The Ebola virus disease (EVD) crisis in West Africa began in March 2014. At the beginning of the outbreak, no one could have predicted just how far-reaching its effects would be. The EVD epidemic proved to be a unique and unusual humanitarian and public health crisis. It caused worldwide fear that impeded the rapid response required to contain it early. The situation in Sierra Leone (SL) forced the formation of a unique series of civil-military interagency relationships to be formed in order to halt the epidemic. Civil-military cooperation in humanitarian situations is not unique to this crisis; however, the slow response, the unusual nature of the battle itself and the uncertainty of the framework required to fight this deadly virus created a situation that forced civilian and military organisations to form distinct, cooperative relationships. The unique nature of the Ebola virus necessitated a steering away from normal civil-military relationships and standard pillar responses. National and international non-governmental organisations (NGOs), Department for International Development (DFID) and the SL and UK militaries were required to disable this deadly virus (as of 7 November 2015, SL was declared EVD free). This paper draws on personal experiences and preliminary distillation of information gathered in formal interviews. It discusses some of the interesting features of the interagency relationships, particularly between the military, the UK's DFID, international organisations, NGOs and departments of the SL government. The focus is on how these relationships were key to achieving a coordinated solution to EVD in SL both on the ground and within the larger organisational structure. It also discusses how these relationships needed to rapidly evolve and change along with the epidemiological curve.
In memoriam -Erin Savage, MD, CCFP(EM) Lieutenant Colonel, Royal Canadian Medical Service T his supplement is dedicated to the memory of Lieutenant Colonel Erin Savage. Erin passed away peacefully on Nov. 7, 2014, surrounded by loving family and friends in Ottawa, Ont., after a lengthy battle with breast cancer.Erin joined the Canadian Armed Forces (CAF) in 1998, during her second year of medical school at Dalhousie University, Halifax, NS. After completing her family medicine residency in 2002, Erin was posted to the 2nd Battalion, The Royal Canadian Regiment, in Gagetown, NB, where she quickly earned a reputation as a fantastic clinician, passionate patient advocate and tough, "hard as nails" military officer. During her 17 years of service with the CAF, she rose to become one of the most respected physicians in the Forces. While serving her country, Erin deployed to both Haiti in 2004 and Afghanistan in 2007 in support of The Royal Canadian Regiment, where she earned a Chief of Defense Staff Commendation for her outstanding work as the senior combat medical physician and leader for Battle Group's medical company.After returning from Afghanistan, Erin continued to work incredibly hard as an instructor and advocate for the CAF medical technicians. She ensured that they were sent to the battlefield with the skills and equipment they needed to save the lives of the soldiers they were there to support. Erin's work in this area included published research that has garnered international attention and that will improve battlefield trauma care.Erin's dedication to improving battlefield care will have a lasting impact on the CAF, and has influenced a large number of CAF medical technicians and physicians. Her impact, however, is perhaps best measured in the tributes from her colleagues in the combat infantry unit with which she served overseas:"The Royal Canadian Regiment has lost a great friend and true member of our regimental family … She will be remembered with affection and respect as one of our own."
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