Here’s an interesting discovery. In 2012 there was a major cholera epidemic in West Africa. Three countries were mainly affected - Sierra Leone, Liberia and Guinea.

Two years later in 2014 these same three countries are at the centre of the Ebola epidemic. This is not random bad luck. The root causes of these infectious epidemics lies in poor basic public health: a lack of clean water; the absence of a proper sewage system. Health systems that have become frail and fragile whether through the consequence of civil war or benign neglect and underinvestment.

The UK government is investing £230 million to help contain the Ebola epidemic in Sierra Leone. This is being matched with donations from other international donors. So half a billion pounds will be burnt in this particular fire, and this is just a fraction of what the cost of the Ebola epidemic will be to the country through economic stagnation and health services collapse.

The cholera epidemic was undoubtedly a mine canary for Ebola - a serious early warning of this subsequent critical event. Half a billion pounds invested in public health development in 2014, providing clear water and effective sanitation, would have been a better investment in the long term health of the country than expensive Ebola Treatment Centres that when this is over will be consumed by the African bush as quickly as they were built.

Hindsight bias can be a lazy informant, but it’s hard not to walk through sliding doors into different possible worlds. Just as we undertake a serious incidence investigation into the root causes of errors that lead to a patient’s death in hospital, we must look back at the root causes of the Ebola epidemic and learn lessons. But this is for the future - there are more pressing matters to deal with.

Susan Elden from DfID invites us to the regular 8pm briefing at the ISAT compound, the base for the UK military attachment.

We enter late to the ops room packed full of fatigue-clad army officers standing in rows around a large table upon which a giant map of the country is pinned down. Crisp military replies to urgent questions provide the latest update for the emergency.

The President has been visiting sites with DfID and urging his chiefs to pick up the pace in surveillance and detection. Progress from the Royal Engineers in completing the five remaining sites is good. There is a communication problem with the UK media which is focusing entirely on Kerrytown - one story suggesting that the £230 million has just been for this Ebola Centre. One of the helicopters is out of service for a day while its engine is repaired.

It is a war room in everything but name. Under the surface of the calm military precision there is a sense that political pressures are being brought to bear. This is an election year and the government's Ebola response must be seen to be an international success - The UK saving the world once again.

This political expediency bears no relation to the reality of the challenges we face on the ground of building and opening hospitals at speed in remote locations and making absolutely sure none of our NHS staff are put at risk.

The US Department of Defence look as though they are backtracking on our much-needed lab. The meeting provides a good opportunity to nobble the senior DfID advisors and ask for political help and the search for alternative donors.

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