Burn Bag: One RMO/P’s ‘just need a man’ prescription

Via Burn Bag:

“When I finally saw the Regional Medical Officer/Psychiatrist (RMO/P) for help, I was told I just needed a man to make me happy.”

Via reactiongifs

Via reactiongifs

 

 

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Former FSO Candace Faber on Coming Home With the Maladies of War

– Domani Spero

Candace Faber joined the Foreign Service when she was twenty-four. She learned Dari, Polish, and Russian. At twenty-eight, she was off to Afghanistan where she spent a year at a “a tiny, crowded, dysfunctional world—one we could not leave.”  She wrote that she “often fantasized about walking off compound, just like Sergeant Bowe Bergdahl did in Paktika. In my imagination, even the Taliban seemed kinder than my colleagues.”

She was thirty years old when she resigned from the the FS.

Via Candace Faber on Medium – The Other Veterans:

[S]eeing them take this woman’s very real suffering so lightly, dismissing both her service and her fears as a woman, did more than hurt. It invalidated my own experience.

If a military veteran on a PRT had no right to struggle with readjustment, then by comparison, my year at the U.S. embassy compound in Kabul was a joke. My closest brush with terrorism was a distribution of children’s books I attended in Logar Province, pulling schoolchildren, government officials, and journalists together in a single building. The next day, that building was attacked by a vehicle-borne IED, and two of my colleagues were injured. I was shaken, but I wasn’t there. I also wasn’t there during the September 10 attacks, a fact that only seemed to invalidate my experience further.

In my mind and that of my colleagues, neither that woman nor I had the right to struggle with our transition. There was no excuse save PTSD, and I didn’t have that. I couldn’t have it. I wasn’t a veteran.
[...]
It has been a hard journey, as everyone close to me can attest. Resignation has also had financial consequences. But money matters very little compared to having my mental health back. As of today, I have not had an anxiety attack in months. I credit psychotherapy for my recovery. The only question in my mind is why it took so long for me to get help—and why no one in the Department of State, not even when I announced my intention to resign, suggested the option. Instead, I suffered alone for a year and a half, convinced that I was simply a broken person who could never be put back together again. All of that could have been avoided.

 

Ms. Faber notes that “the paper-based screening” given to her in Kabul was very limited.   “This seems like more of a way to shield the Foreign Service from liability than a good faith effort to support its corps.” She suggested that this should be replaced with in-person screening at appropriate intervals.

Once more, we’re hearing about the security clearance process; she writes, “the federal security clearance process must get rid of its prejudice against mental health treatment, which deters people from seeking the care they need. There is a double standard here: If you are physically wounded in action, you are a hero. But if you come back from a theater of war psychologically broken, wired to treat everyone as a threat, and angry at the world, you cannot seek help without risking your security clearance—and with it, your job.”

Read in full here.

Below are some of our previous blog posts on mental health, PTSD, security clearance and the State Department’s programs:

 

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US Embassy Conakry Issues Security Message on Ebola Outbreak in Guinea

– Domani Spero

On March 24, the US Embassy in Conakry, Guinea issued the following message to U.S. citizens in the country:

The Government of Guinea has confirmed the presence of the Ebola virus in the Nzérékoré  (Guinee Forestiere) region, mostly in the administrative district of Gueckedou and in the town of Macenta.  Symptoms include diarrhea, vomiting, a high fever and heavy bleeding.  To date over 80 cases have been recorded with 59 recorded fatalities.
The U.S. mission in Conakry strongly recommends that U.S. citizens avoid contact with individuals exhibiting the symptoms described above until further information becomes available.

Ebola Hemorrhagic Fever (HF) is a deadly disease but is preventable.  It can be spread through DIRECT, unprotected contact with the blood or secretions of an infected person; or through exposure to objects (such as needles) that have been contaminated with infected secretions.  The viruses that cause Ebola HF are often spread through families and friends because they come in close contact with infectious secretions when caring for ill persons.  Ebola HF has a high mortality rate and early evidence suggests that the Guinea strain of Ebola is related to the Zaire Ebola strain that carries a mortality rate of 90%. Some who become sick with Ebola HF are able to recover, while others do not.  The reasons behind this are not yet fully understood. However, it is known that patients who die usually have not developed a significant immune response to the virus at the time of death.
During outbreaks of Ebola HF, the disease can spread quickly within health care settings (such as a clinic or hospital).  Exposure to Ebola viruses can occur in health care settings where hospital staff are not wearing appropriate protective equipment, such as masks, gowns, and gloves.

Symptoms may appear anywhere from 2 to 21 days after exposure to Ebola virus though 8-10 days is most common.  A person suffering from Ebola presents with a sudden onset of high fever with any of the following: headache, vomits blood, has joint or muscle pains, bleeds through the body openings (eyes, nose, gums, ears, anus) and has reduced urine.

Since the virus spreads through direct contact with blood and other body secretions of an infected person those at highest risk include health care workers and the family and friends of an infected individual.

For more information on Ebola hemorrhagic fever, please visit the CDC website at http://www.cdc.gov/vhf/ebola

CDC map

CDC map

On 25 March 2014, the World Health Organization provided a status update of the outbreak:

The Ministry of Health (MoH) of Guinea has notified WHO of a rapidly evolving outbreak of Ebola haemorrhagic fever in forested areas south eastern Guinea. The cases have been reported in Guekedou, Macenta, and Kissidougou districts. As of 25 March 2014, a total of 86 suspected cases including 60 deaths (case fatality ratio: 69.7%) had been reported. Four health care workers are among the victims. Reports of suspected cases in border areas of Liberia and Sierra Leone are being investigated.

Thirteen of the cases have tested positive for Ebola virus by PCR (six at the Centre International de Recherche en Infectiologie (CIRI) in Lyon, France, and seven at the Institut Pasteur Dakar, Senegal), confirming the first Ebola haemorrhagic fever outbreak in Guinea. Results from sequencing done by CIRI Lyon showed strongest homology of 98% with Zaire Ebolavirus last reported in 2009 in Kasai-Occidental Province of DR Congo. This Ebolavirus species has been associated with high mortality rates during previous outbreaks.

Doctors Without Borders/Médecins Sans Frontières (MSF) has worked in Guinea since 2001. Its March 25 update indicates that the group is reinforcing its teams in Guéckédou and Macenta, two towns in the south of the country where the virus has spread. Thirty staff members are reportedly on the ground and more doctors, nurses, and sanitation specialists will be joining them in the coming days. According to DWB/MSF, thirteen samples to-date have tested positive for the Ebola virus, an extremely deadly viral hemorrhagic fever. Other samples are currently being analyzed. Suspected cases have been identified in neighboring Liberia and Sierra Leone, but none of these have yet been confirmed by laboratory tests.

The CDC has updated its outbreak page with information from WHO and says that it is in regular communication with its international partners WHO and MSF regarding the outbreak, to identify areas where CDC subject matter experts can contribute to the response.

As of March 25, 2014, WHO has not recommended any travel or trade restrictions to Guinea in connection with this outbreak.

U.S. Embassy Conakry is an extreme hardship post receiving 25% COLA and 30% post hardship differential. Post is headed by Ambassador Alexander Laskaris who was sworn in as the 20th U.S. Ambassador to the Republic of Guinea on September 10, 2012.

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US Embassy Ottawa: Canadian Court Sets Aside FSN Sandra McDonald’s $240K Default Judgment For Now

– Domani Spero

Via Ottawa Citizen, a wrongful dismissal case filed by Sandra McDonald, a former Foreign Service National (local employee) of the U.S. Embassy in Ottawa.

Sandra McDonald, now in her early 60s, worked at the embassy for nearly 30 years as one of its locally engaged staff. She sued for wrongful dismissal after she was fired in early 2011 while on long-term disability with complex regional pain syndrome.

McDonald’s lawyer, Bijon Roy, said she was “very disappointed” with the judge’s decision and that it might force her to fight the case all over again.

In July 2012, Ontario Superior Court Justice Heidi Polowin issued a default judgment in McDonald’s favour after U.S. officials failed to file a statement of defence or contest the case in court. The embassy had been served notice of the case through Canada’s Department of Foreign Affairs and International Trade, and was kept informed of the matter on a regular basis. McDonald’s story also received high-profile coverage from Ottawa media, including the Citizen.

In court this week, embassy officials, seeking to overturn the default judgment, said they had “explicable and plausible” reasons for not having responded to McDonald’s lawsuit, and a “good defence” to be made against it. According to court documents, the Americans claimed that they’d “lost the documentation”, “could not open the email attachment”, that the documentation was “inadvertently directed to the wrong office at the State Department”, and that it was “not indexed correctly”.

Superior Court Justice Timothy Ray questioned how U.S. State Department officials could claim not to have been aware of McDonald’s default judgment. “Its embassy apparently failed to see the front page of the Ottawa Citizen (on) Sept. 11, 2012,” the judge commented.
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Ray said he would set aside Polowin’s default judgment on conditions the embassy pay McDonald’s legal costs and put the $240,000 award in a court trust within the next 60 days.

Read in full: U.S. Embassy wins bid to set aside wrongful dismissal judgment.

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